If you think someone has an eating disorder, should you say something? A dietitian explains how to express concern without body shaming

You notice someone close to you has lost a lot of weight. You also notice that they’re skipping meals and talking more pessimistically about food and their body. You feel concerned but worry that commenting on their body might do more harm than good.

So what should you do? Where is the line between showing concern and being harmful?

I am familiar with the complexities and complications of eating disorders. As a college campus dietitian, I work together with students to confront their fears around food and dismantle the strict rules they might have around eating. My goal is to help students rediscover the joys of food and the social and cultural richness of eating with other people.

Despite my credentials in nutrition and psychology, my deepest understanding of eating disorders comes from my own personal experience with anorexia. I first started struggling with food when I was 13 and became visibly ill in high school, but it wasn’t until after my freshman year of college that I made substantial steps in my recovery journey. While eating disorders are often seen as a “teen problem,” there is no age limit on eating disorders. Adults with eating disorders may also have difficulty accessing appropriate support.

Too often, I see the fear of saying the wrong thing turning into saying nothing at all, regardless of the potential consequences of staying silent. But empathy and respect can open the door to necessary conversations.

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When celebrities lose weight

It can be jarring to see celebrities become suddenly, drastically thin.

Ariana Grande, Cynthia Erivo and Meghan Trainor are some celebrities whose bodies have become the topic of online discussion and speculation. But there are also examples of celebrities whose changes in appearance proved to be due to other health conditions. Chadwick Boseman experienced significant weight loss while privately battling colon cancer, and Selena Gomez has spoken openly about how lupus and the medications she takes to treat it have affected her weight.

Discourse online often goes back and forth between fans expressing concern and others saying it’s none of their business and to leave them alone.

Knowing what to say or whether you should say anything at all can be incredibly confusing. Expressing concern is not inherently dangerous; it might help you process the shock of seeing your favorite celebrity dwindle before your eyes. Concurrently, commenting on someone else’s body on social media can do real and serious harm. Body-focused comments can lead to low self-esteem, depression, self-harm and may also contribute to eating disorders.

When I’m working with students, I choose my words carefully. I don’t start the conversation with “You have an eating disorder.” Rather, I listen closely, ask questions and respond with empathy. But there is a difference between choosing words carefully and choosing silence.

Avoiding talking about concerning changes to someone’s appearance because you’re afraid of saying the wrong thing risks normalizing concerning weight loss. This is especially the case for young adults who look up to celebrities as role models. Not talking about the consequences of life-threatening weight loss could unintentionally send a message that unhealthy levels of thinness is an ideal body type to aspire to.

Eating disorders are on the rise

At the height of my eating disorder, I remember thinking I was healthy. I was thinner than some popular celebrities at the time and had received so many compliments. How could something be wrong with how I look?

I wish I could say my experience is antiquated. But many young adults are asking themselves the same question today: What’s wrong with how they look? Silence becomes hard to defend when looking at the statistics. Eating disorders are on the rise, doubling in prevalence worldwide between 2000 and 2018. Rates continued to increase and grow in severity throughout the COVID-19 pandemic.

Eating disorders are not a phase someone can just “get over.” They are a severe mental illness with medical complications that can affect nearly every part of the body. Anorexia in particular has one of the highest death rates of any eating disorder; patients face a roughly five times increased risk of dying compared to the general population, particularly within the first 10 years after diagnosis.

Despite the risks, many people suffering from eating disorders may refuse to acknowledge the severity of their illness and believe they are healthy. At the peak of my eating disorder I did not think I had a problem, despite being severely underweight. I grew up with magazines that had very similar messaging to what’s seen on social media today, telling people that they should suppress their hunger and be ashamed of their bodies. The message was that weight gain could mean the end of your social life.

Research has consistently shown that greater social media use is associated with increased eating disorder symptoms, particularly by encouraging body comparison and unrealistic body ideals. One study of nearly 1,800 young adults ages 19 to 32 found that those who spent the most time on social media had over double the risk of having eating and body image concerns compared to those who spent the least time on social media.

Restrictive eating and other disordered eating behaviors can start to feel very normal when your whole algorithm is feeding you back-to-back tips on how to shrink yourself.

How to talk to your loved one

There is a fine line between commenting on someone’s body and expressing genuine concern for their health. So how do you start a conversation if you think someone you love has an eating disorder?

The first thing I recommend is doing research on eating disorders to learn the signs and symptoms. Know your facts and myths about nutrition and eating disorders. This background knowledge can help you gently reason with your loved one while avoiding unintentionally reinforcing the misinformation or diet culture that could be contributing to their struggle.

When you feel it’s time to talk to your loved one, be prepared. You could be met with frustration, denial and annoyance. When my friends and family expressed concern, I huffed and rolled my eyes because I “didn’t have a problem.” It could take multiple tries before your loved one is ready for a conversation.

Then find a time and place to talk. Don’t do this during lunch, in front of many people or in the style of an intervention. Overwhelming your loved one could make them feel shame and shut down. A private conversation in a familiar place can make the conversation feel less intimidating, giving them the space to open up without putting them on the spot.

Use “I” statements. This might sound like “I noticed you don’t get lunch with us anymore” or “I really care about you, and I am worried.” Using “you” statements can come off accusatory and make your loved one feel like they are being attacked.

Avoid giving simple solutions. One of the most common mistakes I see is people recommending that loved ones “just eat.” Eating disorders are much more complicated than simply choosing not to eat. Giving simplistic solutions can minimize the internal conflict your loved one is going through and reduce your chances of talking with them again on this topic.

Finally, don’t push the conversation further if it’s short; leave it at that. Let your loved one approach you on their own terms. Sometimes sending texts that you are thinking of your loved one can show your support while still giving them space. While they might not tell you that they have an eating disorder, they may instead talk to you about other symptoms, such as anxiety. This could be the door to suggest that therapy could help.

Progress over perfection

The biggest key to having a successful conversation is compassion and patience with your loved one instead of pushing them. Progress over perfection is the golden rule I teach my students.

If your talk with your loved one doesn’t go the way you hoped it would, that doesn’t mean it was a failure. You still planted the message that you care about and are there for them. They may not be ready to acknowledge that they have a problem or seek help right away, but sometimes simply hearing someone show concern can be encouraging. Over time, the collective support of the people who love them can help them take that first step toward recovery.

Rather than asking whether you should say something, ask yourself how to discuss your concerns with empathy and understanding. The goal is not to force someone to admit they have a problem but to create a space for an honest and empathetic conversation.

A conversation that respectfully acknowledges that something may be wrong can remind the person you love that they do not have to face it alone.