How I learnt to support my closest friend Ella as she battled a dangerous eating disorder.

When I was in my early teenage years, my closest friend Ella was diagnosed with Anorexia Nervosa, a psychological disorder characterised by a warped perception of one’s body weight and image, and an overwhelming fear of gaining weight. The disorder manifests as an immense control over food and can often coincide with excessive exercise and rapid and unsafe weight loss.

Getting to know Ella was sunshine; she was warm, adventurous, creative, intelligent, and so full of curiosity and excitement. We used to spend our summer evenings together practicing cartwheels in the garden, drinking berry smoothies and laughing until our cheeks were sore. It was so beautiful, to have developed such a close friendship in my early teenage years, when everything else felt new and uncertain.

Having spent most of my days with Ella, I was quick to notice the changes in her personality, emotions and actions as the eating disorder began to worsen. Little things, like deciding to spend our lunch break walking around the oval instead of eating and avoiding food when we were out together, began to play on my mind, and I worried about how she was feeling. Eating disorders are extremely complex and different experiences for every person who suffers from them – so how do we go about helping someone we love when they are going through such an isolating illness?

The stark reality is that one in three sufferers will die. It has the highest mortality rate of all mental disorders. That is a daunting statistic, for both you and your loved one. Understanding the seriousness of Ella’s illness was a terrifying experience and a sharp realisation which left me desperate to help. I wanted to reach out and express my openness in supporting her in any way she needed but felt hesitant, not wanting to upset or trigger her. Ella, in a deeply personal and honest conversation, reflected on the way she was feeling at the time:

“I was withdrawn, distracted and unenthusiastic for life and any efforts of socialisation, because all my energy went towards mental obsessions and an endless stream of thought surrounding how much space I was taking up.”

When you’re worried about someone you love, naturally, you want to help in any way that you can. I wanted to wrap my arms around Ella and absorb all her thoughts, feelings, and worries. I often wish that I had noticed the signs earlier and better understood how to uplift and support her.

From this experience, I have come to learn the importance of education when it comes to helping a loved one through an eating disorder. Communication is essential but it can often be confronting and leave you feeling unsure of how to best approach the situation. Rather than generic, clinical advice, I have interwoven some first-hand guidance from both myself and my beautiful friend Ella, to help raise awareness of the importance of understanding during eating disorder recovery, as well as overcoming some of the challenges that accompany trying to support your loved one.

I was withdrawn, distracted and unenthusiastic for life and any efforts of socialisation

 A photograph of Ella’s flower arrangement – now studying floristry, creativity has always been important to Ella.

Don’t let your concern, or their inability to accept and admit to struggling turn you away from offering help and support.

Patience is key when it comes to offering support to your loved one. It is an uncertain time for both parties and naturally, you can feel worried about how to offer the help they need. Anorexia is an illness that thrives on isolation. When Ella was at her lowest, it became increasingly harder to communicate with her. I recall feeling helpless, unable to offer the support I so badly wanted to give.

Even as she detached herself further from myself and our friends, I was determined, in small, gentle ways, to be there for her. This meant reaching out and letting her know that I was there if she needed, keeping invitations to social meet-ups open and free from pressure, and educating myself about the illness so that I could better understand how to approach it. With any eating disorder, your loved one is experiencing an overwhelming plethora of emotions which can be difficult for you to empathise with. Do not let this dampen your efforts in supporting them.

Ella shares, “Your loved one is struggling to keep their head above very choppy waters, and you have the opportunity to throw a life jacket; even if they aren’t yet willing to accept it, please keep trying. From an ED sufferer to a loved one, or confused spectator; please be patient with us.”

Don’t judge their mental health based upon their physical appearance.

Eating disorders are heavily stigmatised; people with anorexia are assumed to be severely underweight and visibly unwell. Whilst this is the case for many people with the illness, it is damaging to judge a person’s mental wellbeing from their physical appearance, and so it is essential that we come to understand the importance of separating any correlations between the two. At times when Ella appeared physically healthy and functioning, she was unknowingly in her worst mental state and in need of support; something which I later learned and wish I had been aware of at the time.

Continue inviting your loved one; keep the offer open.

I often found myself questioning whether it was best to invite Ella to social events that had the possibility of involving food. Eating is a wonderfully social thing; it brings people together and can be a pleasurable way of sharing an experience, but for people with eating disorders, it becomes a constant obsession and something that is severely controlled.

Realising this, meals out, picnics, coffee dates… all those warm and pleasant social catch-ups transformed into worry. I didn’t want to make Ella feel uncomfortable or under pressure, and so I spent much of my time making sure that invitations were the right thing to do. It was important for her to know that we valued her company and wanted to spend time with her. Keep the offer open when inviting your loved one and express gratitude for their efforts; they will appreciate the inclusivity.

“I reflect on the kindness and time people offered to me when I felt weak and alone, and every day I am grateful for it, and slowly, am learning to accept the love and care I have never felt I deserved.”

Ella on kindness.

