Having suffered an eating disorder (ED), I know how hard it is, but I’ve come to realize it sometimes feels just as hard being on the other side, watching a friend or family member slip into an ED’s grasp. If you know someone who’s exhibiting signs and symptoms and you want to be a supportive friend – read on. I’ve assembled a panel of three strong, inspiring women recovered or recovering from EDs, and they are answering questions about how to help a friend alongside myself. I know when I see someone suffering, I feel like I’m failing them. Just remind yourself that simply by still being around in your friend’s life, you’re doing more than you can know.
What’s the line between telling her she needs help and being a supportive friend?
CS: As I was in high school while I was anorexic, my parents were very involved. For me, I just wanted my friends to be there for me by supporting, loving, having fun with me (two doctors’ visits a week for years kind of saps the fun out of life) and not really bringing it up, leaving the difficult stuff for home. That being said, as a college student, I see women suffering whose families don’t see them enough to know what’s going on. I would bring up your concern for her if you don’t think she’s being taken care of, but try and remember just how often this stuff is consuming her mind. Have some nights/outings where it’s just about making sure she has a good time, concern-free.
KN: I think part of being a supportive friend is telling her she isn’t alone in what she’s going through and that she doesn’t have to do it alone. Something I’ve always told my friends and that I’ve been told before is that no one can do it alone. No matter what you are dealing with, everyone needs help sometimes and there is no shame in that. As for crossing a line, I think if your friend’s health (mental or physical) is in jeopardy, crossing the line is worth it in the long run.
AM: This is different with every person I think. For me, if someone knew that I was not eating, then I would not take their advice about anything. It was only my more distant friends who would ask to get lunch with me, or who I would go to the gym with and then eat with that really helped me get back on track. I think as a friend it was most important for me to have people to take my mind off of my problems, give me 10, 15, maybe a full 60 minutes of being happy with my life and who I was, instead of having people who were always reminding me that I was sick, even if their intentions were good. However, I also really needed people just to listen to me sometimes, and friends are always the best people for that.
TS: Sadly, there really isn’t an exact line. Show concern by verbalizing it to your friend but not directly saying, “you clearly have a problem.” Making someone feel cornered and directly saying that you have a problem – that’s crossing the line. A good friend would say something along the lines of “Hey, I just want to make sure that you’re okay, because I care about you so much. I’ve noticed that you….” or you could refer her to support groups in the area.
What resources would be helpful to show her/give to her?
CS: I think therapy and psychiatry can be so, so important, and my lifeline was my dietitian who I loved. If you see a therapist or a dietitian you could recommend, or know someone who has a good relationship with a similar professional, you could recommend their name, and just leave it at that. Don’t press your friend on whether she’ll actually call this person, but provide her with the resource if you believe it’d be a good fit. NEDA, the National Eating Disorders Association, also has a helpline at 800-931-2237.
KN: Sometimes helping someone just get started on the road to getting help is all you can do. For example, helping her look up the phone number to make an appointment at the campus counseling center. Personally, I don’t think giving her something like a healthy eating chart would be helpful, but maybe if you know of an article written by a survivor, or if there is a support group, you can tell her about it and offer to go with her the first time. It might sound cheesy, but reading the book Milk and Honey by Rupi Kaur has become a form of self-care for me because her words always speak to my heart and I’ve lent my copy to multiple friends going through a hard time.
AM: When I went to my most recent physical at the doctor, I filled out a form that asked not only about my physical health, but my mental health, too. I did not open up to my doctor very much, but she gave me scientific evidence that my weight was healthy, and although I continued to digress for a few months, that knowledge eventually helped me get better. Doctors, registered dieticians (not nutritionists!), and mental health professionals are definitely options I wish I had been more willing to go to earlier.
TS: Good resources would be to let her know that you’re there for anything she needs and that you’re not judging her by any means. You could also contact her parents to see if they have been feeling as concerned as you feel. Your friend might get upset if she finds out that you have been talking to her parents, but in the end, she’ll appreciate it more because it really shows how much you care and want what is best for her.
How can I become more educated about what she’s going through?
CS: Ask questions! If you approach her in a completely (and I do mean completely) non-judgmental way and make it clear that you’re not trying to harass her or bring about an intervention, you’re just trying to understand how she feels, I would think she’d be open to talking to you. My best friend wrote down a list of questions, and we went for a walk and she just asked them one at a time and I talked, not even facing her if I remember correctly. It allowed me to feel heard, and it allowed her to try and understand what she saw me going through.
