Helping a Friend with Eating and Body Image Issues

When you suspect that a friend or loved one has distorted eating or an eating disorder, it is natural to be worried and want to help. It is important to recognize what you can and cannot do for this person. “Helping” does not mean making the person better or even making sure that he or she seeks help. You don’t have control over this. “Helping” does mean that you talk with the person about the behaviors and attitudes that you have observed and that concern you. By doing so in a direct and respectful way, you may be able to provide an opportunity for your friend to hear and see things from a different perspective.

It is important to identify a “pattern of behavior” and not jump to a conclusion based on a rumor or an isolated incident. If your friend does have a problem, he or she probably feels embarrassed, fearful of others finding out and of being judged. Sensitivity to this will help you to understand how reluctant someone can be to acknowledge that a problem exists. Your friend may react by getting angry, denying or minimizing the problem when approached. It is important to remember that while the person may know that the behavior is unhealthy, it has become a coping strategy. It can be frightening to give up behaviors that are familiar.

Be gentle with yourself. This may be the first time you have had to confront this issue with someone. There is no perfect way to do this. You will not make things worse by saying something. However, the situation may get worse if you don’t say something.

How to Approach Someone

  • Find a quite place to talk and a time when you won’t be interrupted.
  • Talk with the person privately.
  • Share your memories of two or three specific times when you were concerned. (Examples: Found boxes of laxatives in the trash, heard vomiting after meals, noticed an increase in exercise, food missing from the room, avoidance of meals or gatherings that include food, increase in negative comments about his or her body)
  • Use “I” statements when expressing your feelings (“I am worried about you when I see you exercising more than usual.” “I get scared when I hear you talk so much about dieting.” “I heard you vomiting last night after dinner and I am really worried.”)
  • Avoid “You” statements: “You are too skinny.” “You exercise too much.”
  • Stay focused on sharing your feelings and observations and not on detection of an eating disorder.
  • If your friend reacts negatively, let him or her know that you decided to speak up because you care.
  • Let the person know that there is help available if he or she would like to talk with someone.
  • Once you have talked with the person, you need to let him or her be responsible for taking the next step. Be prepared that the person might not yet be ready. It is important that not every conversation be about this issue, yet if you continue to see the same behaviors, it is appropriate to touch base with your friend again about your concerns.
  • Continue to demonstrate that you care about this person and your friendship.
  • Do not monitor food intake or food choices.

After the conversation

  • Pay attention to your own feelings, which may include helplessness, fear, anger, frustration.
  • Regardless of your friend’s response or whether you see changes occur, NEVER underestimate your efforts. You have expressed that you care about an individual and your words make a difference.

Adapted from the National Eating Disorders Association (800-931-2237)