How to Help a Friend
What to do if you think someone may have an eating disorder
Eating disorders are not about the food. There is always a deeper problem that is causing the person to focus so intently on food. The eating disorder is the outward manifestation signaling that there is an inner problem (e.g. self-esteem, family issues, depression, anxiety). An eating disorder is a person’s attempted solution to that problem. The eating disorder will begin to go away when the inner problem is addressed, and usually counseling is helpful in this process.
- Make sure you approach the person one-on-one. If a group of you is concerned, it is very important that one person be chosen to talk with the friend. Group confrontation can make a person feel “ganged up on” and can cause a friend to feel betrayed, as if everyone has been talking about them. The goal is to support your friend, and often a group confrontation can leave a person feeling like they have been betrayed by their support system.
- Make a plan to approach your friend in a private place. Try to choose a non-stressful environment where you will have time to talk at length, if necessary.
- Present what you have observed and what your concerns are in a non-confrontational, caring way. Tell him or her that you are worried because of what you have noticed and that you would like to offer some help. Stay away from saying “we’ve been talking and are worried” – focus on what you yourself have seen, it is less threatening. (Friends who are too angry or hurt to talk supportively should not be the ones to confront.)
Offer human company and empathy. You don’t need to agree with the person’s feelings or stance. There is a place for challenge, advice, information, pep talks, jokes, and confrontation. Generally, that place is after she or he feels her or his experience is understood and accepted for what it is.
- Listen carefully and non-judgmentally. Give the person time to hear what you have to say and to verbalize their feelings. Ask clarifying questions and then accept whatever they have to say without judgment. Encourage him or her to talk about their feelings.
- Do not argue about whether or not there is a problem. Power struggles are not helpful. You could say, “I hear what you are saying and I hope that you are right and that this is not a problem. But I am still concerned about what I have seen and heard because I care about you.” (It is best not to say what other people feel or what they have noticed. Speak with “I” statements.)
- Do not lay guilt trips, like “Look what you are doing to your family or roommates”. We are each responsible for our own feelings. Bear in mind that people with eating disorders yearn to know that someone could both know the worst about them and love them and care about them anyway.
- If the person denies the problem, becomes angry, or refuses treatment, understand that this is often a part of the illness. They have a right to refuse (UNLESS their life is in danger). You may feel helpless and angry. You might say, “I know you can refuse to go for help, but that won’t stop me from being concerned. I may bring this up again later – maybe we can talk about it then.” Follow through on this, and other promises you might make. Your friend may need time to process what you have said to them. Don’t expect an immediate positive response, the important thing is to follow through and be consistent.
- Provide information and resources for treatment. Make sure that you brush up on your knowledge of eating disorders before you talk to your friend, and be sure to offer resources to your friend. Encourage her or him to see a counselor, nutritionist, or physician and offer to go with them to the first appointment. Remember that recovery is a long process. It may take a while before your friend is feeling better and it is important for you to remain supportive throughout the entire recovery process.
- Do not try to be the hero or rescuer – you may be resented. If you do the best you can to help on several occasions and the person does not accept it, stop. This does not mean stop being aware of their behavior, but you have done all it is reasonable to do. Eating disorders are stubborn problems, and treatment is most effective when the person is truly ready for it. You may have planted a seed that helps them get ready.
- Make sure you get support for yourself. It can be difficult to live with someone who is dealing with an eating disorder. Get the information and support that you need.
For continuing support of your friend:
Remember that she or he is more than the eating disorder. Don’t let it become an identity – focus on his or her other characteristics that make them great. The more you help him or her identify his or her positive attributes, the easier it will be to let go of the “eating disorder” identity.
- Don’t be afraid of conflicts or problems. These areas need to be brought out into the open, not hidden. Be sure to keep lines of communication open.
- Do not focus on weight gained or lost. Focus more on their mental state. If you say, “you look thin” you are focusing on appearance and feeding into their behavior. If you say, “you look healthy” she or he may think you are saying, “you look fat.”
- Don’t focus on achievements – grades, promotions, etc. Instead, talk about his or her inner qualities and strengths. Set an example – be good to yourself and she or he will see that it is possible.
- Stay positive! People do recover from eating disorders. Many people who recover acknowledge the importance of friends who believed in them and kept trying to reach out to them.
Women’s Resource Center
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. 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.
Union College Counseling Center