Eating Disorders: Helping a Friend

Being a friend to someone with an eating disorder can sometimes be very challenging. It is normal to feel frustrated, worried and scared for your friend, especially if s/he isn’t able to admit that there is a serious problem. Being secretive about eating and exercising is a common characteristic of an individual with an eating disorder, and you may feel that you have to watch over your friend to make sure s/he is taking care of her/himself. The truth is that you have very limited influence on your friend’s eating habits, and it is ultimately her/his decision about what and how s/he eats. This is not to say that you should give up on or reject your friend who has an eating disorder. People who have sought treatment for an eating disorder often emphasize how important the ongoing support of their friends and family was to their eventual recovery. They say that having friends who both continued to believe in them, and also to relate to them beyond just their eating disorder was crucial in their taking steps toward health.

Should I say something to my friend?

Perhaps the first thing you may ask yourself if you know someone who you suspect has an eating disorder is whether or not you should confront the issue. Ask yourself about your relationship with that person. If it is someone you know only casually (e.g. an acquaintance in a class, someone you see only at the gym) you are probably not the right person to confront that individual. If you are concerned about someone who is a friend, however, it is important to speak to her or him. Talking to your friend shows that you care enough to say something, even if your friend has difficulty hearing or accepting your concern. Remember that denial of any problem with food is a psychological defense that helps your friend keep her/his real pain tucked away and out of conscious awareness. Eating disorders serve the function of distracting the individual from deeper emotional issues. An eating disorder is a way of coping, and your friend may not be ready to relinquish the sense of control, power or emotional relief that s/he gets from his or her symptoms (e.g. restricting, binging/ purging, exercising). It is important not to interpret your friend’s denial as a personal rejection. Though s/he may resist your efforts, it is still essential to confront your friend in a supportive way and offer to assist her/him in getting help. Ignoring the problem contributes to the secretiveness and denial that is part of the disorder; this may lead to serious health consequences. Many people with eating disorders initially seek treatment not entirely of their own choosing, but because others have raised the issue and urged them to seek help.

How to Speak to Your Friend

The following are some tips to consider in confronting your friend who has an eating disorder:

  • Pick a time to talk to your friend when there will be no distractions or interruptions. Avoid speaking to her/him about the eating disorder at meal time, or during an argument. Also avoid confronting your friend right before a break in the semester, as this prevents both of you from being able to follow up with a discussion at a later point.
     
  • Express your concerns directly and sincerely, but avoid criticism or judgment. Use “I statements” in which you express your concern about how your friend’s health and well-being are being affected (e.g. "I’m worried about you, because along with losing weight you also seem sad lately.”)
     
  • Educate yourself about eating disorders. Realizing that you can’t solve your friend’s problem, and understanding that eating disorders are not just about food will help you to better understand your friend’s struggle.
     
  • Have available resources for treatment. If s/he is willing to see a counselor on campus, have the phone number of the Counseling Center available to call for an appointment. Offer to accompany her/him to the Health Services Building, but respect his or her privacy if s/he wishes to go alone.
     
  • Be prepared for her/him to deny that there is a problem, and/or to become tearful or angry. Know that you are doing the right thing in talking to your friend, and tell him or her that you continue to be concerned. Your words may “plant a seed” which may help your friend to get treatment even if s/he isn’t receptive at the time.
     
  • Offer your continued friendship, support and patience.
     
  • Don’t promise to keep secrets about the eating disorder, or promise not to tell anyone who would assist your friend in getting treatment.
     
  • Talk to a counselor about your own feelings regarding the situation.

How to be supportive if your friend is in treatment

If your friend is in treatment for an eating disorder, there are many ways to be supportive. Most importantly, continue to be a friend to him or her. Point out your friend’s positive qualities and strengths that do not have to do with how s/he looks or how thin s/he is. Comments about weight and appearance, even a compliment that s/he looks “healthy,” can be misconstrued.

Don’t try to monitor your friend’s food behavior or force her/him to eat. Make it a point to schedule time to do things together other than around meals. Many people with eating disorders become very anxious, and self-conscious in dining halls, restaurants or other places where people are eating. Eating in a relaxed way, and without apology can help your friend feel more comfortable when you are together in food situations. You may find that you become overly focused on your own eating habits in reaction to your friend’s preoccupation with food and weight. Avoid making negative comments about your weight or body, or getting into detailed discussions about food.

If you have a friend who recently started treatment for an eating disorder, you may be concerned by a lack of visible progress. It is important to keep in mind that the contributing causes of an eating disorder develop over time, and recovery does not occur overnight. Improvement in symptoms is important, but is not the only gauge that treatment is helping.

What to do if you continue to be concerned about your friend

If you are still worried about your friend or would like more support in helping her/him, the Counseling Center is available for consultation about how to handle the situation. Consultations with the Counseling Center are free and confidential. Depending on the level of concern, the psychologist might suggest you inform someone (e.g. administrator, parents) who can take action to directly address the problem. The psychologist will help you to determine what can be done to help your friend, and is available to provide support for you as well. Appointments can be made by calling (610) 519-4050 or stopping by Room 206, Health Services Building.

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