A person may not wish to attend family events or socialise with friends. Being uncertain about food-centred activities, potential comments or being compared to others makes such situations particularly challenging for those with an eating disorder. Family members may be unsure about approaching the issue, whilst friends may not send invites to activities such as parties or the cinema.
Social isolation is a common consequence of an eating disorder and poor or low social support is also a potential risk factor for the development of eating disorders. A lack of regular positive social interactions can mean fewer opportunities to access support and this, in turn, can worsen a person’s eating disorder. The secrecy and behaviours involved in eating disorders can make it hard to form trusting relationships and seek support.
It is necessary, therefore, to think about recovery as not just a physical and mental process, but one that has a social aspect too. Research with people with eating disorders has noted that recovery is influenced by a person’s sense of self and connection with others. Social groups, peer support, connections and relationships and developing emotional bonds through regular interactions with others, are vitally important for a person’s health. Support such as speaking to health professionals, key relationships with family and friends can positively influence recovery. As a part of this, people need to feel that their situation and symptoms are not being ignored, denied, avoided or minimised. Websites and online supports and forums may also be sources of social support for some people to speak openly about their needs and challenges.People with eating disorders may perceive themselves as different from others, and although they sometimes wish to connect with others, they can feel alienated from them. Stigma related to attention seeking, being seen as personally responsible for the illness and recovery, and a sense of being treated negatively, can all hinder help-seeking. Positive support interactions, peer-to-peer groups and a shared understanding of eating disorders can lead to empathy and a desire for positive outcomes. A sense of relief, reduced feelings of isolation and a hope to continue towards recovery are some of the benefits of group membership and interactions.
Recovery is challenging and can involve negative feelings such as fear, anxiety and guilt. For some people, trying to imagine themselves as ‘recovered’ can feel daunting and in particular, if recovery is defined as returning to ‘normal’ this can also feel like a barrier to getting there. Reaching out, disclosure and engagement with health services are important factors in recovery. This contrasts with the nature of an eating disorder which often encourages secrecy and limited contact with others.