 

 Your loved one is struggling to keep their head above very choppy waters, and you have the opportunity to throw a life jacket.

Avoid talking numbers

With an illness that is so focused on weight and calories, it can be detrimental to draw attention to these issues by bringing them into conversation. In a society that is overburdened with diet culture, weight loss and physical appearance, this can be challenging. Be active in your efforts to steer conversation away from food and body image.

Your loved one’s weight is not a reflection of the state of their mental health or the eating disorder itself, and so it is important not to fixate on outward appearance. Despite best intentions, statements such as, “You look well! You look healthy! You’re looking better!” can be humiliating as you bring attention to their physical change, something highly dreaded during the early stages of recovery. Try complimenting their strength, courage, and resilience. 

Don’t be afraid; if your friend doesn’t want to talk about it, they’ll let you know.

One of my major anxieties when communicating with Ella was a fear of saying the wrong thing – of saying something that may be unknowingly to me, triggering, or damaging in some way. When it came to conversations around her eating disorder, I was unsure of what was okay to venture into and ask about and what should be avoided. It is essential that you don’t stop talking to your loved one; it is more destructive to cut off communication completely, than it is to be open to learning how to have a conversation about their feelings. The bottom line is, if your loved one is uncomfortable talking about something, they will tell you.

Eating disorders are a deeply personal illness, and so to talk about the most intimate parts of their mentality and experiences is a courageous step. Ella describes this feeling, stating: “I wish, in the early stages of my ED, I had the courage and self-awareness I carry with me now. I wish I had spoken to my friends more openly and accepted their support.”  Empathy, reassurance, love, and communication are so valuable. You may be apprehensive, or struggling to understand the intensity of their experiences, but by continuing to reach out and acknowledging their vulnerability is beyond helpful.

Setting Boundaries

I wanted to wrap my arms around Ella and absorb all her thoughts, feelings, and worries

Whilst supporting a loved one through an eating disorder, it is so important to check in with your own mental wellbeing. It is a challenging and emotional experience and so establishing certain boundaries can help to protect you and your loved one. Let them tell you where boundaries are needed, and if you’re unsure of something, ask them. With eating disorders so heavily stigmatised, it is crucial that we normalise open conversation, and create a space free from judgement and criticism. Look after yourself as you look after the person close to you.

Don’t be offended or take it personally

It can be difficult not to take it personally when your loved one detaches themselves from you and becomes unresponsive to your support. Remember that they are struggling through a confusing and life-threatening illness. Regardless of their response, your support and love are valuable and greatly appreciated. Continue to offer your company but separate it from expectations of response. Small acts of kindness go a long way; check in with your loved one, let them know they are in your thoughts, offer your support and express your care in little, considerate ways

 Alternative methods of communication

Ella notes the diversity in experiences of eating disorders, “The process in not linear, and there is no one approach or treatment that will work effectively between individuals.” Because of this, it is important to be aware of different ways of communicating with your loved one if it is difficult for them to be open and discuss their emotions.

Less than one in four people with an eating disorder will seek professional help. Stigmatisation has become deeply rooted in approaches to this illness and can limit the help available, leaving sufferers feeling reluctant to ask for support.

In this case, when spoken communication becomes inaccessible, you can try writing down your thoughts and emotions; perhaps just for yourself, or to share with the person close to you.  This can be an important process in maintaining your own mental health and is something that as a writer and close friend of someone experiencing anorexia, I did on a regular basis.

I reflect on the kindness and time people offered to me when I felt weak and alone, and every day I am grateful for it

Valuable Charities and Organizations

The Butterfly Foundation

Inside Out

Eating Disorders Association

Tabitha Farrar’s ‘Eating Disorder Recovery for Adults’ – YouTube

Tabitha Farrar’s ‘Eating Disorder Recovery for Adults’ – Blog

Education is so important when it comes to eating disorders and supporting the recovery of a loved one. I hope that this article provides you with the information you need to help the person close to you who may need it and gives you a better understanding of how to approach support during this illness.

A note from Ella:

“This is a thank you, to everyone who cares and loves, anyone who has reached out or checked in, thank you to families and friends who are patient and loving, despite the ways an eating disorder causes havoc and pain, thank you for holding onto hope and keeping your loved ones alive, despite us fighting so hard against you as merely a shell of the person you are used to knowing. Thank you to strangers who are kind, and to the people who care without judgement, thank you to the people around us who keep us strong when we cannot do it alone.

And to you, reading this; thank you for being here; thank you for being strong for the people who need you. Thank you for being open to learning, to benefit yourself, and your loved ones. You are valid, and worthy of a life beyond the grip of your eating disorder.”

 

Author

Hannah first began writing as a way of documenting the experiences of her nomadic childhood, hopping between the rugged borders of England and Wales before making the leap to live in Sydney, Australia.She has explored a plethora of writing styles, namely poetry and short fiction. Now, equipped with a degree in English Literature, she is delving into the world of journalistic writing with a particular focus on travel, mental health and feminist issues.

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