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How to Talk about Eating Disorders Safely

BY Jo Doley

There is such a fine line to walk when educating people about mental health concerns like eating disorders. Do we tell them everything but risk telling them too much? Or do we withhold information, knowing that they can find out so much more online- from less credible sources?

We do need to be careful- In the month after Lady Gaga went public with her experience of having an eating disorder, searches for pro-anorexia websites increased by 52 %.

Content warnings or trigger warnings are becoming more common when we discuss sensitive issues in the media, like depression or suicide. You may have even seen content warnings before someone talks about body image or eating disorders. People with eating disorders (and people with body image issues) can find these warnings useful if they’re going through a difficult patch and want a “heads up”. Further to that, we can also make sure that when we discuss eating disorders, we talk about them in a safe way. Similar to the issue of discussing suicide (e.g., good media reports usually refrain from including details about the method of suicide), there are ways of having conversations about eating disorders that can educate people without doing harm.

We conducted some research a few years ago to try to figure out how we should talk about eating disorders in settings like schools, universities, sporting environments, and workplaces. We asked experts in body image and eating disorders – including clinicians, researchers, advocates, and people with lived experience (i.e., people who had a history of an eating disorder) to tell us the things they thought would help educate people in a safe way.

Here are five tips to discuss eating disorders safely:

  1. Details (don’t) matter
    Some people think that showing people graphic, detailed information about what an eating disorder looks like can help educate people and deter them from developing an eating disorder; but actually, the experts we asked think this can be harmful. For instance, showing images of very thin people, discussing (low) amounts of calories eaten by a person with an eating disorder, or talking about methods of purging could a) make people with eating disorders feel like they’re not “sick enough” and b) give people new ideas on how to restrict their food intake or use unhealthy behaviours.
    In our research, experts agreed that discussing eating disorder behaviours in a general way, and explaining some of the medical consequences, was less likely to be harmful. For instance, if discussing restricting food, instead of talking about calories and weight, it would be more helpful to discuss some of the negative consequences like fatigue, digestive problems, and osteoporosis. Note: There may be times when certain details are necessary, e.g., for professionals and adult students in health or mental health fields.
  2. Get the facts
    Online and in everyday life, it’s easy to come across information about health that’s misleading or out of date. Eating disorders are no exception: even some health workers have a poor understanding of what eating disorders look like when they don’t fit the stereotypes. As such, what people think they know about eating disorders isn’t always correct! Luckily, there are lots of organisations that put out evidence-based information about eating disorders. You can find information on risk factors, causes, treatments, and myth busting information from organisations like The Butterfly Foundation and National Eating Disorders Collaboration.
  3. Include lived experience, thoughtfully
    People who have had a history of an eating disorder can provide thoughtful discussion on their experiences and give context for the more fact-based information. They can also help people to better understand the eating disorder recovery process. Experts in our study generally thought that including stories of lived experience (like a speaker) was more appropriate for adult audiences, and probably not at schools. People who want to share their own stories of an eating disorder should make sure they look out for their own wellbeing first – there are organisations who provide support for people who want to share their story – read more here.
  4. Be mindful of your own bias
    Eating disorders don’t always have a particular look. Experts have become more aware that people of all genders, ethnicities, abilities, sexual orientations, sizes, and ages can be affected by eating disorders. It’s easy for us to stereotype eating disorders as affecting white, young, cisgender, able-bodied, thin women – these are the stories we see most commonly in the media. Sadly, these stereotypes can stop people who don’t fit these criteria from getting help, because they think it can’t happen to them (and unfortunately these stereotypes can impact who does and doesn’t get a diagnosis or treatment).
    This is a video I love to show to people (probably best for an adult audience) that shows people responding to the question “You don’t look like you have an eating disorder”. I think this really shows the impact that these sorts of stereotypes can have on people who are unwell.
    Another type of bias that is really important to consider is weight bias. Many of us have grown up in environments where we’re taught that fat is inherently bad, and thin is inherently good. Try to avoid sending messages that people can’t be healthy at a higher weight. If you’re worried about sending the wrong messages, it could be helpful to invite an expert along – there are lots of wonderful professionals trained in body image and eating disorders, and they can help you out.
  5. Have a plan in place for help-seeking
    Media articles discussing sensitive issues usually include a helpline related to that issue, so that anyone experiencing distress can get free support. This is also a great idea when you’re discussing eating disorders. In Australia, we have free services like The Butterfly Foundation and the EDV Hub to offer specific support for people with body image and eating concerns. There are similar services in many other countries – see page 9 of our guidelines for a list.
    Sometimes, you might find that a student or young person specifically asks you for advice or help if you’re on the topic of body image and eating disorders. It’s really good to be prepared for this – you can write down specific steps for what you’ll do, like have a quiet chat with them to give them information on getting help and following up in a week or so to check in.

Resources:

  • Our full paper, published in the Journal of Eating Disorders, here.
  • You can also read our full set of guidelines for discussing eating disorders in community settings here.
  • See also the Mindframe guidelines for communicating about eating disorders here.

Meet The Author,
Jo Doley

Jo is an early career researcher and lecturer in psychology within the College of Health and Biomedicine at Victoria University. Jo completed their PhD, which focused on stigma and eating disorders, at La Trobe University in 2018. Their current research interests are body image in queer women, and body image in transgender and gender diverse people. They are collaborating with the Body Confident Collective to assist in disseminating their research on body image and eating disorders, and to disseminate resources aimed at parents, teachers, and coaches about boys’ body image and supplement use. Jo is a member of the Australian and New Zealand Academy for Eating Disorders (ANZAED) and the Victorian Eating Disorders Research Network (VEDRN).

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