When people are struggling with a restrictive eating disorder, they can often become quickly agitated and easily triggered or upset. Due to low energy intake, the sufferer may have low glucose levels, and the brain releases a chemical called neuropeptide Y, trying to stimulate them to eat. High levels of neuropeptide Y are associated with anger and aggression and in simple terms the sufferer may become ‘hangry’.

Friends of people with eating disorders tend to ‘tiptoe’ around them in fear of saying something unhelpful, however this can lead to them feeling even more isolated than they already are. Restriction is something they can rely on and gives them a sense of security and so the absence of support can cause them to spiral.

Knowing what to say and what not to say can be extremely difficult to understand. Generally it’s best to avoid any comments about physical appearance or food, even if they are said with well meaning. Compliments about weight gain or ‘looking better/healthier’ can be difficult for someone in recovery to hear, as their eating disorder may want them to look unwell.

The prospect of looking healthy is terrifying, as struggling physically can be a way to show how much they are struggling internally; they may believe that others may see them as cured if they have a healthy body and may no longer support or care for them. While this sounds completely illogical to someone who has never experienced an eating disorder, it’s important to remember – eating disorders are not rational; there is no logic.

Commenting on food and eating is dangerous ground too. Labelling foods as ‘good’ or ‘bad’, or making remarks on the content, speed, or manner of another’s eating can be very harmful, whether it’s aimed at the sufferer or not. It reinforces the triggering ideology of diet culture that their illness had engrained into their brain and can make the person feel even more uncomfortable and self-conscious of what or how they are eating, potentially putting them off from eating at all.

Equally, it’s just as hard to know what a helpful thing to say is to someone with an eating disorder. When a loved one is doing well in recovery, it’s natural to want to acknowledge their hard work by complimenting or encouraging them, however it’s important to recognise what they will be comfortable with.

Restriction can strip the sufferer of their identity and personality, so comments such as, ‘your eyes are brighter’, ‘you’re doing so well/working really hard’ and ‘I can see more of you coming back’ can be really positive to hear. Compliments are very subjective and so it’s always best to communicate and ask if you’re unsure whether a comment will be helpful or not, tell them that you’re proud of them and you can see a difference mentally rather than physically.

Caring for someone struggling with an eating disorder requires a lot of patience, care and love. It’s inevitable that you will get things wrong, but it’s important to remind the sufferer that they’re not alone and you won’t leave them. They may be agitated, lash out or easily become upset but remember that the person is suffering with an illness and they are unwell, don’t take things personally.

Every individual is different and what works for one person may not work for another.