How to Help Your Loved One Who You Think Has an Eating Disorder: Supportive guidance from an eating disorder therapist in Philadelphia
Written by Dr. Colleen Reichmann, owner and clinical director of Wildflower Therapy
Noticing signs of an eating disorder in someone you love is one of the most heart-sinking experiences. Maybe it’s your teen who’s suddenly terrified of certain foods. Your college-aged sibling who recently started avoiding meals, and seeming generally more down. A friend who’s lost so might weight that you were startled the last time you met up. Or a parent who has always had a wonky relationship with food, but recently started seeming even more rigid and obsessed with weight. No matter the relationship, most people are stuck with a big, tricky question once they begin noticing (or once concerns reach the level where it feels too scary to ignore):
“How do I say something?”
First, take a deep breath with me. Please remember that your worry comes from love. Why am I reminding you of that? Because the root of the worry matters here (and often more than you might think.) Concern that stems from love can often be heard more easily by someone who might otherwise be defensive. As an eating disorder therapist in Philadelphia and someone who walks with individuals and families through this every day, I want to offer you a compassionate roadmap for approaching this conversation.
Whether you’re supporting a child, sibling, parent, or friend, this guide will help you speak up with warmth, clarity, and steady support.
Why Speaking Up Matters (Even If You’re Afraid You’ll Say It Wrong)
Eating disorders thrive in silence. They also thrive in secrecy, shame, and isolation. One of the most protective things you can do is break that silence gently and lovingly. You do not need the perfect script. You do not need the perfect moment. You do not need to be a professional. Please hear this, because it’s something that holds nearly everyone back at one point or another- fear of saying the wrong thing, or being triggering.
Honestly? The “perfect” approach can sometimes feel too polished or clinical. Your loved one needs your humanity more than your perfection. And saying something is always, always more preferable to turning the other way and saying nothing. In fact, I often tell people that one of the most triggering things for my clients is when loved ones say nothing. Because saying nothing colludes with eating disorder isolation. It colludes with the mindset that everyone around the person probably thinks they are fine. And it colludes with the “race to the bottom” mentality that sometimes haunts people with eating disorders (ie I have to reach a certain level of “sick enough” before I am worthy of receiving help or support.)
If your words come out clunky or emotional or even a little shaky, that’s okay.
What matters is: you cared enough to say something. Early intervention saves lives. And even later intervention saves lives. Speaking up, however imperfectly, is an act of profound care.
Preparing Yourself Before the Conversation
Before you start the conversation, take a moment to ground yourself. The goal isn’t to confront… it’s to connect.
Here are a few ways to prepare:
1. Lead with curiosity, not conclusions.
You don’t need a diagnosis to express concern.
Try to stay open and avoid assuming the “why” behind their behaviors.
2. Choose a calm, private space.
Not the dinner table. Not a rushed car ride.
Think low stress, low noise, low pressure.
3. Remind yourself that emotions like defensiveness, fear, or anger can be normal for people when they are struggling with eating disorders.
These are symptoms of the eating disorder, not a sign that you’re doing the wrong thing.
4. Know your role: you’re not the fixer.
Your job is to notice, support, and guide-not treat.
(That’s where professional help like eating disorder treatment in Pennsylvania comes in.)
How to Start the Conversation with Love and Clarity
Each relationship will have its own rhythm, but here are supportive ways to open the door.
Use “I” statements rooted in care.
Try something like:
• “I’ve noticed you seem really stressed around food lately, and I’m honestly feeling so worried about you.”
• “I love you so much, and I’ve been seeing some things that have me concerned.”
• “I’m worried because I’ve noticed that you’ve lost weight. I really love you, and I want to understand what you’re going through.”
What you want to avoid is:
• Further comments about weight or appearance (other than what was mentioned above- things along the line of “I’ve noticed you look thin, and I’m concerned” if that is what you have noticed.)
• Accusations (“You’re starving yourself!”)
• Trying to argue them out of the eating disorder
• Any tones of anger
And on that last point, please please know that your tone-warm, steady, gentle-will matter far more than perfectly chosen words.
Expect Denial, Anger, or Pulling Away (and Why It’s Normal)
Here is something almost no one tells families:
Denial is not a sign that the conversation failed.
Anger is not a sign that you made things worse.
Shutting down is not a sign you should have stayed silent.
These reactions are incredibly common because eating disorders often feel like a lifeline to the person struggling. In addition, shame tends to intensify when someone notices. (This is sort of a general truth for all of us who are engaging in behaviors that are rooted in secrecy or self harm.) Also, for many folks with eating disorders, letting someone “in” can feel terrifying at first. And lastly, the person’s brain may be malnourished-which makes them more vulnerable to overwhelm and distress intolerance.
