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. Social anxiety can further contribute to avoidance and difficulties in social interactions for those with eating disorders, making it harder to maintain friendships and participate in social relationships. These challenges often stem from disruptions in interpersonal relationships, which are crucial for emotional well-being and recovery.
Introduction to Eating Disorders
Eating disorders are serious mental health conditions that involve persistent disturbances in eating behaviors, often driven by concerns about body image, weight, and self-esteem. The most common eating disorders include anorexia nervosa, bulimia nervosa, and binge eating disorder. These disorders can affect anyone, but they are especially prevalent among young adults and female adolescents. Eating disorders are not just about food—they are often linked to deeper mental health problems, such as anxiety disorders, depression, and substance abuse. The impact of these conditions extends far beyond the individual, influencing their physical health, emotional well-being, and relationships with others.
Definition and Clinical Characteristics
Each eating disorder has its own unique set of symptoms and challenges. Anorexia nervosa is characterized by extreme restriction of food intake, an intense fear of gaining weight, and a distorted body image, often resulting in significant weight loss and health complications. Bulimia nervosa involves cycles of binge eating followed by compensatory behaviors like vomiting or excessive exercise, which can be physically and emotionally exhausting. Binge eating disorder is marked by repeated episodes of consuming large amounts of food in a short period, often accompanied by feelings of loss of control and distress, but without the purging behaviors seen in bulimia. All of these eating disorders can have severe consequences for both physical health and emotional well-being, making early recognition and intervention crucial.
The Impact of Eating Disorders on Friendships
Eating disorders can deeply affect a person’s ability to connect with others and maintain healthy friendships. Disordered eating behaviors and preoccupation with body image can lead to social withdrawal, making it difficult to participate in group activities or enjoy time with friends. For example, someone with anorexia nervosa might avoid gatherings that involve food, while a person with bulimia nervosa may feel compelled to hide their behaviors from others, leading to secrecy and isolation.
Social anxiety and fear of judgment can further complicate these relationships, resulting in a cycle of loneliness and disconnection. Over time, these challenges can erode the foundation of trust and support that friendships are built on, making it harder for individuals with eating disorders to maintain meaningful social relationships.
Social Challenges and Support Among Friends
Navigating friendships while struggling with an eating disorder often involves unique social challenges. Social comparison—especially around body shape, weight, or eating habits—can intensify feelings of inadequacy and low self-esteem, making it difficult to feel comfortable or accepted within a peer group. This sense of competition can create barriers to forming and maintaining meaningful relationships, as individuals may feel they don’t measure up to their friends.
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.
Meals or food-related events tend to be particularly difficult for those with eating disorders. A common thing to do with friends is to 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 are 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.
Navigating Communication and Understanding
Open and honest communication is essential for maintaining friendships when eating disorders are involved. Individuals with eating disorders may need to express their boundaries, such as avoiding certain social situations or asking for support during challenging times. Friends can help by educating themselves about eating disorders, being mindful of their language, and steering clear of conversations that might trigger negative thoughts about body image or food.
By fostering an environment of empathy and understanding, both parties can work together to strengthen their relationship. Supporting a friend through an eating disorder is not always easy, but with patience, compassion, and clear communication, it is possible to build a foundation of trust and support that benefits everyone’s mental health.
Final Thoughts
Although eating disorders can significantly disrupt interpersonal relationships, the presence of strong social support is often associated with better recovery outcomes. Friends who provide consistent empathy, open communication, and nonjudgmental acceptance can reduce feelings of isolation and reinforce positive coping strategies. Asking individuals directly about their needs and preferred methods of support fosters trust and may lessen anxiety during periods of heightened distress. Such relational dynamics highlight the vital role friendships play in promoting resilience and long-term psychological well-being.
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
- 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
- Malmendier-Muehlschlegel, A., Rosewall, J. K., Smith, J. G., Hugo, P., & Lask, B. (2016). Quality of friendships and motivation to change in adolescents with Anorexia Nervosa. Eating behaviors, 22, 170–174. https://doi.org/10.1016/j.eatbeh.2016.06.010
- 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
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.