Lisa Ellis of Integrating Nutrition On How To Support A Loved One Who Is Struggling With An Eating Disorder
Encourage your loved ones to get help. There are many support groups and treatment options available both virtually and in-person
It’s important to remember that seeking help is not a sign of weakness, but a courageous and necessary step towards healing and recovery. Encourage your loved one to explore support groups and treatment options affording a safe and supportive way to learn healthy coping mechanisms and develop new skills. Such resources can range from the sort of private counseling services I provide to organizations offering both virtual and in-person services.
Eating disorders are complex mental health conditions that affect millions worldwide, transcending age, gender, and cultural boundaries. They are not simply about food but involve a range of psychological, physical, and social issues. Supporting a loved one through this struggle can be challenging, requiring understanding, patience, and knowledge of the right approaches to truly make a difference.
In this series, we aim to shed light on the most effective ways to offer support, understanding, and hope to those battling an eating disorder. We are talking to psychologists, nutritionists, doctors, therapists, and survivors, who can provide valuable perspectives on nurturing recovery, fostering resilience, and promoting healthy relationships with food and body image. As a part of this series, we had the pleasure of interviewing Lisa Ellis.
She is a Registered Dietitian, Certified Eating Disorder Specialist and therapist in private practice in Manhattan and White Plains, New York, where she counsels children, adolescents, adults and families. Her areas of expertise include eating disorders and emotion-triggered eating.
Thank you so much for joining us in this interview series. Before we dive into our discussion, our readers would love to “get to know you” a bit better. Can you share with us the backstory about what brought you to your specific career path?
In high school — like so many other girls my age — I struggled with fad diets, weight fluctuations, comparisons, and perfectionism. We all learned about how we “should” look and “should” eat from magazines aimed at teen girls, promoting thinness… and I realize now, the Diet Culture industry. Like so many people, I grew up in a diet culture household that valued thinness. Of course, the term “Diet Culture” wasn’t even a thing then.
I decided to study nutrition in college with the goal of becoming a registered dietitian. I wanted to help not only myself but also others who might be facing similar struggles. I earned a B.S. in nutrition from Simmons University, and an M.S. in clinical nutrition from New York Medical College.
I was in private practice for a little while when I began to realize that traditional guidance approaches to dieting were, unfortunately, ineffective for too many people. This really hit home the day I was working with a young girl, a patient, whose mom was fat-shaming her in front of me during our appointment. The mom was upset and frustrated, the poor child ended up sobbing. It was super-clear that the girl’s disordered eating was rooted in deeper emotional struggles, and that me suggesting she eat more salad and less ice cream was not going to help heal her issues. So, I decided to explore healing methods that went beyond simply pushing restrictive diets.
I returned to school, earned an MSW from Fordham University, did my training at an eating disorder center, and discovered that I loved to work with that population. All the while I continued to explore new perspectives, embracing the value of intuitive eating, emotional awareness, and self-empowerment in nurturing a balanced relationship with food and body. With all that in mind, I wrote Why Did I Just Eat That? to help people heal their relationship with food, by providing a gentle, fresh perspective, self-diagnostic tools, and exercises I use in my practice that are tailored to specific eating issues.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
Certainly, my favorite life lesson quote is, ‘If it doesn’t matter in five years, it doesn’t really matter.’ This quote has been instrumental in helping me refocus my energy on things that truly matter in the long run. Early in my career, I found myself caught up in the pursuit of perfection, and I would worry about every little detail. But as I embraced this idea and understood that I have the power to choose where I direct my focus, I realized that many things simply aren’t worth losing sleep over. This shift in perspective has been invaluable to me both personally and professionally, and it’s something I often share with my clients who struggle with anxiety and food-related issues, especially since the two are often related. It’s a great reminder to prioritize what’s truly important in life.
Are you working on any exciting new projects now? How do you think that will help people?
My first book was launched in January of this year, and I’ve started work on a follow-up book aimed at teen readers. There is clearly a need in that age group for information that pushes back against much of the diet-culture influence on social media. I’ve also been creating on-line support groups to benefit people who otherwise couldn’t afford individual support or assist those from areas that don’t have ED-savvy support.
According to this study cited by the National Association of Anorexia Nervosa and Associated Disorders, at least 30 million people in the U.S. of all ages and genders suffer from an eating disorder. Can you suggest 3–5 reasons why this has become such a critical issue recently?
- The COVID-19 pandemic has undoubtedly contributed to the rise in eating disorders. The sudden loss of control, increased isolation, and heightened anxiety have left many people searching for coping mechanisms. It was sort of a perfect storm of eating disorder triggers. For some, food became a source of comfort, leading to patterns of overeating, while others sought solace in restrictive eating behaviors as a means to regain a sense of control. We are still feeling its effects today.
