How to Help Someone with Anorexia

By: Jayson Tripp, MD


Anorexia is an eating disorder characterized by an obsessive desire to lose weight by restricting food intake. Although, the term anorexic is often used as an adjective to describe someone who is very skinny, anorexia and other eating disorders are not characterized by a person’s weight. Eating disorders are characterized by a person’s self-image as well as their relationship with food. 

Causes of Anorexia

Anorexia has multiple causes and treatment options. Understanding what causes someone’s eating disorder will help determine the best treatment method.  

Biological Factors 

Studies show that anorexia and other eating disorders have a number of biological factors. According to Mayo Clinic , some people have a genetic tendency towards traits associated with anorexia, such as perfectionism, sensitivity, and perseverance. In fact, anorexia is associated with a few different neurotransmitters in the brain.  

Anorexia also tends to run in families. Someone with a parent or sibling with an eating disorder is 12 times more likely to develop one than someone who doesn’t have a family history of eating disorders.  

Psychological Factors 

Another cause of anorexia is obsessive-compulsive personality traits. These traits can make it easier to restrict food, even when hungry. People with these traits typically have an extreme drive for perfection, which can lead to being unhappy with the body and heavily restricting food in order to achieve the body they desire. 

Environmental Factors 

With social media being filled with models who have the perfect body, young girls may feel the desire to achieve those looks. They associate beauty and worth with being thin and are willing to do whatever it takes to achieve that beauty and worth. 

Warning Signs of Anorexia

Anorexia has many warning signs, including physical signs as well as behavioral changes. Some physical signs of anorexia include: 

  • Dramatic weight loss 
  • Fainting 
  • Feeling cold 
  • Fine hair on the body 
  • Thinning hair on the head 
  • Dry and brittle nails 
  • Dry skin 
  • Poor wound healing 
  • Poor immune system 
  • Constipation 
  • Abdominal pain 
  • Lack of energy 
  • Loss of period (post-puberty) 

Anorexia may also cause changes in behavior, including: 

  • Dressing in layers to either keep warm or hide the body 
  • Being preoccupied with weight and dieting 
  • Refuses to eat certain foods or categories of food 
  • Making frequent comments about being fat or overweight 
  • Denying feeling hungry 
  • Developing food rituals such as excessive chewing or rearranging food 
  • Cooking meals for others but not eating them 
  • Consistently making up excuses to avoid food 
  • Expressing a need to burn calories 
  • Maintaining an excessive exercise regimen 
  • Feeling concerned about eating in public or with others 
  • Denying the severity of low weight 
  • Feeling a strong need for control 
  • Having trouble concentrating 

Many people with eating disorders will try to hide their behavior because they don’t want to be told to stop or have other people worrying about them. Be patient with your loved one if they aren’t willing to talk about their eating disorder or admit that it’s a problem. 

Anorexia Treatment Options

Anorexia can be a deadly condition. The health issues caused by anorexia can lead to death, but anorexia may also lead to death by suicide. In fact, one out of five  people with anorexia commits suicide.  

Medical Treatment 

Medical treatment is required to treat the health issues caused by anorexia, including malnourishment, heart issues, and other serious health problems. Additionally, 33–50%  of people with anorexia have a co-occurring mood disorder such as depression or anxiety.  

These co-occurring mental health conditions can be treated with antidepressant medications or alternative options like ketamine  and transcranial magnetic stimulation (TMS treatment) , which may also help relieve the symptoms of anorexia.  

TMS and ketamine are both reliable treatment options, even for the most difficult-to-treat cases of depression, anxiety, and other mental health conditions. These treatments are also known to help repair neuropathways in the brain, which could be helpful for treating eating disorders as well as depression and other mood disorders. 

Nutritional Counseling 

Many people who suffer from anorexia meet with a dietician to come up with customized meal plans based on nutritional needs, history, relationship with food, and other factors. 

Mental Health Counseling 

Another option is to work with a therapist to replace negative and distorted thoughts with healthier views of one’s body and food. Therapists can also help a patient get past the fear of gaining weight by teaching coping skills that help them deal with emotions, stress, insecurities, and relationships in a positive way. 

Talking About Anorexia

Anorexia is a sensitive subject for someone who is struggling with the symptoms of this condition. If a loved one is struggling with anorexia, it’s important to say the right things, as saying something wrong could potentially trigger them. Here are some ways to be supportive of someone with anorexia:  

  • Compliment something other than their physical appearance — i.e. their clothes, hairstyle, or an accessory. This makes them feel good about themselves instead of feeling insecure. 
  • Ask, “how are you?” — asking how someone is instead of asking about how they’ve been eating is a good way to let them know you care about them, not just their eating disorder. 
  • Tell them, “You’re worth more than your eating disorder” — this gives the person who is struggling hope and reminds them that they are a person who isn’t defined by their issues. 
  • Encourage them to seek help — people who are struggling with an eating disorder might not want to get help right away, so it’s important to keep encouraging them to find help, but don’t be too pushy about it. 
  • Let them know you care — it’s important to let not only people with anorexia but also anyone who is struggling know you care. A little bit of support can go a long way.  

The most important thing to remember is to be patient and be there to listen when your loved one is ready to open up and accept help.  

What Not to Say

Keep in mind that people with anorexia have an extreme fear of gaining weight, which causes them to compulsively restrict their food intake. Like someone with an addiction, someone with anorexia can’t just stop their behavior without treatment. So, it’s not helpful, and even triggering in some cases, to tell your loved one, “just eat!”  

You should also never comment on their physical appearance by saying things like, “you look too skinny.” And most importantly, you should not take their behavior personally. People with anorexia have a distorted self-image. Don’t assume they think you’re fat just because they think they are.  

Also, don’t tell your loved one that what they’re doing hurts you. They already have low self-esteem, and making them feel guilty won’t encourage them to seek help and get better. Be considerate of how your loved one is feeling. 

If you or someone you know is struggling with an eating disorder, contact us  at Serenity Mental Health Centers to find a treatment plan that works for you.  

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*All information subject to change. Images may contain models. Individual results are not guaranteed and may vary.