There is a common misconception that eating disorders only impact the people experiencing them. But the fact is, eating disorders do very much affect friendships, as well as other relationships in dramatic ways.
Individuals with eating disorders of any kind (restrictive, binge eating, compensatory, etc.) are often consumed with critically thinking about their eating behaviors and physical appearances. This may lead to distraction, isolation, or avoidance of friends and other social events.
It is not uncommon for those that struggle with an eating disorder to avoid friends and family out of fear of judgment, feelings of shame and guilt around their body or eating behaviors, or out of increased anxiety or poor moods. Restriction-centered eating disorders, in particular, can lead to malnourishment, irritability, depression, and anxiety and can also increase the likelihood of isolation from friends, family, and social activities. This can have an impact on friendships if the isolation persists for a long period.
Meals or food-related events tend to be particularly difficult for those with eating disorders. A common thing to do with friends is go out for dinner, lunch, drinks, ice cream, or try the new trendy restaurant. Someone with an eating disorder may appear distracted, quiet, or more irritable than they usually do if they do attend.
It is also possible that those who are struggling appear totally calm and normal during meals but are highly anxious internally. Either way, they are likely less present during a typical get-together with friends. This can be misconstrued as disinterest in the conversation or the company, when in reality they may be having a difficult time with the meal or their body image.
Another way that self-criticism can manifest is in the form of comparisons. Comparison thoughts occur outside of eating disorders (we all experience comparisons of ourselves to others in some scenarios) but may be particularly prevalent for someone with an eating disorder. They may compare their body shape and size, foods they are eating, and exercise patterns to that of friends or acquaintances.
These comparisons, which often are inflated and inaccurate, can lead to resentment and potentially increase the avoidance of friends or social events. When we are consumed with the judgment of ourselves, it is not unusual that we may not be as engaged, connected, or as supportive as we would like to be.
Unfortunately, this can fuel a vicious cycle of judgmental thoughts. If they are not feeling as connected with friends due to their avoidance or discomfort, they may misperceive that they are not liked because of their body, food choices, or appearance, only worsening their feelings of body shame.
Supporting a friend with an eating disorder can be very helpful. The most important thing to do is ask your friend what they need, or find out from them when they typically feel most anxious. With open lines of communication, you may be able to have them tell you how they’d like you to respond and what you can do to help with their feelings of anxiety. The important thing is to respond with empathy and let them know you are there for them, rather than taking their social withdrawal personally. The impact a good friend can have during times of need can be priceless.
Sources
- Datta, N., Foukal, M., Erwin, S., Hopkins, H., Tchanturia, K., & Zucker, N. (2021). A mixed-methods approach to conceptualizing friendships in anorexia nervosa. PloS one, 16(9), e0254110. https://doi.org/10.1371/journal.pone.0254110
- Westwood, H., Lawrence, V., Fleming, C., & Tchanturia, K. (2016). Exploration of Friendship Experiences, before and after Illness Onset in Females with Anorexia Nervosa: A Qualitative Study. PLOS ONE, 11(9), e0163528. https://doi.org/10.1371/journal.pone.0163528
- Hillege, S., Beale, B. L., & McMaster, R. (2006). Impact of eating disorders on family life: individual parents’ stories. Journal of Clinical Nursing, 15(8), 1016–1022. https://doi.org/10.1111/j.1365-2702.2006.01367.x
Alyssa Greene, LPCC has a Masters degree from University of Wisconsin in Clinical Mental Health Counseling. She is a licensed therapist practicing in Minneapolis, Minnesota. Alyssa has experience in working with various populations, but most experience working with eating disorders and body image.