Helping a friend with an eating disorder

[{paintedroses}]

Does anyone have any experience or suggestions for helping a friend with possible (probable) anorexia? A girl I'm quite close to is basically not eating nearly enough, has a lot of symptoms of having an eating disorder, complains of being overweight when she's clearly very underweight, etc.. Other friends and I know we have to do something before it gets worse, I'm aware of how difficult it will be to overcome and that she needs professional help, and that she needs to be helped to make the decision to get this help. What can we do? If anyone has been in this situation of having to help a friend your advice would be very very useful!

 

[BonosBaby12]

I had a friend who suffered from the same thing that your friend is going through. She would barely eat anything at all and that was only when we would be around her and make her eat. She was underweight too. But yet she would complain of how fat her legs and thighs were. Also that her clothes were just too tight on her when that was clearly not the case at all. My mom happened to pick up on what was going on and she stepped in. The friend would come over a lot and so my mom would literally make her sit down and eat. Said she was not going to leave the table till she did. Naturally there was A LOT of resistance in the beginning but eventually she was able to break through. Thankfully this was caught early enough before it got any worse. She's now at a healthy weight and is better about her body image. Took awhile to reach that point though. My advice would be to confront your friend and encourage her to seek a professional's help. Let her know that she has your full support and really care and are concered. Unfortunately it's going to be a rough battle but hopefully she will see that she's not alone with this. I sincerely hope that your friend is able to overcome this.

 

[Liesje]

First, you have to decide whether she actually has an eating disorder, or just practices disordered eating. The former is a life threatening disease and there's not much chance she will get better on her own or get better simply by having friends encouraging her (like, you can't help a person with AIDS disease unless they seek professional help).

If she has an eating disorder, she needs to see a doctor and get professional treatment/counselling. EDs are about maintaining control; being thin and not eating is purely incidental, it's just the means for gaining control. It's more of a psychological thing, like "My parents won't get off my back, I'm way over my head in school and sports, I'll control my life by controlling my weight" than a girl thinking "I feel fat so I'll stop eating".

If she's just practicing disordered eating (maybe she thinks she's fat or has low self esteem or whatever), rather than having a full blown ED, you can help her out by encouraging her and listening to her. Try to talk to her, but about things other than her eating. Don't let it consume her or consume your friendship. Why does she feel like she needs to not eat or why does she feel fat when she's not? Get to the bottom of the issue.

Like I said, the important thing in deciding how to help/treat someone is first knowing how advanced their condition is. A lot of people either don't realize, or just don't think there's a significance between an eating disorder and disordered eating.

 

[u2bonogirl]

If she really does have an eating disorder then theres something behind it, and its not about her weight...
Ive been there and it was all about control and a cry for help. Is she in a bad relationship? Have trouble at home? Under too much pressure? These are all things that can trigger an eating disorder.
Convincing her that shes not fat wont solve the problem, its to be solved deeper than just the skin

 

[{paintedroses}]

Thanks guys, thats all really helpful. We have done some research on the internet, theres a lot of websites set up to help people in this kind of situation. A lot of things such as that she's been a dancer all her life, is a very hardworking, perfectionist type etc seem to point towards the problem. As far as I know she has no trouble at home, or in a bad relationship, although pressure may be an issue as she's doing a very taxing subject here at university, and she takes her studies very seriously. She's said to me before that when she was taking her A-level exams (last year.. end of high school type exams) she panicked loads and emersed herself in work.

I think the best way for us to help her is to gently persuade her to see someone about it, as none of us are trained to help someone with psychological problems and can't really help other than to get her to recognise she has a problem and point her in the right direction to help. I'm not trying to diagnose her condition or decide how to treat it, or figure out what issues are behind the problem, thats something for proffesionals to do.. I just know she needs to seek this kind of help. And she can only get help if she wants help. Which is where her friends/family or whatever have to come in and support and offer advice. I know this won't be easy because its likely she will deny it to begin with then not want help because that would involve getting back to a healthy weight which is not what she wants right now.

So really I need to know how I can help, as a friend, to make her realise she needs help and to want to be helped.

 

[u2bonogirl]

Even if she realizes or admits that she has a problem there might still be an issue with her getting back to a healthy weight as well. There can be a real paranoia of returning to where she started to begin with and ruin everything shes sacrificed to get thin.
When I was getting better it was very hard for me to let go even though I realized that I needed to change. But I eventually got there, so dont get discouraged if you encounter that in this situation
I think its great that you are concerned about your friends health, especially if she really has a big issue. Its goo for her not to have to go it alone

 

[WildHoneyAlways]

According to the DSM-IV distorted body image is certainly a part of eating disorders. (ie, extreme desire to be thinner) Please don't discount this. Her disordered eating / eating disorder may come from this as well. Sometimes it is about body image.

