Eating disorder resources for families & friends

Bullying is not a new topic. It continues to prevelant throughout schools, homes, communities, and online platforms across the United States. About 19.2% of students ages 12-18 enrolled in grades 6-12 experienced bullying nationwide during the 2021-2022 school year. While many believe bullying to be a school-yard problem, one can experience it from peers, coaches, and even family members.

The impact can be profound; victims of bullying face depression, low self-esteem, anxiety, PTSD symptoms and suicide, along with increased feelings of shame, guilt, fear and sadness – many of the same symptoms experienced by those struggling with eating disorders.

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Bullying as a Contributor to Eating Disorders

But can bullying cause an eating disorder? The short answer: Not solely, but it can be a strong contributor factor.

Many factors can lead to an eating disorder like anorexia, bulimia, or binge-eating disorder. While it’s never the same between two individuals, most cases consist of what we often refer to as a ‘perfect storm’ of vulnerabilities, as part of the biopsychosocial model of eating disorder development. 

Factors Influencing the Development of Eating Disorders

Biological Eating Disorder Influences

Family history of eating disorders or other psychiatric disorders, certain brain chemistry, low birth weight and being a twin.

Psychological Eating Disorder Influences 

A person’s thoughts, emotions and behaviors, including low self-esteem, anxiety, depression and stress; difficulty regulating emotions; cognitive distortions in regards to reality and self.

Social Eating Disorder Influences

Cultural, societal and media pressures to maintain an “ideal” body type, weight or physical appearance, with any shortcomings often resulting in dissatisfaction with oneself or hurtful “body shaming” from others.

How Social Media and Bullying Amplify Eating Disorder Risk

It’s the social aspect of the biopsychosocial model where the intersection of bullying and eating disorders come into play, particularly with social media. More than 80 million photos are shared on Instagram daily, 500,0000 “Likes” on Facebook every minute, 500 million Tweets per day and 9,000 photos (“Snaps”) on Snapchat every second. Although much of this content may support positive body image, some promote the opposite – body shaming – with the spreading of harmful rumors and cyber bullying of children and adolescents.

The relation of body image to bullying is strong. In a study of 600 individuals, 90 percent indicated that they are currently bullied and 75 percent reported struggling with a clinically significant eating disorder.

Bullying Fuels Emotional Distress That Can Trigger Eating Disorders

So, how exactly can bullying play into the development of an eating disorder? We know for sure that bullying can increase anxiety and depression, encourage withdrawal and apathy and contribute to feelings of guilt, shame and low self-esteem. 

What do people experiencing uncomfortable emotions want? Relief. Unfortunately, many individuals find it difficult to use the adaptive coping skills when feeling anxious or sad or guilty, and may begin using eating disorder behaviors as coping mechanisms for these intense feelings.

The onset of eating disorders are especially prevalent in children and adolescents who have been bullied for their physical size or shape. This may reflect in an increase of cognitive distortions often with the fear of gaining weight, becoming “fat” or not obtaining the perfect shape and size.

3 Ways to Help Someone Being Bullied

1. Pay attention

‍Whether it’s ourselves or others saying negative things, spreading rumors and/or body shaming, it is important to identify what is going on. Take note if someone is isolating themselves, decreasing time with friends or family or displaying unusual eating habits (reducing food intake, hiding food or eating in secret).

2. Don’t ignore it

‍The phrase “sticks and stones may break my bones, but words can never hurt me” isn’t necessarily true. Words can be very damaging. The more education there is in the community, the more positive self-talk can be created. Starting and maintaining a dialogue can prevent bullying and reduce the number of cases that ultimately lead to an eating disorder.

3. Identify supports

‍There is a wealth of professionals and organizations that are able to help. This includes school counselors, therapists, psychologists and treatment programs to support with symptoms of being bullied and eating disorders. National organizations such as stopbullying.gov and nationaleatingdisorders.org are great too.

Help for Eating Disorders Is Within Reach

There is nothing positive or productive about bullying, especially given the harmful consequences.

We know finding eating disorder treatment can be tough. Monte Nido is here for you. If you are concerned that you, or a loved one, may have an eating disorder, please reach out.

