I Think My Friend Has An Eating Disorder & I Don’t Know What To Do

Illustrated by: Norah Stone.
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Hey Kelsey,

I recently attended my college roomie's wedding, reuniting with another very close college friend who I've lost touch with over the years. When we met freshman year, she was open about the fact that she struggled with eating disorders in high school. She was careful about her food, but always healthy.

Now, over 10 years later, she's slimmer than I’ve ever seen her, and seemed downright unhappy. When I tried to ask pointed questions about what's going on in her life (job, relationship, family), she mostly reacted by saying she's got it under control. She's fine. She also spent a lot of the wedding reception running back and forth to the bathroom, which, as an adult I felt silly keeping track of. In the moment, I didn't want to say anything or put her on the spot, but I find myself worrying that maybe she is not okay.

Is there any helpful way I can reach out and see if she needs some support? Or, once someone's over 30, are you supposed to just butt out and let them come to you if they need help?

Sincerely,

Worried Friend

Dear Worried,

This is one of those situations in which the answer is so simple, and the execution is so damn complicated. Adulthood, amiright?

The simple answer is yes, of course, if you see a friend in trouble, you offer them help. Then there all those complications: Am I the best person to approach her? What if I’m wrong? What if I’m right, but I make things worse? Is this any of my business? The bad news is, no one can answer those questions for you. The good news is, it doesn’t matter. Whether or not you’re the best person to approach her, the universe or the wedding planner seated you near her at the wedding, and now you can’t unsee what you’ve seen. This is your business because you’re the one who noticed, and you’re the one who’s concerned.

I spoke with Claire Mysko, CEO of the National Eating Disorders Association, who confirmed that if you suspect something’s up, you should reach out. “Early intervention can make a big difference, and many people wait too long to say something because they think ‘it's not that severe,’” she says. Don’t wait for some sort of proof, because you probably won’t get it. “It can be tough to recognize red flags, especially in a culture where preoccupation with food and weight has sadly become the new norm. But the bottom line is that if you are noticing your friend's preoccupations are leading her or him to seem anxious and unhappy, or to withdraw from social activities and connection, that is enough of a sign to talk about.”

As for when and how, again, there’s no perfect answer. The conversation is going to be uncomfortable — but there are ways to make it more effective. “Raise your concerns directly, but in a non-judgmental way,” says Mysko. "Stress first and foremost that you’re addressing this because you care. Don't focus on weight. (‘You've gotten so thin!’ ‘You've gained weight.’) Instead, zero in on the behaviors. (‘I was concerned that you still went to the gym when you had the flu.’ ‘You've seemed so down recently and I heard you vomiting in the bathroom.’)" In your case, perhaps think of some specific moments from the wedding, or comments she made.
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Illustrated by: Norah Stone.
The point is to keep this private, caring, and clear. Beating around the bush may seem gentler, but to someone in the grip of ED, anything left open to interpretation will almost certainly be interpreted the wrong way.

Most people know that eating disorders aren’t just about food or weight. But most people don’t really understand the possessive quality of this illness. By that, I mean it can possess you like a demon, blotting out reality, speaking through your mouth, and sharpening your skills of defense to an almost magical degree. I don’t mean to glamorize these disorders (as they so often are, unfortunately), but to remind you that you’re more likely in for a fight than a hug.

“Be prepared to be met with denial or defensiveness,” says Mysko, adding: “Remember that it doesn't help to get into a battle.” If things turn toward an argument, don’t take the bait. Remain calm and stay on message: You are a friend, and you’re willing to help. There is nothing more frustrating than staying neutral when someone’s trying to fight with you, but there is nothing more powerful either. That wily demon will see that you are onto its tricks, and somewhere inside, your friend will see you, too. She’ll see the lifeline.

And she might not take it. “You might not get through the first time, or even the 10th time,” says Mysko. “But do keep trying, in a calm and compassionate way.” Perhaps enlist mutual friends you trust, with discretion. This is not about ganging up on her (or doing anything that might look like ganging up). But this is not and cannot be your responsibility alone. Choose allies carefully, but do choose them. Then work together to be the most effective support system you can be. Reminds Mysko: “The best thing you can do as a friend is to educate yourself about eating disorders.”

When in doubt, remember that this is not about you solving her problems, or even diagnosing them. You don’t need to do any of that to be a good friend. Really, the only thing you’re capable of is extending that lifeline between her and the help she needs. You can’t control whether she takes it, ignores it, or throws it back in your face. The important part is that you, and everyone around her, just keep tossing the lifeline back out there.

And, remember, there are lifelines out there for you, too:

If you suspect you or someone you know is dealing with an eating disorder, please go to the National Eating Disorders Association for resources, online support, and guides to local professionals. You can also call the free, confidential NEDA Helpline at 1-800-931-2237.
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