- This is not a recent phenomenon, but… our culture’s obsession with dieting and the unrealistic expectation that everyone should strive for a specific body type has perpetuated feelings of shame and inadequacy. This “one-size-fits-all” mentality fails to recognize the natural diversity of body shapes and sizes. In response to societal pressure, individuals may engage in extreme dieting behaviors that resist their own natural body type, which can ultimately result in cycles of restriction and overeating.
- Social media platforms have played a significant role in exacerbating body dissatisfaction and promoting fad diets. Constantly being bombarded with images of “ideal” bodies — many of them digitally altered — and seemingly perfect lives can lead to unhealthy comparisons and unrealistic expectations. This social media culture fuels the desire for instant results, often pushing people towards dangerous eating practices.
- Unfortunately, even the medical community can contribute to the rise in eating disorders by placing excessive emphasis on weight loss. Patients who are made to feel ashamed or judged for their body size may develop negative associations with food and engage in harmful eating behaviors. They may also avoid regular physicals out of fear of being weight shamed. It’s crucial for healthcare professionals to prioritize patients’ overall well-being and mental health, rather than focusing solely on weight or unreliable standards such as those promoted by BMIs (Body Mass Indexes).
Based on your insight, what can concrete steps can a) individuals, b) corporations, c) communities and d) leaders do to address the core issues that are leading to this problem?
- Individuals — Practice body acceptance by refraining from making judgmental comments about others’ bodies. Remind yourself that someone’s body shape or size is their personal matter. Focus on cultivating a culture of respect and empathy, starting with your own actions and words.
- Corporations — Promote diverse and inclusive representation in media by featuring models with various body shapes and sizes. Increase the minimum BMI requirement for models to encourage healthier industry standards. Doing so can help dispel unrealistic body expectations and contribute to a more body-positive environment.
- Communities — Develop and implement educational programs that celebrate body diversity and promote self-acceptance. Encourage schools and parent groups to actively participate in these initiatives. By fostering open dialogue and offering resources, communities can combat harmful misconceptions and provide support for those in need. Outreach to the medical community is particularly critical (I’ve had too many 5–10 year olds tell me that they need to lose weight because their doctor told them that their BMI was too high.)
- Leaders — Advocate for responsible social media practices to reduce the prevalence of potentially triggering content. Collaborate with technology companies to improve algorithms and protect vulnerable users. Additionally, create policies that support accessible, affordable, and comprehensive treatment options for individuals struggling with eating disorders, recognizing the life-or-death nature of these conditions. Encourage physical inclusivity and diversity.
As you know, one of the challenges of an eating disorder is the harmful, and dismissive sentiment of “why can’t you just control yourself”. What do you think needs to be done to make it apparent that an eating disorder is an illness just like heart disease or schizophrenia?
Changing how people see eating disorders starts by inspiring key players — such as parents, teachers and healthcare providers — to understand the complex, multifaceted nature of eating disorders. By sharing accurate information and challenging misconceptions, we can create more understanding and empathy. It’s vital to show the complex reasons behind eating disorders, not just spinning it down to self-control. That way, those affected get the help and support they need without fear of judgment. And by fostering empathy, we might better equip these guiding authority figures to recognize the signs and symptoms of eating disorders.
Here is the main question of our interview. Can you please share with our readers 5 ways to support a loved one who is struggling with an eating disorder? If you can, can you share an example from your own experience?
1 . Be actively empathetic by helping them understand that an Eating Disorder is not their fault.
Of course, your loved one should not feel guilty or ashamed about their Eating Disorder struggles. Remind your loved one that their Eating Disorder is not a result of a character flaw; instead it may be a condition actually influenced by their brain chemistry. (In fact, there is growing research suggesting many people have a genetic tendency to develop an Eating Disorder.) Empathy and compassion on your part are powerful tools, and go a long way toward providing support, understanding, and a safe space for them to face their eating, food, and/or body issues without fear of judgment.
As a teen, I believed my disordered eating came from a lack of willpower and my own (perceived) personal flaws. I blamed myself for not maintaining a rigorous diet and not attaining the idealized body image, and I thought not having the “perfect” body made me less-than.
2 . Be careful on how you exhibit your support
The words we choose to use can have a profound impact on those navigating the challenges of Eating Disorders. Of course, you want to feel like you are guiding them constructively. But it is essential to be mindful of where you place your focus. Shift away from guidance that may unintentionally cause harm or perpetuate self-blame. For example, asking questions like “Why can’t you just eat?” to someone with Anorexia or “Why can’t you just stop eating?” to someone with Binge Eating Disorder can be triggering; making things worse by inflaming feelings of guilt and helplessness.
When I was a kid, the frequent “helpful” comments from loved ones about my eating habits and weight loss goals only made things worse. Their remarks triggered my self-doubt, and made me feel like my worth came down to my weight and appearance.