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September is National Suicide Prevention Awareness Month, a time to shine a light on one of the most pressing issues in mental health: suicide. While conversations often focus broadly on depression or trauma, it is essential to recognize the deep connection between eating disorders and suicide risk. Studies show that individuals with eating disorders experience some of the highest rates of suicide among all psychiatric illnesses. For example, suicide is one of the leading causes of death for those with anorexia nervosa, bulimia nervosa, and binge eating disorder.

This heightened risk is tied to the immense emotional pain eating disorders bring, including feelings of hopelessness, shame, isolation, and self-hatred that can overwhelm anyone. Talking openly about suicide can reduce rather than increase suicidal thoughts, making education and awareness critical tools for prevention.

This blog post provides a curated list of suicide prevention resources specifically relevant to eating disorders. Whether you are an individual struggling, a loved one seeking to support someone, or a clinician looking for tools, these resources are designed to open pathways toward hope, safety, and healing.

Understanding the Elevated Risk of Eating Disorders and Suicide

• Suicide rates in anorexia, bulimia, and other eating disorders.

• Contributing factors: depression, PTSD, impulsivity, trauma.

• Why this intersection demands awareness.

Eating disorders are among the deadliest mental health conditions, with suicide being the second leading cause of death.  

Research indicates that individuals with anorexia nervosa are up to 18 times more likely to die by suicide than the general population. Those with bulimia nervosa and binge eating disorder also face elevated suicide rates compared to peers without eating disorders. LGBTQ youth with a diagnosed eating disorder are nearly four times more likely to have attempted suicide in the past year compared to peers who have never had, or only suspected they had, an eating disorder.

Several factors contribute to this intersection. Many clients live with co-occurring depression, PTSD, anxiety, or trauma histories that compound their risk. Traits such as perfectionism, impulsivity, and intense emotional pain also increase vulnerability. People experiencing eating disorders often feel overwhelming guilt, shame, and hopelessness, which can create a dangerous cycle of self-criticism and despair.

The urgency becomes even clearer when looking at global data: suicide is the #1 cause of death among adolescent girls, and the #2 cause of death for individuals aged 10–34. Within eating disorder populations, risk factors such as weight suppression, social isolation, and medical complications add further strain.

Because eating disorders and suicide share such a dangerous overlap, raising awareness is not optional - it’s lifesaving. Families, clinicians, and communities must be equipped to recognize warning signs, understand contributing factors, and offer timely interventions that combine eating disorder care with suicide prevention strategies.

Why Support for Eating Disorders & Mental Health Is Crucial

Stigma and shame remain major barriers for those living with eating disorders and suicidal thoughts. Many feel silenced by fear of being judged or dismissed, making it less likely they will reach out for help. Without compassionate intervention, isolation can reinforce the dangerous belief that no one cares.

Early support changes outcomes. Asking directly about suicidal thoughts does not increase the risk. In fact, research shows it can reduce suicidal ideation by breaking through secrecy and showing that someone is willing to listen. Communities, caregivers, and professionals who create safe, nonjudgmental spaces play a crucial role in reducing risk and encouraging treatment engagement.

Eating disorder recovery requires not only nutritional rehabilitation but also attention to the emotional struggles that accompany the illness. By combining evidence-based therapies with suicide prevention strategies, treatment can address the whole person—body, mind, and spirit. Supporting those at risk is about more than safety; it is about affirming their worth and helping them envision a future beyond the eating disorder.

Curated Directory of Resources for Eating Disorders & Suicide Risk

Crisis Hotlines & Immediate Help

• 988 Suicide & Crisis Lifeline (U.S.): Call or text 988 for 24/7 confidential support from trained crisis counselors.

• Crisis Text Line: Text HELLO to 741741 to connect with a crisis counselor.

Warning signs of acute suicide risk include talking about wanting to die, seeking access to lethal means, or showing dramatic mood changes. If these behaviors appear, immediate help is necessary. Parents, friends, and caregivers should never wait to act - call 911 if someone is in imminent danger.