 

[BonosBaby12]

Know with my friend she turned to her eating disorder because a bf called her fat. Just be her friend PaintedRoses and not give up on her. After reading what you have written so far I can see that you are the type that wouldn't give up on your friends . Good luck

 

[redkat]

You may want to bring it to her parents attention if you are really concerned and think they can help.

If you watch her eat or make it an issue in your friendship she is likely to push you away. The more she thinks the people around her are trying to control her the worse she may get. Just be her friend let her know that if she wants to go for help you'll be there with her.

Good Luck

 

[LarryMullen's POPAngel]

I agree, bring it up to her parents if you think things are really that serious.

Best of luck, paintedroses, to you and your friend.

 

[-macphisto-]

Dont take any chances, act now, try to get to the bottom of this asap. It pains me to see this, it happened to my sister. For 3 years one of my sisters was hiding a eating disorder, and nobody in my family had any idea. Luckily a source found out before it was too late, and we saved her( or actually she saved herself). My sister made a full recovery, and is in top physical condition, married, and all is good. But it was a real scare, and it made me want to know more about this, and what drove her to this. I suggest reading "The Secret Language Of Eating Disorders", by Peggy Claude- Pierre. It is crazy what the mind is capable of, it can so easily destroy a person. But my heart goes out to everybody that suffers with eating disorders.

 

[Hallucination]

I can't really comment as I've never had any experience dealing with or knowing anyone with an eating disorder. I do know that it's a scary disease and is extremely serious as you're dealing with someone's psyche. Hopefully everything works out for your fiend {paintedroses} and you are able to help out in some small way.

 

[Liesje]

According to the DSM-IV distorted body image is certainly a part of eating disorders. (ie, extreme desire to be thinner) Please don't discount this. Her disordered eating / eating disorder may come from this as well. Sometimes it is about body image.

It's part if it, but of all the people I've known w/ diagnosed EDs, it's never been the cause. If I'd ask them why, they'd say "because I wanted to be perfect for my parents" or "I wanted to be perfect for my coach" or "It was the only way I felt in control of my life". I've never heard someone say it was because she wanted to be skinny, period. It takes a certain type of personality in order for an ED to exist. Most girls think they're ugly and/or fat at some point in their lives. Speaking for myself, I've thought this a lot, especially when I was in gymnastics, but I don't have the right personality to ever even be susceptible to developing an ED b/c I simply don't have that amount of self-control and perfectionism in me. It's not about body image as much as it's about controlling body image.

This is why the distinction between an ED and disordered eating (which I notice you've lumped together) is so important - they have different causes and need different treatments. Disordered eating is often a self-esteem issue; and ED is a disease, a psychological disorder, an addiction. If you consider them the same, you're down-playing the significance and danger of a true ED and what it takes to treat them.

Of all the people I've known personally w/ EDs and all the cases I've studied, I haven't come across a single person that was able to appropriately treat and "cure" the ED on their own or simply with encouragement and support from friends.

I agree w/ April, if this is serious, the parents need to get involved. A lot of times, parents are either in denial, or are unfortunately part of the reason behind the ED. It's important to have a grasp on where they stand.

 

[VertigoGal]

I'd also agree you probably need to talk to her parents about it. I had a friend like that, and she was able to hide the fact that she simply wasn't eating from her entire family. She moved a few years ago, I don't even know if she's alright...

Good luck, I hope you're able to get to the bottom of this

 

[WildHoneyAlways]

It's part if it, but of all the people I've known w/ diagnosed EDs, it's never been the cause. If I'd ask them why, they'd say "because I wanted to be perfect for my parents" or "I wanted to be perfect for my coach" or "It was the only way I felt in control of my life". I've never heard someone say it was because she wanted to be skinny, period. It takes a certain type of personality in order for an ED to exist.

Then you haven't talked to very many sorority girls.
I don't want to derail this thread but the fact is eating disorder are caused by the desire to be thin. I have talked, at length, with my friend who is getting her Phd in psychology and specializes in eating disorders and she has said repeatedly that wanting to be thin can be the cause. The control part is controlling how much you weigh.

PR, I can give you my friend's email or ask her what she would do in this situation. It's good to know that you are so concerned.

