Severe eating disorders often carry a hidden voice, one that doesn’t speak through words, but through withdrawal from meals, emotional shutdown, or resistance. What appears on the surface as refusal, avoidance, or distress often reflects a deeper emotional struggle – fear, a need for control, or response to past trauma. In the intimate moments around mealtimes, behaviours become a form of communication, and to care effectively, we must learn to listen to, interpret, and respond to these behaviours as a form of legitimate, meaningful communication.
More Than Meal Refusal: The Hidden Dialogue
When someone chooses not to eat, hides food, or checks themselves obsessively, these actions may be signalling distress. Research supports this: individuals with bulimia often show social withdrawal. Similarly, those with anorexia may display ritualistic patterns – cutting food into tiny pieces or refusing to eat in a communal space – often rooted in maintaining a sense of safety.
Recognising these behaviours as part of an emotional language allows us to shift our response from authority to allyship – creating a space of compassion rather than conflict.
Non-Verbal Clues Matter
Eating disorders also shape the way individuals interact – and disengage. We often rely on words to understand how someone feels. Beyond overt avoidance, non-verbal signs – like rigid posture or minimal eye contact – often reveal hidden distress. As carers, our role is to recognise these signals not as “non-compliance”, but as pleas for safety and understanding.
When our posture, tone, and timing align in calm, respectful ways, we help people feel safe to express what they cannot – or will not – say.
Moving from Control to Communication
What does this mean for care workers? It demands a shift in mindset, training must frame behaviour as communication, not defiance. When carers perceive behaviours as deliberate defiance, responses tend to become confrontational or coercive – often triggering escalation. Instead, effective training encourages us to reframe our approach:
- What personal need is being expressed? Anxiety, control, identity?
- How can we offer support without imposing? Choice, calm acknowledgement, presence.
This shift requires care teams to listen, not just respond. In doing so, we move from trying to control behaviour to helping someone co-regulate—regaining autonomy and emotional balance together.
Creating Space for Compassionate Response
Working with individuals facing severe eating disorders is never straightforward. It demands presence, patience, and a willingness to see beneath the surface. When we shift from a lens of control to one of understanding, challenging behaviours stop being seen as obstacles, and instead become opportunities for connection.
By recognising behaviour as communication, we empower our care teams to respond with greater empathy and skill. This not only de-escalates potential crises but builds trust, routine, and emotional safety for some of the most vulnerable people under your care.
Through our positive behaviour management training, carers learn to observe with purpose, respond with confidence, and embed practices that respect both individual autonomy and wellbeing. Together, we can transform how eating disorder behaviours are understood – moving from reaction to reflection, and from compliance to compassion.