Eating Disorder–Specific Support

• Monte Nido: Offers inpatient, residential, PHP, IOP, and virtual treatment, with suicide prevention integrated into care.

Eating disorder–specific hotlines and organizations provide targeted support for those whose struggles with food and body are closely tied to suicidal thoughts.

Broader Mental Health & Suicide Prevention Organizations

• American Foundation for Suicide Prevention (AFSP): Offers research, advocacy, and support groups.

• The Trevor Project: Crisis services for LGBTQ+ youth, who face elevated risk for both eating disorders and suicide.

These organizations provide a wider net of mental health resources that complement eating disorder–specific supports.

Safety Planning & Emergency Tools

If an individual is struggling with suicidal thinking, a mental health professional can help develop a Safety Plan which can be designed to give individuals a step-by-step approach for managing suicidal thoughts when they arise.  These plans can offer a crucial bridge between a crisis and ongoing treatment.

Professional & Educational Resources

Mental health professionals are trained to provide a suicide risk assessment and when needed to help someone into the level of care that can best assist them.  Additionally, there are numerous continuing education programs designed to equip professionals with the latest knowledge and to ensure that suicide prevention is embedded in treatment programs, schools, and healthcare systems.

How to Use These Resources

• For individuals: keeping numbers accessible, joining groups, therapy.

• For loved ones: listening, validating, helping with safety plans.
  For clinicians/educators: screening, integrating safety planning, awareness in programs.

Suicide prevention resources are most effective when they are accessible and actively used. Individuals living with eating disorders can benefit from keeping hotline numbers saved in their phone, downloading safety planning apps, and exploring peer support communities. Therapy and structured treatment programs remain essential in reducing long-term risk.

For loved ones, the role is to listen without judgment, validate feelings, and encourage the use of crisis services when needed. Parents and caregivers can help teens create safety plans, remind them of available resources, and normalize asking for help. Even if conversations feel unproductive, research shows that those at risk are often listening closely.

For clinicians and educators, resources should be integrated into daily practice. Screening for suicide risk, creating safety plans, and connecting students or clients with crisis services are essential steps. Educational institutions and treatment centers alike can reduce stigma by openly discussing suicide prevention and ensuring that staff are trained in compassionate intervention.

The key is to make these tools part of everyday life—visible, accessible, and actively used, so that when risk arises, help feels within reach.

Taking Action: Support for Suicide and Eating Disorders

Suicide prevention starts with awareness and action. Saving helpline numbers, sharing them with others, and talking openly about eating disorders and suicide can create life-saving connections. Each conversation helps break stigma and reminds those struggling that they are not alone.

Monte Nido offers evidence-based, compassionate treatment designed to address both eating disorders and the co-occurring risks that come with them. If you or someone you know is in need, reach out today. Every step toward connection is a step away from isolation, and toward recovery.

Hope and Healing Beyond Suicide and Eating Disorders

Eating disorders carry a high risk of suicide, but risk does not define destiny. With timely support, compassionate treatment, and strong community connections, healing is possible. Talking openly about suicide does not create risk - it creates relief, reminding individuals that their pain can be shared and lightened.

No one has to face this alone. Help is always available, and recovery is within reach. By raising awareness this Suicide Prevention Month and beyond, we can help more people move from despair to hope—and toward lives full of meaning and possibility.

Although it can happen, most mental health disorders don’t happen by themselves. There are usually one or more other disorders occurring at the same time, in a phenomenon known as a dual diagnosis. Eating disorders are no different; they are listed in the DSM-5 with other forms of psychiatric illnesses, and they tend to appear in conjunction with disorders like depression, OCD, and PTSD.

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Here we’ll explore some of the types of psychiatric illness that co-occur in a dual diagnosis with eating disorders such as anorexia nervosa, bulimia nervosa, binge eating disorder, and other types of an eating disorder. Common psychiatric treatments and recovery options are also going to be covered here.