 

[{paintedroses}]

Thanks guys. The thing is, we're living on campus at university so I have no contact with her parents or anything, we're all suddenly living quite independently and there are no authoritative figures to go and see or ask for advice. I guess I could talk to the health service here, but thats really something she should have to do. Another thing is that I've only known her six weeks, and although we've become quite close friends its not like we're close enough to talk about personal things without feeling intrusive.

Something else to add is that since she's been here at uni she's gradually ate less that when she started, so perhaps now she's not eating meals with her parents like she would have while living at home she can control what she eats more.. So maybe when she goes home at Christmas and has to eat meals with her parents again they will pick up on it.

WildHoneyAlways, if you think your friend would be able to help that would be great as I'm really stuck with what I can do as like I said I can't speak to her parents and don't know if or how I could step in and bring it up with her.

 

[{paintedroses}]

This is why the distinction between an ED and disordered eating (which I notice you've lumped together) is so important - they have different causes and need different treatments. Disordered eating is often a self-esteem issue; and ED is a disease, a psychological disorder, an addiction. If you consider them the same, you're down-playing the significance and danger of a true ED and what it takes to treat them.

This is good to know, but at the moment all I want to do is point her towards getting help and from there on a doctor can find out what it is and how to treat it. The issue to me is that she's endangering herself by not eating, whatever the reasons or problems may be are for the doctor to find out once I've persuaded her to get help. If there are deep set issues or insecurities I really doubt anyone who's not professional in that field will be able to help significantly. It's not my place to pry or find out exactly what's going on, I just want to help.

 

[yolland]

As a university professor, I have had several severely anorexic students over the years whose continued attendance was made contingent on their attendance of therapy, at the behest of campus officials in charge of student affairs. While coercive and invasive, ultimately this is really the only reliable way to ensure that they get the help they need. As LivLuv explained (and without getting into a protracted debate on the correct full diagnostic profile of EDs--a hugely controversial topic even among professionals) anorexia *does* entail, among many other features to be sure, the classic psychology of addiction, including (and most importantly in this case) the mechanism of denial. The attachment to dieting exerts such a profound influence over the anorexic's will as to cause her to perceive those who merely wish to help as threatening obstacles to her "freedom" to manage her diet as she would like.

Which puts you, unfortunately, in the difficult position of having to decide whether the imperative to help overrules the imperative to respect your friend's autonomy and privacy. Personally, I would strongly encourage you to take your concerns to whomever the relevant officials at your campus would be--a dormitory director perhaps, or it that doesn't apply, a campus health provider or student affairs official.

But I am not the one who has to live with the consequences here. So yes, by all means, start by directly expressing to your friend your concerns that she is losing control over her health, and not granting her friends' concerns the well-intended consideration they deserve. Just be aware that this by itself is, sadly, unlikely to result in the response that you wish.

Good luck. For what it's worth, you have my prayers and support.

 

[redkat]

I don't think it's caused as much by the desire to be thin. Your weight is like a scale as to how well you are able to control things. If that makes sense.

I know we all want to be thin... and many start out thinking this is a good way to do it but it usually starts at a point in girls/womens lives that they are feeling out of control. It's becoming more and more common among adult women as well. Feeling too much pressure and competition.

Painted being away at school is like the ultimate freedom for an anorexic. No one is supervising your meals at all. It's a relief and she is likely to loose a lot of weight quickly while first there. It's easy to go to the dining hall and eat nothing but two slices of cucumber without anyone noticing.

You might want to go to your health services and tell them your concerns. Ask them what the usual protocol is for this type of case and what resources they have on campus. Then if you do confront your friend you'll be ready with some facts to help her.

She's lucky to have you as a friend!

 

[Liesje]

Then you haven't talked to very many sorority girls.
I don't want to derail this thread but the fact is eating disorder are caused by the desire to be thin. I have talked, at length, with my friend who is getting her Phd in psychology and specializes in eating disorders and she has said repeatedly that wanting to be thin can be the cause. The control part is controlling how much you weigh.

I understand, I just disagree. My research and experience has proved otherwise. I think EDs is an issue that a lot of even the most qualified professionals in psychology or health studies or whatever still disagree on quite a bit. If we all knew exactly what caused it and how it all worked, it wouldn't be as big of an issue as it is today.

I think in general there's a continuously growing about of pressure on today's youth, especially young women. To me it's not so much about being thin, but being perfect overall and trying to meet everyone's expectations. 30 years ago, it was fine for women to graduate from high school, marry their sweetheart, and stay at home raising a famility, but now women are supposed to get advanced degrees, be successfull, look great, and support families while still having to deal with negative stereotypes and unequal treatment (as far as men vs women). You can't stack up unless you're a perfectionist and able to control yourself.

