Today is international day of friendship and we are celebrating! Without strong, supportive friendships, recovery from an eating disorder would not be possible. We all need caring, loving friends in our corner, especially during the difficult parts of life and eating disorder treatment is one of those difficult parts. My experience in adolescent eating disorder treatment in Columbus, Ohio has taught me a lot about eating disorders impact on adolescent friendships. I have worked in child and adolescent eating disorder treatment centers in Columbus, Ohio and seen examples of wonderful, supportive teenage friendships and examples of hurtful and traumatizing teenage friendships. I will share the ways in which I have seen eating disorders negatively impact friendships as well as the ways I have seen friendships positively impact eating disorder recovery.

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Let’s start with the not so good. Unfortunately, many teens have shared with me that their experience with an eating disorder had a negative impact on their friendships.

Eating disorders, (anorexia nervosa or bulimia nervosa in this scenario), can be very all-consuming and isolating. Eating disorders live in secret and thrive when no one knows what is going on, allowing behaviors to continue. This clearly impacts closeness and relationships with peers. Eating disorders do not want other people to know about the behaviors they are engaging in (restricting food, throwing up or purging, excessive exercise, counting calories) because #1, there may be shame about engaging in these a-typical behaviors and fear of judgement from friends, and #2- if others know about these behaviors, they may intervene and try to make the person stop. Whether by calling parents or telling their own parents or a teacher, children want to help their friend. This can cause children with an eating disorder to isolate and spend less time with their friends. If their friend does notice something isn’t right and tells an adult, this can be the first rupture in the friendship. A child with an eating disorder may not see that their friend was trying to help and see it as a betrayal of trust.

Eating disorders also cause dishonesty and comparison.

ED’s, as mentioned before, thrive in secret. This can lead to a child hiding the truth from parents or friends and lying, when that is not a typical behavior they ever did before. It can also cause fierce comparison with others, even friends, especially in preteen and teenage girls. If the eating disorder is constantly comparing, in person or on social media, and focusing on body image, this can lead to tension and feelings on uneasiness in the relationship. Friends may feel like the person with an eating disorder is always judging their body or appearance. If someone is constantly talking about their own body or what they are eating, it is natural to think they are thinking about your body or what you are eating. This can be really uncomfortable for teens, who are already feeling awkward in their changing bodies.

Eating disorders also tend to steal joy and happiness from children and teens. Many parents will say “I just want my child back. He used to be so happy and funny and carefree”.

Eating disorders can numb feelings or joy and enjoyment. They can also increase depression and anxiety. This can affect friendships as well because teens don’t know how to help someone dealing with serious mental health issues. They may want to help, but they are not trained professionals. They also miss their old friend who was happy and carefree.

Once children and teens with anorexia nervosa or other childhood eating disorders get treatment and professional help, friendships can be impacted in a different way. Sometimes eating disorder treatment requires missing school, sports, and other activities. This can make it difficult for children to maintain relationships and closeness when their activities are limited. Eating disorder treatment also often requires a lot more adult supervision that typical and this can make it challenging to have sleepovers or go out in the same ways they used to. The thing to note is this is all temporary. It is important to help children maintain social connections in treatment in ways that are appropriate and safe. You can discuss this with your child’s treatment team to get ideas on how to best navigate maintaining friendships during treatment. Your child will also be under a lot of stress and may not be in the best place emotionally to spend a lot of time with friends. They may feel more supported with texting or facetiming friends as a way to stay connected with a safe distance and space.

Treatment is not easy for teens and having an outside support who is just there to listen and be on their side can have an enormous impact on their recovery. Family has to be involved in eradicating the eating disorder, so they will not always be able to listen when your child just wants to vent about how difficult recovery is. A friend can be a great neutral party to do that. Friends can also be a great way to keep your child’s mind occupied with something other than the eating disorder. Treatment takes a lot of time and talking about the eating disorder and sometimes it can be a great distraction for your child to hear about the school gossip or what happened in math class. This will look different for every child and teen. Younger children will want to play and have fun with their friends when they have a break from treatment. The thing to watch is that they are not doing too much physical activity if it is not in their movement plan. Try board games, watching a movie, crafts & art projects. Older teens may want a break from their parents, but need supervision. Think about allowing them to do something with a trusted aunt or uncle or older sibling, outside of meal and snack times.

Friendships can be a great assets to recovery and a huge motivation for your child. They want to return to normal. Staying connected to supportive friends can help remind them what they are working to get back to. It can help them feel they are not alone. Make sure that friends they are spending time with during recovery are not suffering from their own eating disorder as this can be extremely triggering and dangerous to recovery. Also make sure that the friends they are spending time with know about the eating disorder and encourage your child to be open about it. Make sure their friends aren’t making and triggering comments and if they are, make sure to talk with your child afterwards about how they want to handle it and what they can say if it happens again. Recovery is a sensitive time and small comments about food or body image can have a big impact on your child.

Parents make sure you are spending quality time with your friends too! It may be hard to open up and share about the eating disorder, but try to find good friends who will listen and be understanding- and that won’t be everyone! But those that do will be your biggest asset during recovery. We can’t do it alone! We all needs friends to help us get through. And sometimes we have to teach our friends how to help us- by telling them what to say and what not to say- and that’s ok! We are all human and we are all learning.

Here's to friendships! May we all be the friend that we need.

Eating Disorders do not go away on their own- they require help from a professional therapist and a strong support team of parents, loved ones, dietitians and doctors. Inquire on my website today for more information on eating disorder treatment in Columbus, Ohio and to get started with your child’s eating disorder treatment today.

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This blog is intended to be educational and informational and does not substitute for professional medical and therapeutic help, which is highly recommended when treating an eating disorder. If you would like help treating your child’s eating issues or want to learn more, Schedule a free consultation call today.