Common Psychiatric Disorders That Co-occur With Eating Disorders

These psychiatric disorders may co-occur with an eating disorder, or they may be a cause of one or caused by one. In most cases, the diagnostic team of doctors and psychiatrists will develop a simultaneous treatment program that addresses both. Some of the common psychiatric disorders include:

Depressive Disorders

The DSM-5 (Diagnostic and Statistical Manual for Mental Disorders-5-TR) supports a diagnosis of clinical depression if five or more of the following symptoms are reported by an eating disorder patient:

• Insomnia or hypersomnia (oversleeping and sleeping more than 12 hours a day)
• Anhedonia, or a loss of interest in previously enjoyed activities
• Self-isolation/avoiding social situations
• Cognition difficulties such as memory loss, difficulty concentrating, and trouble making decisions
• Suicidal ideation (contemplating or planning suicide)
• Sadness, lack of motivation, and/or a feeling of emptiness

Depression in Teens

Adolescence is a time of complex changes involving biological, social, and emotional milestones. It can be difficult for parents to recognize early signs of depression in teens because adolescents’ emotions can be turbulent, with mood swings and negative feelings being common. Depression often precedes the development of an eating disorder in adolescents as disordered eating behaviors can alleviate the sadness and anger they feel.

Possible signs an adolescent has clinical depression include:

• Consistent angry or hostile attitude, especially when confronted or questioned about their behavior
• Increased withdrawal from family and friends; socially isolating oneself
• Feelings of worthlessness, low self-esteem, decreased self-worth Disinterest in activities that were once enjoyed
• Increased sleeping or increasing sleeplessness
• Suicide ideation

Anxiety Disorders

Generalized Anxiety Disorder

Characterized by irrational worries, a constant sense of apprehension, and a negative outlook on the future, generalized anxiety disorder (GAD) is commonly co-diagnosed in teens with eating disorders. Anxiety disorders often engender a sense that the person is losing control over their circumstances, which can trigger eating disorders as a way to “regain” control over something. This can become a cycle that exacerbates both the anxiety disorder and the eating disorder. Thankfully, many therapeutic methods effectively treat both kinds of disorders.

Phobias and Panic Disorder

Also on the spectrum of anxiety disorders are phobias and recurring panic attacks. Many people with eating disorders, especially anorexia nervosa and ARFID, have fears about food and eating, resulting in food avoidance or extensive food rituals. People with anorexia nervosa may suffer panic attacks if they are forced by their parent or loved one to eat even a small amount of food they consider fattening or high-calorie. Treating psychiatric disorders such as phobias and panic is an essential precursor to successfully addressing a person’s eating disorder.

Schizophrenia

While co-occurring diagnoses of eating disorders and schizophrenia are relatively rare compared to depression or anxiety, it has been known to happen. A serious, difficult to treat psychiatric disorder, schizophrenia can be managed to an extent with medications and professional counseling, as well as family support and life skills classes. If a person is diagnosed with schizophrenia and an eating disorder, the eating disorder is typically a selective eating disorder like ARFID, pica (eating inedible things like dirt), or overeating disorder not otherwise specified.

Symptoms of schizophrenia include delusions, audio/visual hallucinations, incoherent speech, and inability to understand reality.

Post-Traumatic Stress Disorder (PTSD)

Experiencing traumatic events such as abuse violence, a divorce, loss of a loved one, or even an auto accident can cause a debilitating disorder known as PTSD. Symptoms of PTSD such as extreme anxiety, nightmares, flashbacks to the traumatic event, and difficulty coping with normal life stressors. As with GAD, PTSD can trigger disordered eating behaviors as a coping mechanism and means to take back control.

Personality Disorders

Personality disorders can be much more difficult to treat than other forms of mental illness because they form a central aspect of the person’s self-identity. Borderline, obsessive-compulsive, and avoidant personality disorders are some of the most common types of personality disorders diagnosed in people with anorexia nervosa, bulimia nervosa, or binge-eating disorder. Evidence-based talk therapy such as CBT and DBT may help combat personality disorders, as well as certain medications, which may continue long after residential eating disorder treatment has been completed.

Psychiatric Evaluations in Eating Disorder Treatment

A comprehensive psychiatric evaluation allows the treatment team at an eating disorder treatment facility to assess a person’s complete treatment needs. This information is critical to developing an individualized recovery program that can capably treat any and all disorders, giving the individual the best chance at a full recovery.