My own experience with eating disorders is mainly b/c of my involvement and obsession with gymnastics. But even then, it wasn't about thin per se. Most if it was control b/c girls couldn't control who won or when they'd be able to master certain skills. The type of personality you have to have to remain at the higher levels of gymnastics is the same type of personality that lends itself to an ED. A lot of girls also did it for attention. In gymnastics, even negative attention (like being yelled at for being unhealthy) is better than being ignored by your coach and teammates.

I like to think of EDs as addictions. With drug addictions, you don't take the drugs because of the high, you take them to escape from the pain of real life. EDs are the same way. If you can control one single aspect of your life and control it so well you risk killing yourself, it's an escape from the pain of everything else, like too much pressure to succeed.

 

[VertigoGal]

Thinking of it as an addiction, is it possible that, *for some*, self-esteem issues or the desire to be thin could be the root problem? but that it eventually spins out of control. Similar to how many people will distinguish between alcohol abuse and alcoholism.

 

[Liesje]

Thinking of it as an addiction, is it possible that, *for some*, self-esteem issues or the desire to be thin could be the root problem? but that it eventually spins out of control. Similar to how many people will distinguish between alcohol abuse and alcoholism.

Like you said, alcohol abuse does not equal alcoholism. Likewise, disordered/unhealthy/inadequate eating does not equal an eating disorder. Full blown eating disorder are more common than they should be, but still not nearly as common as disordered eating. As it is a disease, there are medical criteria for diagnosing an ED.

 

[VertigoGal]

Yeah. The thing that doesn't make sense is that in terms of alcohol, most people will describe abuse as an "emotional" addiction and alcoholism as a full-blown physical dependancy. In the case of eating disorders/disorded eating, wouldn't even an ED as you describe it be purely emotional?

It just seems to me (although I don't have much experience with it at all) that a lot of the people with eating disorders have very similar backgrounds, and that it's possible many of them started their habits to feel thin. I'd definitely agree that it seems to become about much more than thinness pretty quickly though...

 

[Liesje]

It just seems to me (although I don't have much experience with it at all) that a lot of the people with eating disorders have very similar backgrounds, and that it's possible many of them started their habits to feel thin. I'd definitely agree that it seems to become about much more than thinness pretty quickly though...

Well, wanting to be thinner, or having a parent/coach/friend/boyfriend/whatever make some comment about being "fat" can certainly be the jumping off point, so to speak. I can't believe that this is the cause though, b/c then I think we'd see over half of young women struggling with a full blown ED (although I'm guessing near half of women, maybe more, have at some point participated in disordered eating and such). I mean, what young women doesn't go through a time where she feels fat or ugly? That's just not enough for me. There's more to it. You have to have a certain personality, a certain level of perfectionism, and a certain ability to totally control yourself in order for it to stick. "Correlation doesn't prove causation". Same thing here. I don't completely understand it myself, but I simply can't believe that desiring to be thin is THE CAUSE of a clinically diagnosed ED. Having been obsessed with gymnastics since I was 8 and being a female college student, I know a lot of people who practice disordered eating and a bunch of people w/ clinically diagnosed EDs, and of the latter, I've never heard "thinness" given as the cause of the ED.

Nevermind the alcoholism analogy, if that's confusing. Think of a sexual predator - they don't rape b/c they enjoy having sex; they use sex as the means of controlling women. At the simplest level, that's how an ED works. Being thin is purely incidental. It's all about control. Weight is the best/easiest/most efficient choice because it is visible and easily measureable.

If thinness were the cause of most EDs, why do we see such an increase of male EDs? Last year I did a study of ED cases in both male and female gymnasts competing at the highest levels of the sport. The most severe case was actually a guy who has had an ED for three years, including being hospitalized for it. He had been clinically diagnosed and gone through counselling and unfortunately at the time my research was due, was still struggling with the lasting effects of the ED.

 

[{paintedroses}]

Just wanted to say thanks to everyone who replied to this thread, my other friends have also talked to people they know who've been through similar situations and now we have a really good idea of whats going on and how to approach it. I'm probably going to have a word with her, I know that its only a start and will take maybe months just to persuade her to sort herself out or admit she has a problem.. and I know to expect her to deny it and get more protective. I understand that it's kind of risking our friendship by intruding to help her but it needs to be done.

Thanks for the insights and advice! I'll hopefully have good news to update.