Friday, July 18, 2014

How to help someone struggling with weight, food & body image issues

Originally published by Walden Behavioral Health:



What Not to Say: How to Help Someone Struggling with Weight, Food, and/or Body Image Issues.




There are no quick or easy solutions to help anyone who’s struggling with weight, food and/or body image issues.  Whatever is going on with food is only a symptom of the problem; the real problem usually is not about food.
People who binge are often trying to cope with uncomfortable or painful emotions.  They eat as a way of comforting or distracting themselves from these difficult emotions and conflicts, and can get so accustomed to using food that they never recognize the emotional trigger.
Therefore, it’s important thing to recognize that whatever is going on with food, it’s not about willpower.
In order to change their behavior with food, people have to identify and process painful, upsetting ideas, thoughts and emotions, and then change the way they respond when triggered.  You cannot make those changes for them.  All you can do is support them.
Allow yourself not to know all the answers about how to help the person you care about.  This does not make you any less of a friend, partner, parent, or sibling.  Admitting your lack of understanding of the problem demonstrates that you are human.  There are resources for help.  You do not have to be the expert.
Here are some guidelines for how to help.
DO NOT BECOME THE FOOD POLICE
Do NOT say, “Do you think you should eat that?”
Do NOT say, “Maybe you should make a healthier choice.”
Do NOT say, “Do you really need a second portion?”
Such a comment has never made anyone put down a fork, and declare, “I never thought of that.  I shouldn’t eat this.  Thank you for enlightening me.”
Avoid getting in discussions or arguments over weight and food. Do not give sermons about eating or get into battles about losing/gaining weight (you will lose that battle!).
DO NOT USE LOGIC
Do NOT say, “If you want to lose weight, just eat a little less.”
Here’s why logic doesn’t help.  What seems like a weight problem or a food problem is usually not about food at all.  Whatever is going on with food is a “symptom” of the problem.
In gardening, if you chop off a weed it grows back.  To eliminate a weed permanently, you have to dig out the root. Overeating is the equivalent of a weed.  To stop overeating, people have to identify and work through the conflicts and emotions that lead to overeating.
Talking about food or being logical isn’t going to help, because the focus is on the wrong thing.
DO NOT OFFER REASSURANCE
If your friend, spouse or loved one complains of looking fat or feeling fat, do NOT reassure them by saying, “ What do you mean? You look great.”
Think about it.  If you say, “You look amazing” to someone, has that person ever said, “Really? Thanks, I don’t feel fat anymore.”
Fat is a substance, not a feeling.  If someone feels “fat” she (or he) may be using the term “fat” as a default description for feeling unsatisfied, or wishing for more of something they’re not getting. They may feel fat because it’s preferable to feeling emotional.
Telling someone they look great doesn’t reassure them if on some level they’re using “fat” to express a fear that they’re not good enough, or because it’s easier to feel fat than to feel anxious, scared, vulnerable or upset.
DO NOT TALK ABOUT APPEARANCE
Although, overeating is about deeper issues than weight and food, commenting on anyone’s appearance can actually trigger abehavior. When people feel bad about themselves (comparing themselves to a celebrity who lost all her baby weight in three weeks can create bad feelings) they might turn to food for comfort or distraction.  Or they might feel as if they are under scrutiny.
All of this leads to feeling bad, which makes people more vulnerable to turning to food for comfort, distraction or just to numb out.
Thus far I have addressed what not to say.  If you want to find the right words to help, keep the following in mind:
DO ASK (CERTAIN) QUESTIONS
Ask what someone is thinking and feeling (not about what he or she is doing). Keep the focus on the inside person, not the outside appearance.
An effective way to communicate is to ask open-ended questions, which are questions that that can’t be answered with a yes or a no and which delve into the person’s thoughts, feelings and experiences.
A classic open-ended question is the classic question from therapists, “How do you feel?”   In contrast, closed questions are, “Are you upset?  Are you happy?”
Here are some examples of open-ended questions:
  • What do you want more of right now?
  • What would make you happier?
  • What are your hopes and fears about closeness?
  • What aspects of your life are satisfying? Unsatisfying?
  • What are you feeling right now?
  • What worries you?
  • What can I do to help?
Notice that all these questions are about the needs, wants, wishes, hopes and fears of the other person, not about their behavior with food.
DO TALK ABOUT FEELINGS:
The person you care about must feel safe to express disappointment, sadness, frustration, anger, fear and other emotions.  Do not protect her (or him) by avoiding uncomfortable topics.
Feelings are reactions to situations, not evidence of wrongdoing.  If someone you love or care about has an unhealthy relationship to food, you might feel worried, helpless, frustrated, angry, and bewildered.
Instead of judging and criminalizing your emotions, give yourself the right to feel what you feel.  Go ahead, get annoyed, frustrated, or enraged, but with this caveat:  allow yourself to be angry at the person’s behavior, not at the person.
Express your love and affection, as well as your concern and frustration. You will sometimes feel angry, frustrated, helpless, afraid, powerless, enraged and more.Expressing those feelings is good, as long as it’s done in a caring, gentle and non-judgmental manner.
By showing your feelings, you are providing the most direct permission for others to feel and express their feelings.   By communicating effectively, you can better understand the other person, and develop more a trust and a deeper connection.
Eventually, that may help your loved one turn to you for comfort and connection instead of to food.
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