Ask A Dietician: How To Help A Friend Living With An Eating Disorder


Your monthly installment of "Ask A Dietitian" is here, and we're tackling some questions.

As women, we've all been there. We've had friends or family members who've been living with eating disorders. Maybe we've even battled through one ourselves. Maybe we still are. But what's the right way to support someone you care about, who's struggling an eating disorder?

It's a big, sometimes overwhelming topic. But it's one that dietician Alexandra Reed is going to address today. Here are three of your reader-submitted questions, answered. 

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I have a friend who is trying to overcome anorexia on her own. How can I help her? I know a lot about food and nutrition, but her mental issues are beyond me. What can I say or do to help her? She won't go to a therapist or doctor, no matter what I say. She's smart and educated, and worth so much in this world, I just want to help her be her best!

- Concerned Friend

Hi Concerned,

It sounds like you are a caring and thoughtful friend and it’s difficult to stand on the sidelines when your loved ones are suffering. First, general life advice—you cannot help anyone who is not ready to be helped. It’s a tough pill to swallow. You're ready for your friend to start her recovery, but she is not. You cannot force it.

It sounds like she has discussed her eating disorder openly with you, which is a great first step. Being open comes with a level of trust you have earned with your friend (and it means you guys are tight AF). Cherish that. 

Remember eating disorders are complicated, serious mental illnesses. There isn’t a simple solution to this, however, you can still be there to support your friend. You’re not an expert or professional though—you cannot give solutions, coping mechanisms, etc. But here are some ways you can help right now.

Harmful things to stop:

  • Lectures. You are not the professional, and this could do more harm than good.
  • "You" statements a.k.a. “You should just eat!”
  • Shaming or blaming e.g. “Why would you do this to yourself?”
  • Simplifying. A.k.a. the “just eat” response.
  • Ultimatums like “I will not talk to you anymore” is the worst thing you could do.

Helpful things to start:

  • No more talk about weight or size—about your friend, yourself, or others.
  • Remind your friend of everything amazing they do, that has nothing to do with body image (career, personality, etc).
  • Be honest about your concern (without blame or shame).

Next time the conversation comes up just ask, “What can I do to help?” This lets your friend knows you care, but, at the same time, you are not telling her what to do. Again, you are not a trained professional. Only they will be able to help her cope with her illness. You might even realize things you say/do are triggering, this is why seeking professional help is always the best approach.

I hope this helps. And if you are worried about your friend's welfare, or feel like her life is in danger, please don't ever hesitate to contact the National Eating Disorder Association (NEDA) for resources and referrals. You can also visit this site and this site.

I've been hearing a lot about lectins lately. What can you tell us about them? Is this a sound nutritional pursuit, or just another fad?

- Blueridge Girl

Wow BG,

Thanks for the question. Seeing “lectin” just sent me back to long nights studying nutritional biochemistry and food science. It’s the first time I’ve heard of this becoming public interest though, and it’s sounding a lot like gluten trend. Let me explain.

First, lectin is a protein found in both plant and animal-based foods. The highest concentrations of lectin are found in grains, legumes, and seeds. But they are also found in dairy, eggs, fruits, vegetables (tomatoes, potatoes). They are key nutrients and play in immunity and cell growth. 

I’ve read some research abstracts hoping these proteins could potentially be used in cancer treatment. However, in large doses the plants used do have the ability to damage the gut wall.

Lectin is often referred as an anti-nutrient because of its ability to reduce the absorption of nutrients a.k.a lectins are kind of clingy. Basically, they hang out in your gut and digestive distress—in high doses.

It’s important to note the research claiming lectins are “toxic” were conducted in vitro on animals, with isolated lectins (not lectins in food). Basically, these studies have not been done in humans with real foods. This information is isolated to a test tube. Their full role in the human body has not been studied. (And trust me, shit gets complicated in human studies.)

Plus, it’s difficult to consume to the amount of lectin that causes adverse effects. Lectins are most common in raw beans, the cooking process actually degrades most of the lectins in your foods.

Basically, BG, if you aren’t downing cans of raw beans—I wouldn’t be concerned. Your body can tolerate low doses of lectin—which is what most people consume in cooked grains and beans, all the time.

I have suffered chronic migraines for the past six years and it remains a bit of a mystery, particularly to the doctors I speak to, as it be caused by so many factors. Is there some recent studies that can advise us on foods to avoid? What are the biggest everyday triggers? I know stress is a major trigger (but hard for business owners to avoid).

- Head First Hunny

Hi Hunny,

That sucks. Personally, I have migraines triggered by stress. So I know how irritating it can be because they shut you the fuck down. Migraine triggers vary per individual so it’s important to keep working with your medical team to determine what causes yours.

Most migraines are triggered by non-dietary factors, however, commonly-reported diet triggers include skipping meals, alcohol, chocolate, smoked fish, nitrates, nitrites, MSG, and artificial sweeteners (aspartame). As mentioned, triggers are individualized so none of these foods may bother you.

As far as my expertise, I suggest keeping a food journal. Keeping a journal empowers you with information and enables you to learn about how your body reacts to certain foods. Otherwise, we are just playing a guessing game, right?

Start with two to three days, writing down what you eat, the time, and any reactions you notice (physical and emotional). Then, note any trends. I highly suggest you take it to a dietitian, since we are trained to look for trends and triggers.

Finally, I appreciate you mentioned stress is difficult to avoid, especially as a small business owner. It may not be avoidable but you can change how you handle stress. This is something you can write down in your journal as well. With this information, you will be able to take more control of your stress, knowing what causes it, and preparing for it rather than reacting.

So, in the future, you might take a walk or sit in a dark, quiet room for five minutes to get yourself centered. I know it doesn't seem like you have time, but I promise you will never regret taking five minutes out for yourself.

Alexandra Reed is a registered dietician and nutrition coach.

Before making any changes to your diet or nutrition plan, be sure to personally consult with your doctor or a registered dietician/healthcare provider first.

Words: Alexandra Reed