How to Support Eating and Body Image Distress
Updated: Nov 22, 2021
This week is Eating Disorders Awareness Week
For many people, the new year signals the start of the yearly ‘health kick’, the indulgences of Christmas providing just enough guilt to get that gym contract signed, a diet plan printed and the message out to everyone we know that #newyearnewme! In many cases that’s as far as the health kick goes - I have heard of people sticking with it into February, but only anecdotally.
This year was different. Gyms have suffered enormously without the usual surge in sign-ups and my sympathies are with those whose livelihoods are connected to them. But for many of us for whom the closures added an extra hurdle to hopping on the health kick, we decided it was probably time we took a year off anyway. For most of us, any resulting guilt could be relinquished without too much difficulty.
If this sounds anything like you then hopefully this is the closest you have come to knowing what it is like to live a life dominated by rules around eating. Realistically, few of us have entirely escaped the discomfort of feeling that we don’t measure up (or down) at some point or another and many of us harbour dissatisfaction with some aspect of our bodies that can frequently feel disheartening or even acutely painful (thanks unrealistic cultural standards around beauty and fitness!). But (hopefully) these feelings are manageable on the whole. They do not seriously interrupt our lives and they are placated by semi-vague plans to work on our figures next week, next month or next January.
Food, Eating and Control Over Weight or Shape
For those who experience more pernicious distress around eating, however, managing thoughts, feelings or memories through food, eating and controlling weight or shape has become an inescapable trap. One that cannot be ignored and that can only be placated through adhering to ridged rules, with overwhelming floods of feeling or harsh punishments meted out when those rules are transgressed. This is never an enjoyable lifestyle, although a temporary sense of achievement or absence of distress can provide short term relief. But neither is it a lifestyle choice. No one chooses it, but it can be frighteningly difficult to break away from.
How to Be Supportive
If you’re not someone who struggles with food, weight or shape yourself, you may well know someone who does, whether you’re aware of it or not. And if you are actively supporting someone with an eating disorder, navigating their distress can be a fraught experience. Equipping yourself with some key ideas can really help, and the following tips may give you a grounding for how to navigate conversations sensitively.
Body and food neutrality
The way we talk about food and appearance is heavily influenced by mainstream standards of beauty. Foods that aren’t considered ‘healthy’ are described as ‘bad’ and being thin is promoted as more desirable than being overweight.
It's easy to overlook how frequently we reference these narratives in our everyday conversations and compliments can often convey unintended messages to someone struggling with body image. Avoid commenting on physical appearance altogether and practice connecting with someone over how you think they might be feeling.
It’s not about looks
It can feel confusing or frustrating to see someone going to what might seem like unnecessary lengths to alter their appearance. Remember that the struggle with body image is the ‘symptom’, so 'just eating' or 'caring less about appearance' is unlikely to be the solution. Beware of engaging with the problem at the 'symptom level' alone and let the person know that you're open to hearing about the underlying distress.
Weight is just one aspect
Suffering might be easiest to spot in somebody who has lost extreme amounts of weight, but difficulties with food, eating and body image aren't always to easy to identify. People can look 'well' but still be struggling with food or body image in a number of ways. The physical toll can be significant, even when weight loss is not apparent, so all struggles with food and control over weight or shape should be taken seriously.
Be mindful around recovery
Recovering from an eating disorder can take a long time and people often begin to look physically 'well' long before the urges to restrict/binge/over-exercise subside. This can be an extremely difficult time for the person in recovery and well intentioned comments on their physical progress can be distressing.
Be careful not to make assumptions about how 'well' someone is based on physical changes and remember to steer clear of talking about physical appearance.
Eating disorders don't only affect girls
People of any age, gender or culture can struggle with food and body image. Many people from older generations, of non-white ethnicity and men struggle in the same too and may be more easily overlooked. Changing standards of masculinity and narratives around 'clean' eating have also contributed to a wider range of pressures and difficulties faced by people of all ages and walks of life.
Seek professional support
If you are worried about yourself or someone else, don’t wait to seek support. Contact a GP is the first step. It can be exceptionally hard to reach out if you’re the person struggling and NHS waiting lists can be off-putting but getting specialist input is important. Eating disorder are the most deadly of all mental health conditions and it's easy to overlook the signs that someone is struggling. A good eating disorder resource like the charity, BEAT, can also be a helpful place to start for resources and guidance.
Further Reading & Support
The London Centre for Eating Disorders and Body Image
Food practices, eating distress and the perils of bewildering interventions in 'eating disorders' treatment settings. John Adlam (2020). BPS Psychotherapy Section Review.
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