Loneliness and eating disorders: a guide for parents

Jill is beside herself with worry. Her daughter Melody has an eating disorder and is struggling with loneliness. Between treatment, COVID restrictions, and starting high school, she has become very isolated. “She has always been more on the introverted side,” says Jill. “But it’s gotten to the point where I’m pretty sure she doesn’t have a single good friend.”

“She has people she talks to in class,” says Jill. “But there’s nobody she can call or share notes with or hang out with after class or on the weekend. I think that loneliness is making it harder to recover from her eating disorder. But loneliness is also partly driven by the eating disorder. I don’t know what to do.”

Jill’s worry makes a lot of sense. And she’s right that loneliness is both a contributing factor to and a symptom of an eating disorder. Melody is naturally introverted. But she’s also been hit with a triple whammy: a pandemic, the transition to high school, and eating disorder recovery.

Loneliness and social isolation

Loneliness is a major factor in mental and physical health. In fact, social relationships are the most important lifestyle factor in longevity. Social connections are even more important to health than avoiding tobacco and alcohol. Humans are social beings, and connecting with others is essential to our health and well-being.

How to help a child who has an eating disorder decrease loneliness

Of course parents like Jill desperately want their kids to form social connections and feel a sense of belonging. This is especially important during the teenage years, so it’s understandable that Jill is concerned. But what can she do? How can Jill help Melody reduce her loneliness during eating disorder recovery?

Friendships lead to positive life satisfaction, minimize stress, and even contribute to better physical health outcomes. And the good news is that there is a lot that parents can do to support social connections. Here are five places to start:

1. Reduce the pressure

The first thing to know is that every person has a different need in terms of social connections. And while most of us think about a large pack of kids getting together on the weekends, it’s perfectly acceptable if your teenager has just one or two good friends. In fact, set your sights very low: one.

“The biggest return we get in friendship is going from zero to one friend in terms of its impact on our mental health and well-being,”  says Marisa Franco, author of Platonic: How the Science of Attachment Can Help You Make — and Keep — Friends. “If you can get that deep with one person, it’s going to be powerful and it’s going to be impactful, and you don’t need to have a ton of friends.”

Taking the pressure off having a large number of friends can be a great place to start. Find ways to weave this idea into your conversations with your child. You can talk about your own friends individually vs. as a group. And when your child complains about having no friends (plural), help them understand that just one friend would be awesome. Encourage them to look around for just one person at school who they can eat lunch with. Set your sights low, and normalize the idea of just one friend.

2. Family relationships

Your child wants and needs peer friendships, but that doesn’t mean they can’t get a lot of benefits from their social connections with family.

Our first social group is our family. How strong are your family ties? Does your child feel integrated and as if they “belong” to your family? Start by building family traditions and telling stories that help your child see how they fit into the family. Spend time building family integration every single day. A great place to begin is a family meal, which has countless health benefits, probably in part because of the social belonging it builds.

If possible, schedule activities with extended family members. It’s OK if you don’t have a strong connection with biological family – can you build a family of friends? Do what you can to expand your child’s social interactions within the scope of your family. And don’t forget to help them integrate into family activities. This may be uncomfortable if your child is feeling lonely and vulnerable, but parents can help grease the wheels of interaction!

3. Social skills

If your child is struggling with loneliness and an eating disorder, combined with COVID and a major transition like starting high school, they may need to brush up on their social skills. This can be a tricky area for parents to get involved, but the first thing to consider is whether your family is upholding and modeling good social skills.

Many families slip into dysfunctional patterns of not being friendly, not speaking politely to each other, not managing their emotions, and acting out against other family members. If you see these dynamics in your family, then get some coaching or family counseling to work on interpersonal boundaries and emotional regulation. Before you decide that your child is the one who has a problem with social skills, consider whether this is a family dynamic. It will hurt your child’s chances of success if you treat a family problem as if it is a personal failure.

Next, talk to your child about social skills. The easiest way to do this is to talk about your own experiences or use characters on TV and movies. Ask questions like: How would that behavior make you feel? What do you like about that character? How do you think that character could be a better friend? Remind your child that relationships can’t be adequately portrayed in the media, and that just like bodies, we need to take media relationships with a grain of salt.

4. Formal social groups

Teens have undergone tremendous upheaval in the past few years, and lots of them are struggling with loneliness. This is the perfect time to use formal social groups and organizations to help support social development. Ask your child to investigate clubs at school.

Many schools have a wide variety of clubs that appeal to a broad array of personalities and interests, but you can also look for clubs in the community and at your place of worship if you have one.

Encourage your child to join at least one club. This may require some well-placed parental pressure. Someone who is lonely may resist the idea of joining a club because they are stuck in a cycle of feeling low. It’s OK for you to insist on some participation. You can’t force your child to go, but don’t underestimate the power you have to influence them to give it a try. Sometimes lonely kids need a lot of verbal encouragement and requests to get out of their rut.

5. Get help

If you do all these things and your child’s loneliness is not lifting at all, then you and your child need more help. Talk to your child’s eating disorder care team. They are probably as concerned about loneliness as you are. Find out if they have any suggestions or can help your child get involved in activities. Sometimes having a non-parent make these suggestions is the key to getting them done.

A worthy focus

Loneliness is a contributor to the psychology of an eating disorder, so supporting them in addressing this is a worthwhile activity. You want to understand your child’s loneliness and support them in feeling better. Loneliness has been correlated with eating disorders and other mental disorders. It is also correlated with the No. 2 and No. 3 mortality factors: tobacco and alcohol addiction.

Jill was relieved to know that she wasn’t being silly worrying about loneliness. “There was a part of me that thought maybe I was worrying about nothing,” she says. “Or that this is none of my business. But now I feel as if my worries make sense, and I’m going to take some action to start helping Melody feel better.”

See Our Parent’s Guide To Mental Health And Eating Disorders

---

Research links

Social relationships and mortality risk: A meta-analytic review, Holt-Lunstad, Julianne, Smith, Timothy R., and Layton, Bradley J, PLOS Medicine, 2010

Loneliness and Social Isolation as Risk Factors for Mortality, Julianne Holt-Lunstad, Perspectives on Psychological Science, 2015.