If your loved one responds with:
• “I’m fine.”
• “You’re overreacting.”
• “It’s not a big deal.”
• “Why are you judging me?”
• “I’m not talking about this.”
…it doesn’t mean you were wrong to bring it up. It probably just means you hit something tender and real, and that it may take your loved one some time to process your concerns (and their own) before taking the next step. It also might mean that the conversation will need to be ongoing, and something you lovingly and assertively circle back to. Stay steady. Stay loving. Don’t stop expressing your concerns.
Revisiting the Topic (Because One Conversation Usually Isn’t Enough)
Eating disorders are persistent, and sometimes insight into the problem (or a desire to address the problem) simple takes people time to develop. That means you’ll likely need to revisit this gently over time.
Some ways to return to the conversation:
• “I’m still here, and I’m still worried.”
• “I care about you too much to stay silent.”
• “We don’t have to figure everything out today, but I wanted to reiterate that I am still so worried. I just want to support you.”
• “I know this is hard to talk about. I’m not going anywhere. I want to talk and to help you get help, even if it feels scary.”
Your persistence- kind and gentle persistence-is what helps.
Repetition shows them:
You weren’t just having a moment of worry.
You see them.
You care.
You will not disappear when things get scary.
Supporting Them in Getting Professional Help
Once the door is open, you can gently guide them toward resources.
Here’s how to help without overwhelming:
1. Offer options, not orders.
You can say:
• “Would you be open to talking to a therapist who specializes in eating disorders?”
• “I can help you look for someone if that feels easier.”
• I looked into some specialist and have a list. I would be happy to call them together if it feels easier.”
2. Emphasize that treatment is about support, not judgment.
Eating disorder therapy is collaborative, compassionate, and focused on healing, not blame. It should also happen in a way that doesn’t feel totally unsafe for people. Remind your loved one that a skilled therapist will be able to guide them through recovery in a way that helps them feel pushed, but not flooded.
3. Offer logistical help if appropriate.
• Scheduling appointments
• Driving them
• Attending a family consult session
• Helping navigate insurance or self-pay options
4. Choose specialized care.
Help them look for someone who definitely works specifically with eating disorders-like a therapist or practice that offers eating disorder treatment in Pennsylvania or eating disorder therapy in Philadelphia.
Specialized care matters here. I cannot emphasize this enough. These are complex illnesses with emotional, relational, and biological roots. People who are struggling often do not want to seek help in the same way that folks struggling with depression, for example, might want to. So you really need a professional who is trained and understands how to foster motivation, work with people who feel conflicted, and also just knows how to treat all of it- behaviors and psychological symptoms alike.
How to Support Your Loved One After That First Step
The bad news? Recovery is not “tell them once and then everything changes.” It’s simply not.
Recovery looks like:
• Listening more than fixing
• Validating feelings
• Avoiding comments about bodies, weight, or diets
• Keeping mealtimes low-pressure
• Continuing to check in
• Celebrating non-food victories
• Reminding them they deserve help and healing
• Staying patience and grounded in your concern and love, and making sure to check yourself when you begin to feel anger towards your loved one.
• Remember, we would never feel angry with a loved one who is going through treatment for a medical illness and struggling with the process- we need to keep that same spirit of patience and empathy for loved ones who have eating disoerders.
Strive to be the safe person they can keep coming back to- the one who is honest about not having instant solutions, but also upfront about sitting with them in the rain while they figure out the umbrella.
You Don’t Have to Do This Alone
If you’re feeling scared, overwhelmed, or unsure of how to help, that doesn’t mean you’re failing. It means you’re human and you love deeply.
If you’re in Pennsylvania and want support for your child, teen, young adult, or loved one, specialized help is available. Wildflower Therapy is a team of eating disorder specialists in Philadelphia who can provide guidance, structure, and a compassionate plan for both the individual struggling and their family. We also offer coaching sessions for family members who want guidance on how to approach this topic with their loved one. Our team of eating disorder therapists specializes in eating disorder and body image therapy in-person in Philadelphia, or virtually anywhere in Pennsylvania, New Jersey, Delaware, Florida, South Carolina, Vermont, Virginia, Ohio, and Massechusetts.
Remember-You don’t have to be perfect. You just need to be able to say the thing, even if it’s clunky. Just start with the showing up for that scary conversation. The step alone is such a courageous act of love.
Reach out today for your free consultation call.