Talking to ‘Ed’ - Post Discharge Conversations

By: Kara Shelman, MSW, MPH-Clinical Therapist

An important part of treatment is involving the family in a discussion of what can be helpful topics to talk about and what can be more triggering topics to discuss with your loved one when they return home from an inpatient stay. Triggering topics can include discussion of weight, calories, food talk, exercise, etc. and talking extensively about these can be very difficult for your loved one. Of course there is no way we can avoid such talk outside the safe walls of treatment but family members willing to learn what can help at home is another way to show that support!

Words that could hurt:

“You look so healthy” or “Wow, you look better”

You are trying to say that you think they look good, have energy, and seem fit. But the person with an eating disorder, even if they are in recovery, may wonder what looking healthy might imply about their lack of thinness.  This only addresses the ‘outside the physical being’ we see but not ‘the inside being’, which might not be better yet.  For some it might suggest that they weren’t sick at all.  To others it could suggest they’ve gone too far in the direction other people want them to go or think that at one time you thought they looked bad. 

“I wish I could lose weight”

Even simple comments about how you wish you could lose a few pounds reinforces the assumption that there is nothing more worthy of praise than losing weight.

Words that are helpful:

Think about what you admire (other than weight)

Every time you think about complimenting someone about losing weight, think of something else to recognize, such as their kindness, talents, accomplishments, skills, or why you value their friendship. Say these on a regular basis.

Stop Talking About Weight

Take note of how often you criticize your own weight.  Don’t talk about your own eating in negative terms. Any reference to fat and being disgusting is a trigger for people with an eating disorder to assume that you think they are disgusting.  It’s not helpful to ask people about their diets, or how they stay so thin. People with eating disorders of all ages report that when important people in their lives tell them how good they look, the more they look into the importance of continuing their destructive eating habits.

Taken from a great resource for families: Talking to Eating Disorders: Simple Ways to Support Someone With Anorexia, Bulimia, Binge Eating, Or Body Image Issues by Ph.D., Jeanne Albronda Heaton and Claudia J. Strauss (Jul 5, 2005)