KN: I think understanding that an eating disorder is a physical and mental issue is the first step to being educated on the issue. Every person’s struggle is different so asking her about her personal struggle and how it started, what her triggers are, and just how she feels can give you a sense of what she’s going through. As for understanding eating disorders in general, NEDA’s website has a LEARN tab on their homepage that leads to a lot of helpful info.
AM: Talk to her! Maybe she is not ready to talk about it yet, but just ask. And knowing that you are ready and willing to listen will mean so much to her. There are also plenty of articles written by people who are working through, or have overcome, eating disorders that can help you understand. I personally like TED talks.
TS: To become more educated about what she’s going through you can talk to ED professionals, read scholarly articles online, talk with recovered ED individuals, and ask her personally if she would be open to talking about what she’s going through. However, you need to respect her wishes if she doesn’t want to discuss it and just simply let her know that you are there for her if she ever wants to.
How do I start a conversation about the problem without offending her?
CS: The friend I finally came to is the one who never tried to start the conversation. She waited. And waited. And eventually a year went by, and I told her I was ready to talk. I don’t think there was a question in her mind about what I meant. But her patience and her staying my friend despite what must have been endless confusion and frustration showed me that her love would be unconditional and judgement-free, and so I turned to her. I find for many of us, we have to make our own mistakes and learn our own lessons. I wouldn’t say this applies if you think danger or serious medical concern would befall her, but otherwise, I would say give her space.
KN: I’ve brought this topic up to multiple friends at different points in my life, and I’ve had it brought up to me. There’s so many questions you can ask like “Are you trying to lose weight?” “Are you starving yourself?” “Why do you always go to the bathroom right after eating?” But I think the best way to do it is to start by affirming how much you care and that it is a safe space to open up. Asking simply, “Are you really okay?” can sometimes be enough. The bottom line is to not make accusations or try to make anyone feel guilty and to make sure your friend knows it’s okay to not be okay. When I was in high school and one of my friends was struggling but I didn’t know how to talk to her, I wrote her a letter telling her my feelings and that I had noticed a change. I asked if she was okay. I gave her the letter the next time I saw her, and she wrote me one back, and that is how we came to support each other through many, many joys and struggles.
AM: Honestly I don’t know the answer to this. I was so touchy. Last year my friend brought cookies into my bedroom to share and my other roommate made a comment about how “she won’t eat them anyway.” Definitely don’t do that. I think it depends where in her ED she is. I still get touchy. Sometimes I wish someone would say that they care, and they want to help me get better, but that would involve me admitting there was a problem which I did not want to do. If she is ready to admit the problem, try talking about how you can work on it together. Two heads are better than one.
TS: There isn’t a perfect way to start the conversation because no matter what, you’ll feel as if you’re walking on eggshells when trying to protect your friendship and also her health overall. Be as compassionate and understanding as possible because in many cases, she knows that she has a problem and just doesn’t know how to talk about it herself. Maybe start with saying something like, “Hey so I know you’re okay and you’re strong, but is anything going on that you want to talk about?” Never make her feel like you’re accusing her or attacking her about what she’s going through. Realistically, she’ll be offended on some sort of level no matter how you go about addressing the issue at hand.
Is there a point where I should get more involved – like talk to her parents/boyfriend/etc.?
CS: I would approach your friend before you approach someone else. Some friends went over my head in high school, and I wound up having to speak to a counselor at the school, which was humiliating for me, especially because said friends didn’t realize I was already in therapy and seeing a dietitian to address the problem. Their attempt at help only did me a disservice because it caused me greater stress and anxiety. If you truly believe an adult or parent needs to intervene, tell her you feel that way, and that you’re scared for her and not trying to make her life difficult but you just want her safe. You may learn she’s ready to approach someone herself or already has, and if not, I’d say go ahead and reach out to a trusted adult.
KN: Honestly, yes. If your friend isn’t taking any steps to take care of herself and you feel that her mental or physical health and safety is in real danger, it is okay to reach out. Not only for her sake, but for yours as well. No matter how much you care about your friends, they aren’t your responsibility and worrying about your friend’s life is a lot to carry around for you, and isn’t getting her the help she needs. If you feel your friend is in danger, it is okay to tell her parents about your concerns. I would say parents before boyfriend because she isn’t his responsibility either and having him involved may cause more problems. Even if your friend will be mad, her life is worth it.
