How to Have a Conversation with Someone You Think Has an Eating Disorder

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If you suspect someone you know may be struggling with an eating disorder, it may be difficult to approach them with your concerns—but it could also be life saving. Follow these steps to have a conversation with a person you’re concerned about.

Build Rapport.

Trust is key. This conversation will not go well if the person doesn’t feel safe. Before you have the conversation, learn the person’s name and make an effort to get to know them Establish a caring, curious, non-judgmental relationship. Make sure the person knows you care about them, and that you are on their team. If there’s no time to build a relationship with the person ahead of time because of a safety issue (e.g., a severely underweight student arrives at yoga class for the first time), skip straight to the next step.

Speak in Private.

Invite the person you’re concerned about to speak with you in a confidential space — perhaps after yoga, over tea, or during a walk. If others are around to overhear, the person might shut down out of shame or fear. Be gentle and cautious. Remember that eating disorders are enwrapped in shame and secrecy — ensure that the space you’re speaking in will feel private and supportive.
Remember that eating disorders are enwrapped in shame and secrecy — ensure that the space you’re speaking in will feel private and supportive.
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Ask permission to speak openly

Begin the conversation with the question, “May I speak openly with you?” Asking permission gives the individual a sense of control and agency. It reminds them they can exit before the conversation even begins. Don’t force a conversation if the person declines, and do your best to remain unattached to the outcome.

Offer observations without judgment.

Tell the person what you’ve noticed with conviction and compassion. Use direct and clear ‘I’ statements like, “I’ve noticed you have lost a lot of weight” or “I heard you purging in the bathroom.” Don’t make accusations like, “I think you have an eating disorder!” or “You look so anorexic!” Remember there are many causes for changes in weight, and come to the conversation with an open mind. Let the individual know you see and support them and give them the opportunity to respond.

Let the individual know you see and support them and give them the opportunity to respond.

Come with information and resources.

Don’t come to the conversation empty handed. Before having conversation, seek out eating disorder resources in your local community — therapists, nutritionists, treatment centers, and support groups. Do your research ahead of time, so you can make suggestions for where the person can get professional help. Not sure where to start? If you’re in the U.S., The National Eating Disorders Association (NEDA) provides a searchable treatment directory. For those in the United Kingdom, BEAT offers a searchable database for individuals looking for eating disorder services. If costs are a barrier, Project HEAL awards grants and other forms of support to highly-motivated individuals who cannot afford treatment.

Set clear boundaries if needed

If you’re a yoga or fitness instructor speaking with a student you think is too physically compromised to take your class, let them know you’re concerned you can’t keep them safe. You can suggest they take less rigorous forms of yoga (restorative, yin, meditation) until they are more healthy. If you receive pushback, ask that the student be medically cleared by a cardiologist before returning to class.

While that may seem harsh, individuals who engage in dangerous eating disorder behaviors put both themselves, and the class at risk. As a yoga or fitness teacher, your first job is to keep everyone in the room safe. Not just the one suffering from an eating disorder.

A conversation of this nature often feels confronting, if not outright rejecting, to individuals with eating disorders. Remind the person that they are welcome back to your class when they're in a better place.