Like most other mental health issues, eating disorders aren’t one-size-fits-all. According to the National Alliance on Mental Illness, “Eating disorders are a group of related conditions that cause serious emotional and physical problems. Each condition involves extreme food and weight issues; however, each has unique symptoms that separate it from the others.” Because eating disorders can vary so much from person to person, it can be tough to know how to support your loved ones who might be struggling. That’s why we checked in with Dr. Erin Parks, a clinical psychologist, researcher and co-founder of Equip, a new startup on a mission to transform eating disorder care. With more than 15 years of experience treating adolescents and adults in inpatient, partial hospitalization and intensive outpatient settings, she shared five things you should never say to someone who has dealt with an eating disorder—regardless of the type.
1. I would have never guessed; you look great!
“You cannot tell by looking who has, or who has had, an eating disorder. Full stop. Most people who struggle with an eating disorder do not appear ‘underweight’. Also, you don’t know what weight their body wants to be at, nor what is healthy or ‘normal’ for their body. A good rule of thumb is, if you wouldn’t say that about someone’s height, don’t say it about their weight.”
2. How much weight did you lose?
“Eating disorders can involve losing weight, but they can also involve gaining weight, or failing to gain weight as expected (e.g., a child who should weigh more at age 14 than they did at age 10). Our culture loves before-and-after photos, but for eating disorders, the before and after is in the mind. When people are struggling with eating disorders, their brains are monopolized by thoughts of food or of their body. The real ‘after’ is that they are happier, able to enjoy life and less anxious. Focus on how they are feeling, not on the size of their body.”
3. Ugh, I wish I could become anorexic, but I have the opposite problem.
“If I had a penny! This is the most common (bad) joke that I get when I tell people that I work in the eating disorder field. Our culture is obsessed with weight loss. But would you say to someone going through cancer, a divorce, or grieving a loved one’s death, ‘I wish I could have that so I could lose weight?!’ If yes, you are a jerk. We should all choose happiness over thinness and stop equating the two.”
4. I totally know what you went through—I used to always try to just drink smoothies to stay thin.
“Your intentions are so good—but you’re missing the mark. While you’ve both been victims of our fat-phobic culture, you’re conflating two things. Being sad isn’t the same as having depression. Being worried isn’t the same as having an anxiety disorder. And being a victim of our fat-phobic, diet-obsessed culture isn’t the same as having an eating disorder. When in doubt, validate and offer support: ‘That sounds hard; how can I help.’”
5. Ohhh, I didn't know guys got eating disorders?
“You can replace ‘guys’ with Black people, fat people, poor people, but the point is the same—don’t say this. There’s a stereotype that eating disorders only affect thin-bodied, affluent, young cis females. In reality, up to 40 percent of people with eating disorders are men, they affect people of all races, ethnicities, socioeconomic statuses, body sizes, genders and sexual orientation fairly equally, with a few exceptions. We know that there are higher prevalence rates of eating disorders in trans people, student athletes and in people who live in food deserts. We also know that the stereotype that this is a thin, white girl issue often prevents people who don’t fit that stereotype from getting the help that they need. So if someone tells you that they have, or had, an eating disorder, stick with validation and support: ‘Thanks for being vulnerable with me. That sounds hard. How can I support you?’”