7 Things You Shouldn’t Say to Someone Who’s Had an Eating Disorder

In the U.S. 30 million people. will have an eating disorder in their lifetime

Related: 11 Subtle Signs of Eating Disorders

10 Things Not to Say to Someone With Depression

quicklist: 2category: 7 Things You Shouldn’t Say to Someone Who’s Had an Eating Disordertitle: I wish I had your willpowerurl:text:

“They see this person as being very disciplined for their ability to restrict food,” she says. In reality, the person doesn’t want to have an eating disorder but is compelled to restrict or binge and purge. “An E.D. patient uses their behaviors around food as a way to control their emotions,” Mosesso says. The kind of language in the above phrase can reinforce disordered eating by giving them power, says Mosesso. When everything around them may feel chaotic or they feel they can’t do anything right, someone with an eating disorder can point to their restrictions, which are often “the only place where they are seeing success in their lives.”

quicklist: 3category: 7 Things You Shouldn’t Say to Someone Who’s Had an Eating Disordertitle: You don’t look that skinnyurl:text:

Throw out the antiquated idea that a “typical” eating disorder patient is an emaciated young woman. People of all shapes and sizes can have eating disorders; just because someone hasn’t dropped below a certain weight doesn’t mean they aren’t suffering from a crippling disease. “You aren’t validating what they are going through and that makes them feel worse,” says Mosseso. And you’re actually feeding into their disordered thinking: In the mind of an E.D. patient, it could be taken as you pointing out that they haven’t lost enough weight.

19 Signs Your Thyroid Isn’t Working Right

quicklist: 4category: 7 Things You Shouldn’t Say to Someone Who’s Had an Eating Disordertitle: Don’t you know how bad that is for you?url:text:

It should come as no surprise that the answer is yes. On some level, people with eating disorders do know how bad it is for them. “They have both an eating disorder brain and their rational brain,” Mosesso says. Think of it like good cop/bad cop: the longer someone goes untreated, the louder the bad cop becomes. Soon, according to Mosesso, the E.D. brain overpowers the rational inner self, dominating all thoughts, feelings, and behaviors. So while a person may understand the negative impacts of their disease, they don’t see those things as reasons to give it up.

quicklist: 5category: 7 Things You Shouldn’t Say to Someone Who’s Had an Eating Disordertitle: But you’re all better now, right?url:text:

“Someone in recovery can feel a lot of pressure to get back to ‘normal’ again,” says Mosesso. “You can’t just wipe all those feelings away like a chalkboard. Like with drug addictions, relapses happen; the key is not exacerbating the patient’s guilt for falling back into old habits.” Understanding that this will be a lifelong struggle can be one of the best ways to support your loved ones.

quicklist: 6category: 7 Things You Shouldn’t Say to Someone Who’s Had an Eating Disordertitle: Let’s grab dinnerurl:text:

Eating is a social activity: it’s one of the easiest ways to reconnect with friends. But if that friend struggles with eating, you should avoid suggesting that you catch up over a meal at a restaurant, she says. Instead, try going to a museum or for a walk in a park. Your conversation will flow just as easily and they won’t feel added pressure to eat a certain way.

If you do share a meal, steer clear of stressful topicsEating is already stressful enough for recovering patients; so don’t add to it by discussing things that may increase anxiety for them. If you are eating at home together, focus on upbeat topics that aren’t related to food; cheerful conversation can sometimes serve as a good distraction from food-related anxiety. Mosesso says one patient’s family bought TableTopics ($25; amazon.com), a box filled with thought-provoking questions like “If you could master one instrument which would it be?” to prompt lighthearted discussion. If the person lets you know that they’re struggling during the meal, ask them what they need from you but avoid talking about their emotions too much, she says.

Related: 15 Diseases Doctors Often Get Wrong

quicklist: 7category: 7 Things You Shouldn’t Say to Someone Who’s Had an Eating Disordertitle: I ate so much last night, I’m going to skip breakfasturl:text:

There’s a difference between having disordered eating behaviors and having an eating disorder. Normalized eating changes every day, as Mosesso describes: “someone who doesn’t have a history of an eating disorder can binge on Thanksgiving dinner one day and skip breakfast.” These aren’t healthy behaviors but it doesn’t lead that person down the slippery slope of daily restriction. Take the time to explore your own relationship with food, but understand that while you may be able to eat a sleeve of Oreos and skip your next meal without ruminating too long about it, just talking about that could trigger a relapse in someone in recovery.

What should you say?

“Ask how you can be supportive,” Mosesso suggests, “and be there for them to do or say whatever they need. Don’t be confrontational and don’t become the ‘food police’—monitoring everything they put in their mouths.” You avoid talking only about their eating disorder, which can diminish who they are as a person. Mosesso stresses, “Don’t define them by their disease, encourage their individual thoughts, feelings and beliefs outside of recovery.”

This article originally appeared on Health.com.