Standard Questionnaires and Cognitive Assessments

Certain standard questionnaires can get the ball rolling. Because many psychiatric illnesses and eating disorders can both impair cognitive ability, various cognitive questionnaires can be administered to assess their cognitive abilities. For example, tests containing questions that measure a client’s complex attention processes can determine how well they can observe stimuli without being distracted.

The Role of Medical History in Medical Health and Eating Disorders

Although psychiatric illnesses are generally mental health disorders, the individual’s medical history must also be assessed, especially since in cases of eating disorders, there are often severe medical complications that need attention. Does the patient have a history of seizures? Migraine headaches? Recurring infections? Heart disease? Dental issues?

Any prescribed medications and medical allergies should be discussed as well. If the individual has a history of substance abuse, their last usage, and type of drug should be mentioned. While much of this may be something the individual wants to keep secret, it’s essential to their health that all avenues are explored.

Psychosocial and Developmental History in Dual Diagnosis Evaluation

The final component of psychiatric evaluations involves the individual’s developmental and psychosocial history. Developmental history involves a discussion of the individual’s childhood and adolescence and examines important past experiences that have influenced a person’s development. Some things of particular concern to psychiatrists include a history of chronic diseases, physical abuse, or sexual abuse that may have had a profound effect on the patient’s psychological maturation.

Family relationships and those with close friends are explored to get an idea of the individual’s psychosocial baselines. Sexual history, sexual orientation, and cultural beliefs concerning sex are also examined as part of a complete psychiatric evaluation. Every effort should be made to include cultural sensitivity as part of this evaluation, as it will play a central role in the eventual individualized treatment plan.

Treatments for Dual Diagnosis of Eating Disorders and Mental Illness

After the initial psychiatric evaluation, the medial, therapeutic, and psychiatric team at an eating disorder center will design an individual treatment plan. This includes several different types of therapy, each of which is designed to help the individual overcome both the eating disorder and the co-occurring mental health disorder.

Psychotherapy

The basic building block of any recovery program, psychotherapy is a type of “talk” therapy that reinforces how to process their emotions and maintain control over them. Psychotherapists talk with the individual about their thoughts and feelings even if they experience anxiety and fear over acknowledging them. Therapy sessions can also uncover previously repressed feelings and memories, hopefully leading to a “breakthrough,” where new insights can be made.

Cognitive Behavioral Therapy

Decades of evidence-based studies of psychotherapy utilized by eating disorder therapists and psychologists has led to the development of cognitive behavioral therapy (CBT). CBT helps people recognize distorted thoughts and behaviors as being unhealthy via an objective one-on-one dialogue between client and therapist. This has proven to be especially helpful for people diagnosed with borderline personality disorder, depression, eating disorders and anxiety/phobias, CBT challenges false assumptions and rigid thought patterns.

Central to CBT is helping individuals see the way they think objectively and not through the filter of their subjective emotions. For example, a person with an anxiety disorder who reports they are unable to focus on anything because they feel something bad is going to happen to them will be guided by a CBT therapist to systematically and objectively examine these thoughts to see if there is any objective reason to think so. Eventually, after several sessions, the individual might come to realize their fears are not based on solid evidence but are instead irrational.

How Treatment Programs Can Keep an Individual Motivated

Many teens and adolescents who need eating disorder treatment may feel guilty about their disordered eating behaviors, but treatment centers’ programs for family and friends can increase their motivation to get better. Family members and support groups can be of great help to those who may need extra motivation and support when the urge to start engaging in eating disorder behaviors is persistent and overwhelming.

While externally supplied motivation is a necessity to complete an eating disorder recovery program, people in eating disorder treatment, on a residential or day treatment basis, must realize the incentive to enjoying a successful recovery lies primarily within themselves and their desire to live a healthier life with a better relationship with food and eating. No matter the program eventually chosen, securing a psychiatric evaluation and a specialized treatment plan based on that evaluation is the essential first step to a full recovery.

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