How to Help a Friend

Dieting, seeking comfort in food, and concern about weight are very common practices and concerns, among females in particular. Eating habits become problematic when behaviors become addictive, meaning that the person cannot stop restricting or eating, and thoughts become preoccupations.

In addition to being cultural by-products, eating disorders are also psychological problems and serious health conditions.  People with eating disorders eat or starve or purge in an effort to cope with feelings that they cannot sufficiently understand or directly communicate.  Most people with eating disorders also struggle with feelings of inadequacy and unrealistic self-expectations.  Eating disorders cause physical consequences ranging from thinning hair to anemia to life-threatening conditions such as electrolyte imbalance.  They require treatment, which always consists of psychotherapy and medical monitoring and which may also involve nutritional counseling and medication.

The process of giving up an eating disorder is sometimes lengthy and often emotionally difficult; however, recovery and the restoration of emotional and physical wellbeing are possible. Although signs of difficulty may be apparent to friends and family, many people with eating disorders are reluctant to avow the existence of a problem and to seek treatment. Nevertheless, persistent, patient expressions of concern and provision of information about treatment resources can be helpful.  

How to approach someone who may be struggling with food:

Remember that you do not need to be the food police.  Nor do you need to diagnose another person.  However, if you are concerned about a friend’s eating, follow these general guidelines:

• Start by having a one-on-one conversation with your friend.  If several people confront her at once, she is more likely to feel ganged-up upon.

• Approach your friend when you are calm and have a period of uninterrupted time. 

• Describe what behaviors you have observed (specifically).  For example, “I thought that I heard you throwing up.”  “I’ve noticed that you’ve lost a lot of weight very quickly this year.”  Your observations should not be phrased as accusations but rather as expressions of concern.

• Don’t trivialize her problem.  Eating disorders are complex social, psychological, and medical disorders.

• If your friend frequently asks you how she looks or whether you thinks she’s eaten too much, tell her that her feelings about herself are what most matter, not what you think.

• Don’t become over-involved in your friend’s eating.  Honor your own time and emotional energy limits.  

• Let your friend know that there is support and treatment available to her on campus.  She can contact the Counseling Services, at extension 4-2092.   Counseling Services can also refer her to eating disorders specialists and clinics off campus.   

• If your friend gets angry, or you don’t know what else to say, stop the conversation.  You can always consult with a clinician from Counseling Services and continue the discussion at another time.

• If your friend persists with her eating disorder but denies needing help, your area director may arrange for an administrative referral, which mandates her to attend a consultation at the Counseling Services.

• If you think the situation is exigent, seek professional guidance.  Call the Counseling Services to arrange for a consultation. 

What requires immediate intervention: 

A person who collapses, faints, or cannot walk due to weakness.  If this is the case, call Health Services at extension 4-2091.   If it is after hours, call security at extension 4-3362 and have her taken to St. Luke’s Hospital, which is at 113th Street and Amsterdam Avenue.

What to keep in mind:

• The first confrontation may not propel your friend into treatment.

• She may feel invaded, angry, ashamed, or relieved by the confrontation. 

• It sometimes takes several confrontations from several sources   before a person is willing to seek treatment.

Caveat:

There is a limit to how much you can affect another person’s behavior. 

 A person who has an eating disorder will not be able to significantly change her eating until she accepts the existence and seriousness of her disorder.