Do you suspect that a friend has an eating disorder? It is likely that at some point in your life, you will have someone you care about that will struggle. Research tells us that over 13% of girls will struggle with some form of an eating disorder by the age of 20, and that doesn’t even include males.

It can be really scary when a friend shows signs of an eating disorder, and it can feel overwhelming trying to decide if and how you should handle the situation. Here are a few suggestions if you suspect a friend is struggling.

Advice for Teens and Adolescents Living at Home

Has your friend stopped wanting to eat around you and other friends? Do they run to the bathroom after eating, are they constantly obsessing over food, diet, appearance, exercise? Have you noticed them being more distant, saying no to hanging out, not quite themselves?

You are right to suspect something is not right. It is normal to worry that if you tell your friend you think there is a problem your friend will get mad at you. You may hope that your friend’s parents know what is happening and that the problem is being addressed so you don’t have to say anything.

When it comes to eating disorders, it is best not to assume anything, and instead try to be brave and have a heart to heart with your friend. It is important not to get angry at them for their behaviors, but instead share that you are very concerned about their health and wellbeing.

Instead of putting them on the defensive and attacking them by listing off all the reasons you know they have a problem, try for a warm and caring tone. Saying things like, “I feel worried about what I am seeing, and all I want for you is to be healthy and happy,” will make it easier to have a productive conversation.

Be prepared for your friend to be defensive or angry. Sadly, very rarely does anyone with this disease ever say “You are right, and I thank you for your concern. I’m so glad you brought this up,” the first time they are confronted. It is okay that they may be mad, or give you some serious pushback.

Before you talk to them, make sure you remember that the end game of getting them connected to help is your goal. You can handle a friend being mad at you if it means saving their life. If they get defensive or mad, just stay really calm and don’t try to ‘win’ an argument over this.

They may give a lot of excuses as to why they are fine, but don’t let this become a debate. Just continue to express your concern that what you see is worrisome and that you really care about them and their health.

Understand that you are not responsible for healing them. That is the job of a professional.

Eating disorders are very serious, so do not attempt to be their doctor or therapist. It is not appropriate for you to beg your friend to eat at lunch, to track the food that they are eating, or to become the food police by telling them what they can or can’t eat.

“Do not assume that anyone else knows what is going on with your friend’s health.”

Know that your role as a friend is to be there supporting them.

You can ask them what would be supportive and encouraging. You can ask them how much they would like to talk about it or not. You can give them hugs when they are struggling, you can be an ear when they are upset, you can be non-judgmental and steady and just be there.

As a friend, it is your job to walk with them, not to try to lead the way.

There are some secrets that belong between best friends. An eating disorder is not one of them. Your friend may beg you to keep their secret, in return they promise to stop doing what they’ve been doing.

This is usually a promise they won’t be able to make good on, as eating disorders rarely just go away without real help. Do not promise to keep this a secret. If you need someone to figure out what to do regarding your friend, find a trusted adult who can give you some solid direction.

Do you have a parent, teacher, coach, guidance counselor you can talk to? Do you have a relationship with their parents? Can you and your parents or guidance counselor meet to talk with them?

As scary as it is blowing the lid off of this, it is crucial that your friend gets treatment as soon as possible. We know the faster we get someone help the quicker they recover with less damage to their body, so don’t wait too long before you start talking.

Advice for an Adult Friend

Eating disorders happen at all ages, and as we get older we sometimes don’t know the rules around addressing concerns with friends. Eating disorders thrive when there is no accountability, and the older people the more autonomy they have.

It is really important to openly address concerns about an eating disorder with your adult friends.

Do not assume that anyone else knows what is going on with your friend’s health. I hear all the time friends who have serious regret that they didn’t talk to their friend about their concerns before it was too late.

“As a friend, your job is to walk with them, not to try to lead the way.”

Eating disorders have the highest mortality rate of any psychiatric disorder. It is easy to believe that a person’s parents, family, or significant other knows what is happening and is addressing it. Remember, eating disorders thrive with secrecy so assume nothing.

Ask the question who knows and what is being done. If you are not sure that anyone is aware of the problem, you may need to be the one to reach out to share your concerns. Often it is life-saving when a friend calls home and tips the family off as to what is really going on.

Families are not often aware of what is happening, and they are thankful for the knowledge so the problem can be addressed. If the family does know, then there is no harm in you contacting them. It can be relieving to a family to know that their son or daughter has people around them that care about their health and wellbeing.

All the same rules apply from the teen section on the stance to talk when talking to your friend. Make sure you express concern for their health and do not shame them or blame them. Make sure you convey respect and understanding that this is a disease, not something to feel embarrassed or ashamed about.

Be prepared when talking to your friend. Do your research ahead of time and find local resources for therapists, doctors, treatment centers, support groups. Make sure that you not only express your concern, but you take it to the next step of getting them connected to help.

Follow up with your friend; ask them if they’ve had any luck scheduling appointments, or ask how treatment is going.

Ask if they would like for you to take them to any of their appointments to be there for support. Ask them how you can be a support system for them. If they don’t want to talk about it with you, remember you are not their therapist.

It is enough for you to know they are engaged in treatment, they don’t need to divulge any details. Respect their boundaries. Try to engage in as normal of a relationship as before, but know it is okay to express your encouragement, love, and concern.

Click here for more content by Melissa Miller, Psy.D.!

Melissa Miller, Psy.D.
Melissa works with teens, adults, and couples. Her areas of specialties include disordered eating, weight management, body image, and self-esteem, relationship difficulties, and sleep disorders. She also provides bariatric assessments as well as pre and post-surgery support. Melissa believes the relationship between a therapist and client is essential to the success of treatment, and she strives to create a warm and caring atmosphere.

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