How to help a loved one with an eating disorder: be with them, reassure them, and avoid temptation to problem solve, says author who overcame anorexia nervosa
- Mental health advocate Stephanie Ng shares her experience of anorexia nervosa in a book she hopes will educate and empower others to speak up and get help
- ‘I wish people knew how painful the inner battle is,’ says Ng, who credits her mother for seeking out capable therapists for her – and knowing when to step back
Stephanie Ng’s Facebook memories recently turned up a blast from the past that reminded her of just how far she has come in her relationship with her body.
The photograph of herself as a teenager, grinning and holding a bottle of slimming cream, was captioned, “I’m stoked I’m getting this for my birthday”.
Her relationship with food and her body began to change in her early teens. At the age of 16, she was diagnosed with anorexia nervosa – when individuals severely limit how much they eat or drink.
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The eating disorder that would take control of her life crept up on her slowly. It was not in response to a single big trauma, but rather a means of coping with what was going on internally, adjusting to changing hormones and friendships.
She reflects on her eating disorder, her recovery and the pressure of diet culture in her newly published book, Big Bites Break Boundaries.
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She was in her second year of high school and the flood of compliments from peers and teachers came as a pleasant surprise.
She became keenly interested in exercise and devoured books, magazines, workout DVDs and YouTube videos on physical fitness. Along the way, she picked up the language of diet culture.
“I learned that food contained ‘threatening’ substances called ‘calories’ and that the main purpose of exercise was to get rid of them as quickly as possible. I learned that appetite was to be strictly controlled, and cravings denied,” she writes in Big Bites Break Boundaries.
“That identity seemed like a better alternative to being a nobody. I knew I wasn’t going down the right track in my pursuit of health, but there was also this familiarity with food,” she said.
The turning point came on January 12, 2012, a day that she refers to as “Death Day”. That was the day her doctor could not detect her pulse – the doctors had to resort to using a manual pumping device to check her heart rate – and she was told she would have to be admitted to hospital.
Through the haze of her eating disorder, she understood that something was seriously wrong when she was more worried about being force fed than dying. Seeing her family so distressed, she determined to shift her trajectory, if not for herself then for them.
“When people see someone with an eating disorder they see the physical body and think that’s the worst part of it, it’s just someone who is really skinny. I wish people knew how painful the inner battle is,” she said.
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With hindsight, she recognises that the sense of perfectionism that she had applied to food and exercise she then applied to her work and productivity.
“It was a shape shifting of the disorder. I was more open with eating and exercise, but I became very rigid about time in a bizarre way, how much time I could spend on a particular activity. That same mindset was still hanging around and manifesting in a different world,” she said.
Her supportive parents – including her mother, with her buckets of patience – sought out professionals to help with her recovery.
Interestingly, the ones who looked the most impressive on paper were not the ones who helped effect change.
One therapist, well qualified in the field of eating disorders, read her the clinical diagnosis of her eating disorder directly from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) – the standard classification and diagnostic tool for mental disorders – something Ng did not find helpful.
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The therapists who really supported her were the ones she connected to, who listened to her and made her laugh.
“They saw me as not just a sick person, a patient or a client. They were kind and wanted to understand me beyond the disorder,” she said.
Recovery is difficult, not just for the person recovering but for those around them. There came a point at which her mother reached the end of her rope and said she needed some time to herself.
Even if a reader can’t relate to the eating disorder they can relate to not meeting a particular standard
In the moment, Ng said that felt terrible, but she now recognises that her mother asserting her own boundaries was very healthy.
For anyone supporting someone with an eating disorder, Ng says one of the most helpful things to do is to just sit and be present with that person. And, crucially, avoid the temptation to prescribe or problem solve.
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“Just being there and saying, ‘That sounds horrible, I can’t imagine how that must feel’ is so reassuring to hear. Or say, ‘If you want to seek help, I’ll come with you. When you are ready, I’ve got you.’ But if it’s a life-or-death situation, they need you to be more forceful,” said Ng.
She wrote the book with her 15-year-old self in mind as the reader, but says it will also appeal to a broader readership of those concerned with breaking out of their “identity box”.
“Hong Kong has a culture of perfectionism and achievement. Even if a reader can’t relate to the eating disorder they can relate to not meeting a particular standard,” said Ng.
Her recovery required a psychological shift to acknowledge and accept that she deserves to be fed without conditions. The next shift was accepting that she is worthy of being loved even if she is not perfect. And this year she has started dancing.
“Dancing has taught me that I can suck at something and still love it,” she said.