AM: Eating disorders can have pretty drastic visual effects, but sometimes we don’t see them until it’s too late. I think the more important indicators of when you should get involved are when she stops acting like the friend you knew. I don’t mean get mad at her for being stressed, or for not making time for you. I mean when she stops finding the same things funny, when she is never home, or always is. I know it is scary to see someone you care about hurt herself, and there are people who are trained to deal with that. If you think involving parents or a boyfriend will help her open up and start getting better, do that, but it might seem like everyone is ganging up on her, which is the opposite of what you want. If you are concerned, get the advice of a professional.
TS: You should talk to whoever is most present in her life first. In the case of college, it’s usually her boyfriend. Ask him if he’s noticed anything different about her or if he is concerned, as well. Then if you both come to an agreement then you could both reach out to your friend together so she can really understand how there might actually be a serious problem if two people who know her well have noticed it. Then reach out to her parents if she isn’t actively trying to change anything or if she is struggling but is too scared to change anything. Parents should be alerted at least that their daughter is safely being cared for when they’re not there and should be included when the ED becomes detrimental to your friend’s health.
Should I wait for her to bring it up to me or should I tell her what I’ve noticed and that I’m concerned?
CS: This is my hardest piece of advice, but I’d say wait. I know it’s agonizing to watch as someone hurts themselves in this way, and yet, when I was struggling with my ED, I loathed the people invading what I felt was my privacy (though of course my behaviors were easily and publicly observable). I began to sever friendships with people who pried and pressed me. My friend who helped me most and who I leaned on during my recovery was the friend who never said anything – AT ALL. I came to her when I was ready, and she told me she’d been waiting for just that.
KN: If you’re concerned, say something. Every time I’ve been worried about a friend and waited to bring it up, I always wish I would have done it sooner.
AM: Just make sure she knows you are listening. I held it in from my roommates for such a long time, and when I finally told them they said, “I know,” which made me pretty mad, and I didn’t really want to talk about it anymore. I knew it was obvious, but I did not like knowing they were just waiting for me to admit that I was wrong, or at least that is what it felt like. Just keep talking to her, ask her how her day was, and let her know you are listening whenever she is ready to open up.
TS: Wait to see if she brings it up and then if it’s clear that her ED is negatively impacting her life/health then you should bring it up to her in a checking-in type way.
Is it okay for me to ask her out to eat/how do I behave when eating with her?
CS: People with EDs typically like to know what they’re going to be eating and when. They’re very obsessive. There was nothing more stressful for me than when plans unexpectedly changed and what I thought would be eating became something completely different. I would say you can definitely eat with her, but try to plan things in advance. If you’re the spontaneous, makes-plans-at-the-last-minute type, try to understand how stressful this might be for her if she’s mapping out her meals.
KN: That is something you can talk about with her. If eating in public places is a trigger for her anxiety surrounding food, she may not want to go out. You won’t know unless you talk to her. As for eating with her, I would say act like it is not a big deal. I think the worst thing you can do (both in the moment and for your friendship) is to take on the role of monitoring her every bite. It will probably increase her anxiety and make her not want to eat more. Eat your food how you normally do.
AM: Of course it is! It will help her to know that you want to spend time with her! Don’t be offended if she says no, though. I did not eat with other people for almost a year. I did everything I could to avoid everyone around meal times. When you pick somewhere to go out to eat, just keep her eating habits in mind. Don’t pick somewhere that she is going to have to get something she avoids. When you do eat with her, don’t make comments, and don’t force her. Encouraging her to eat more is good, but to be honest, I don’t know the best way to do it.
TS: It’s totally okay to invite her to eat. Offer to let her pick the place to make her more comfortable. Don’t change all of your habits, but ask her what makes her more comfortable and try to adjust. For example, if she doesn’t want to go get pizza, then take her somewhere that she can get something she feels would be more suitable but where you can also get your pizza. If there are certain foods that trigger her, try to avoid them when she’s around but don’t stop eating them all together. Simply be mindful when eating with her while respecting her and yourself at the same time.
When did you realize that you needed help?
CS: The typical things didn’t bother me. Hearing doctors say I might have a heart attack. Hearing my mom tell me one more pound would put me in in-patient. But one day, I woke up and thought about how many tears, doctor’s visits, brutal conversations my mom had been through. I thought about the friends who were by my side, waiting for the old me to wake up again. I realized that even if I was too stubborn to help myself, what I was doing to the people I loved wasn’t okay anymore, and that’s when I accepted help and started on antidepressants which changed everything for me.