3 . Avoid commenting on their weight or appearance.
Obviously, making negative or judgmental comments can be upsetting to anyone struggling with eating issues, no matter the severity of the disorder. But did you know that making comments meant to be positive can also be triggering? Even well-intentioned remarks like “I see you’ve lost weight! Keep it up!” can inadvertently reinforce unhealthy behaviors and negative thought patterns, causing more harm than good. So it is best to not comment on their body or eating habits at all. Rather than focusing on specific physical attributes — unless they ask you directly — you might instead support them by acknowledging that they look well and happy. Celebrate their strength, resilience, things unrelated to their weight or appearance. Any encouragement should emphasize their inherent worth and value… not their outward appearance.
When I was a kid, there was a lot of discussion about the looks and body shapes of friends and relatives. Some of it was negative and dismissive, but even the positive remarks were filled with something negative: hidden judgements, or suspicion, or envy. And even positive remarks to me, about me felt like warnings… “You look great!” had an unspoken “Don’t you back-slide now!” attached. Also, there was a lot of focus on “healthy” eating; what food was okay and what food was off-limits. It all added fuel to the fire, making my disordered eating that much harder to deal with.
4 . Be aware of your responsibility as a role model.
Demonstrating healthy behaviors is an important part of supporting a loved one with an Eating Disorder. Modeling a balanced approach to your own eating habits and self-image fosters a supportive environment that promotes recovery for others. And consistency is key: for example, encouraging your loved one to eat carbohydrates while restricting them yourself sends mixed messages, undermining your credibility as a supportive presence. Equally important, expressing dissatisfaction with your own body or commenting on the bodies or eating habits of other people may reinforce harmful attitudes and contribute to the triggering of eating issues. Remember that our actions are the unspoken language of support.
In my case, it didn’t help that — when I was a teen — my family members would go on about their latest diets, how much they “needed” to diet, and what parts of their bodies they didn’t like. It was a constant reminder of everything I was struggling with, and reinforced that mindset.
5 . Encourage your loved ones to get help. There are many support groups and treatment options available both virtually and in-person
It’s important to remember that seeking help is not a sign of weakness, but a courageous and necessary step towards healing and recovery. Encourage your loved one to explore support groups and treatment options affording a safe and supportive way to learn healthy coping mechanisms and develop new skills. Such resources can range from the sort of private counseling services I provide to organizations offering both virtual and in-person services.
Moreover, to those in need, there are low-cost or even free options offering assistance with Eating Disorders. Some of the options include:
The National Eating Disorders Association (NEDA) https://www.nationaleatingdisorders.org/ offers a helpline, support groups, and online resources, and can also help connect people with low-cost treatment options in their area.
The National Association of Anorexia Nervosa and Associated Disorders (ANAD) https://anad.org/ provides a free helpline, online support groups, and information on affordable treatment options.
Eating Disorders Anonymous (EDA) https://eatingdisordersanonymous.org/ offers free, peer-led support groups in various locations, as well as online meetings.
Additionally, Many universities and community health clinics offer low-cost or sliding-scale therapy services, often provided by graduate students under the supervision of licensed professionals.
How do you navigate the balance between offering support and respecting the autonomy of a loved one with an eating disorder?
Balancing support and autonomy for a loved one with an eating disorder can be tough. When someone’s brain is malnourished, it becomes increasingly difficult for them to think clearly and make constructive decisions. This is when they may require more firm external support. Family-based treatment is particularly effective for younger individuals struggling with anorexia, especially for younger patients. As they recover and their brain function improves, they can gradually regain autonomy over their choices. In cases of something like binge-eating disorder, it might be easier to grant autonomy sooner, as the immediate risks are typically less severe compared to anorexia. The key is staying compassionate, understanding, and flexible while supporting them and ultimately encouraging their independence.
Is there a message you would like to tell someone who may be reading this, who is currently struggling with an eating disorder?
Recovery from an eating disorder isn’t in a straight line — there will be ups, downs, and stumbles along the way. So be patient with yourself as you learn new, beneficial ways to cope that don’t revolve around food. The most important thing to remember is that hope is on the horizon. Most people recover from their eating disorders, and with dedication, support, and self-compassion, you will too!
In your experience, what are the most effective strategies for building resilience and a positive self-image in individuals recovering from an eating disorder?
Individuals recovering from an eating disorder should first set and respect their own boundaries, both with others and with themselves. Part of that is finding their own voice and practicing self-expression to develop a stronger sense of identity. Also, with self-compassion, take steps toward being accountable for actions taken — both the good and the not-so-good — to foster honesty and self-awareness. It is also important that they learn to honor their body’s internal hunger and fullness cues to re-establish a healthy relationship with food.
