10 Things You Should Never Say to a Friend with an Eating Disorder

When a friend is dealing with an eating disorder, it can be hard to find the right words to show your support. Eating disorders are widely misunderstood — many people assume an eating disorder is just an obsession with being thin.

But it's important to realize eating disorders are serious medical conditions that can lead to heart disease, brittle bones, kidney failure, hair loss, even death.

 In fact, eating disorders have the highest mortality rate of any psychiatric disorder. So if you suspect a friend is struggling, it's important to talk to a parent, teacher, counselor or trusted adult to get them help, stat. While they'll need your support during recovery, sometimes certain words, even said with the best intentions, can do more harm than good. Strike these phrases from your vocab —they can actually make your friend feel even worse.

1. "Eat a cheeseburger!"

An eating disorder isn't a diet, and it isn't a choice. "I describe it as having a voice in your head that's controlling you, almost like an abusive partner," says Jennifer Rollin, MSW, LGSW, a mental health therapist and member of the Junior Board of Directors for the National Eating Disorders Association. "Telling someone with an eating disorder to eat is like saying to someone with a broken leg, 'Why don't you just walk on it?'" There's no simple fix, and commenting on what your friend should or shouldn't be eating can make things worse. Instead, offer to help your friend find a professional who can guide her through treatment options.

2. "You're too skinny."

Weight loss is often the most visible symptom of anorexia or bulimia, but avoid making negative remarks about your friend's appearance. Someone with an eating disorder likely has a distorted self-image, so commenting on her weight could reinforce her insecurities and unhealthy behaviors. "It might serve to fuel the disorder even further," Rollin says. "For most people who are struggling, there is no weight that their eating disorder will see as 'too thin.'" Instead, bring up specific behaviors that worry you: Mention that she seems withdrawn lately, or that she's stopped going out to eat with your crew.

3. "[Insert celeb here] looks anorexic."

"Anorexic" isn't a synonym for "skinny," and the word shouldn't be thrown around carelessly, especially not to bash or to glorify someone's body type. How you talk about eating disorders in everyday conversation will clue your friend in to whether she can trust you to listen without judging, so avoid using "anorexic" as an insult or a compliment, and show compassion when talking about celebs who have opened up about their struggles with eating disorders.

4. "Eh, who hasn't skipped a meal or two?"

Eating disorders are characterized by a pattern of self-destructive behaviors — it's not the same as running out the door without breakfast, so don't brush off your friend with a we've-all-been-there response. "That kind of normalization of eating disorder symptoms can really stop somebody from seeking the life-saving treatment that they need," Rollin says. As much as you want to reassure your friend or may not want to deal with the fact that she could have a real problem, remember that eating disorders are dangerous and you need to take her concerns seriously.

5. "I hate my thigh-jiggle too."

Resist the urge to bond over body insecurities. "Just because you've had a few days where you felt bad about your body, that's entirely different than the mental anguish someone with an eating disorder is going through," Rollin says. "It kind of trivializes their suffering." Plus, you don't want to normalize or encourage any destructive behavior. Your friend doesn't need you to relate — she just needs you to listen.

6. "Dude, are you manorexic?"

Guys can struggle with eating disorders too, but it's important to understand there's no such thing as manorexia — eating disorders go by the same name when guys have them. And they still carry all the same risks, so if you're worried about your BGF, speak up and direct him towards resources that can help.

7. "I wish I had your willpower!"

Remember your friend is losing weight because she's battling a potentially deadly disorder — it's a symptom of a serious illness, not something to envy or encourage. "Eating disorders aren't about willpower, and they're not a choice," Rollin says. "Tell her you understand she's not choosing to feel this way, but you know full recovery is possible, and you're here to support her."

8. "Gross. I hate throwing up."

If a friend is brave enough to open up to you about her eating disorder, steer clear of shaming her behaviors. "Stigma is something a lot of people with eating disorders already experience, so making judgmental statements only causes them to be less likely to reach out for help," Rollin says. A better response: "I'm here to support you. I understand you're not choosing to do this."

9. "You don't look like you have an eating disorder!"

Eating disorders can be invisible, so even if your friend looks fine to you, don't dismiss her concerns. "It could cause the person to struggle for much longer before seeking help," Rollin says. And someone with an eating disorder might even take this as a suggestion that they're not skinny enough yet. Instead of assessing whether she looks sick, say, "I didn't realize you were dealing with this. What can I do to help you?"

10. "You look so much healthier now!"

When someone's in recovery, any comment about her appearance can be triggering. No matter how stoked you are to see your friend getting her healthy glow back, stick with positive comments about her attitude or her inner strength. "Focus on other things like, 'You seem much happier,'"