KN: When I was 14, my mom gave me a long hug, and when she pulled away, there were tears in her eyes and she said, “It makes me so sad when I hug you and feel your bones.” That really shook me, and I realized things had gone way beyond my control. I agreed to talk to a therapist about my eating disorder as long as I could choose the therapist.
AM: The first time I made myself throw up I was pretty shaken, but I had been trying for months, so I was also almost proud of myself. I ended up telling my boyfriend and he helped me, but I don’t know that I ever got to a point where I realized I needed help, I think those around me helped me before I even asked. It was not until a few months later when I stopped purging and could no longer starve myself did I realize how bad I was.
TS: I realized I needed help when all of my family, friends, and doctors hit me with the reality that my heart was about to give out at any second. Sadly, I didn’t realize I needed help sooner, so it led to an extreme for the reality to fully sink in for me.
When you were experiencing your disorder, what did your friends do that was helpful? What did they do that you wish they’d done differently?
CS: I resented people who talked about me behind my back. Frankly, we all do it. If I am concerned about a friend now, I’ll bring it up to another friend to make sure I’m not seeing something that’s not there. But my friends were a little careless at the time. I would walk up to my friends and the conversation would hush. Once I got sent a group chat message about me that was supposed to be sent to a group without me in it. If you’re really concerned, talk to your friend, don’t just let the gossip run rampant.
Again, my friends that waited until I approached them, I appreciated. My friends that treated me like I was the same person, the friends who still wanted to laugh and play Just Dance at sleepovers, those friends I appreciated.
KN: My friends were always there when I needed them if I wanted to talk, and they didn’t treat my disorder like the elephant in the room. However, my friends would always try to tell me to finish my food or take one more bite, and that increased my anxiety about eating because I thought everyone was watching me.
AM: The most helpful things were going to the gym with me and eating with me. My boyfriend told me I was beautiful, which is always nice to hear, especially because I think that was a big part of what made me lose my self-confidence. Having friends that helped me keep up with my exercise, but then also encouraged healthy eating at the same time made me feel good about how I was nourishing myself.
TS: My friends avoided talking about it for a while and would just ask my mom if I was okay and if I was eating, which really bothered me because I wish they would have just checked in with me face to face. I didn’t like knowing that people were constantly talking about my health when I wasn’t around. My friends also were great in supporting me by eating with me instead of me eating alone. They also promoted being more relaxed about exercise and food and led by example in the sense of not going to the gym every single day, and they would treat themselves, which allowed me to feel like I someday would be able to, too.
My friend has been leaning on me for support and now I feel drained – how do I support them without their issues consuming me?
CS: I had the hardest time understanding what I what doing to my friends and family while I had an ED. I would vent for hours to my mom, my aunt, my friend, a youth group leader, and then I would say, well who needs therapy if I have this! Eventually my mom told me that these people couldn’t be my therapist because they didn’t know how to detach themselves from the pain they felt at what I shared. I could walk away feeling unburdened, but they walked away carrying what I’d just put on them. Once I had professional resources, I could talk to my friends and let them know what was going on in my life without needing them so much.
KN: First, remember that your friend is not your responsibility. You can listen and support them and help them find resources, but remind yourself that ultimately what they do is out of your control and it isn’t your job to save them. Second, take care of yourself. Whatever self-care things you do for your mental and physical well-being, do a little extra on the days you feel drained. If you are the only one who knows what is going on, suggest your friend tells someone else they can trust as well.
AM: This is really important, and it is not your burden to bear. Talk to a professional, talk to your parents, talk to your other friends. Remember that it cannot stay bottled up inside you. And, as hard as it sounds, sometimes you need to let your friend know that there are professionals they can talk to. Keeping yourself happy will be better overall for your friend; you don’t want to become grumpy whenever you are with her. Don’t imply you don’t care, but at a certain point a friend is just not enough, contact a professional.
TS: It’s completely normal to feel drained, because having an ED is something that consumes a person and everyone around them. If you supporting them gets too much for you, then you need to take time for yourself and just tell her that you’re still there for her, but make sure she’s aware of the strain you’re feeling. This can cause her to want to change her habits more if she knows that it’s affecting the people she loves. For me the hardest part wasn’t the damage I did to myself but was the damage I did to others when they were just trying to support me and care for me.