Finally, they should absolutely be selective about the people they surround themselves with and listen to. Supportive, understanding relationships can greatly aid in recovery, but unsupportive ones can hamper it.
What are your favorite books, podcasts, or resources that have helped people with this struggle? Can you explain why you like them?
Podcasts:
I find each of these podcasts enjoyable to listen to, with informative guests, and they share good information. Christy Harrison’s podcast has been around the longest, I believe, and I’ve worked with the Renfrew Center, but they’re all worth your time.
“Food Psych Podcast,” hosted by Christy Harrison.
“All Bodies. All Foods” podcast by The Renfrew Center, a pioneer in comprehensive treatment for eating disorders, offering residential and outpatient services across the U.S..
“The Eating Disorder Trap” with Robyn Goldberg.
Rebecca Scritchfield’s “Body Kindness Podcast”.
Books:
There are so many good books, but the ones that really stand out for me are:
Evelyn Tribole and Elyse Resch’s ground-breaking book, Intuitive Eating: A Revolutionary Anti-Diet Approach.
The Eating Disorder Trap by Robyn Goldberg.
8 Keys to Recovery from an Eating Disorder by Carolyn Costin.
Life Without Ed: How One Woman Declared Independence from Her Eating Disorder and How You Can Too by Jenni Schaefer.
As far as apps go, I have less experience, but really like one:
InsightTimer. Very effective and easy to navigate.
You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the largest amount of people, what would that be? You never know what your idea can trigger. 🙂
If I were to promote a movement, it would be called “Going for the Gray.”
A lot of people are all or nothing when it comes to eating. And there is often a connection between eating issues and anxiety. One of the ways we tend to manage our anxieties is through trying to get a handle on our world by controlling as much of it as we can. One way the impulse to control shows up is through perfectionism. And perfectionism is a major trigger of Black-and-White-Eating issues.
Perfectionism and Black and White Eating thinking both often have an “all or nothing” aspect at the root. The all-or-nothing aspect views eating choices in strictly opposing terms. You either do your diet with complete, 100% perfection, or you just bail on it totally.
It often works like this: people go on a strict diet, and then do something like eat a couple of cookies and then tell themselves that the diet is ruined, so they might as well eat the whole box. This can lead to binging, or it can lead to other poor nutrition habits. This often ends in a yo-yo cycle of extreme restriction followed by complete abandonment of dietary guidelines. Ironically, the very act of trying to gain control through perfectionism can actually contribute to losing control and exacerbating disordered eating patterns.
So I recommend that my clients who are Black-and-White-Eaters go for the Gray… that is, give up on unattainable perfectionism in exchange for an outcome that is very attainable, through attitudes like “just-do-your-honest-best” and “good enough is good enough.” This mindset shift can alleviate pressure and encourage a more sustainable relationship with food.
Such a new perspective can have a ripple effect, touching every aspect of our lives. “Going for the Gray’’ isn’t about settling; it’s about finding a healthy balance and accepting ourselves, imperfections and all. With that mindset, we can realize that perfection isn’t the path to happiness — space for growth and self-compassion are.
How can our readers continue to follow your work online?
I have two websites, one for my private practice ( https://integratingnutrition.com/ ) and one that is a companion website for my book, Why Did I Just Eat That?: How to Let Go of Emotional Eating and Heal Your Relationship with Food ( https://whydidijusteatthat.com/ )
Thank you so much for these insights! This was so inspiring!
About the Interviewer: Yitzi Weiner is a journalist, author, and the founder of Authority Magazine, one of Medium’s largest publications. Authority Magazine is devoted to sharing in depth “thought leadership interview series” featuring people who are authorities in Business, Tech, Entertainment, Wellness, and Social Impact.
At Authority Magazine, Yitzi has conducted or coordinated thousands of empowering interviews with prominent Authorities like Shaquille O’Neal, Peyton Manning, Floyd Mayweather, Paris Hilton, Baron Davis, Jewel, Flo Rida, Kelly Rowland, Kerry Washington, Bobbi Brown, Daymond John, Seth Godin, Guy Kawasaki, Lori Greiner, Robert Herjavec, Alicia Silverstone, Lindsay Lohan, Cal Ripkin Jr., David Wells, Jillian Michaels, Jenny Craig, John Sculley, Matt Sorum, Derek Hough, Mika Brzezinski, Blac Chyna, Perez Hilton, Joseph Abboud, Rachel Hollis, Daniel Pink, and Kevin Harrington
Yitzi is also the CEO of Authority Magazine’s Thought Leader Incubator which helps business leaders to become known as an authority in their field, by interviewing prominent CEOs, writing a daily syndicated column, writing a book, booking high level leaders on their podcast, and attending exclusive events.
Lisa Ellis of Integrating Nutrition On How To Support A Loved One Who Is Struggling With An Eating… was originally published in Authority Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.