Dear Fran,
A close friend of mine has been struggling for years with an eating disorder. We went to high school together, and she was heavy then, but always on and off diets. I remember there was a period where she was making herself vomit. I thought it had stopped.
We went our own ways during college but kept in touch, and now we’re both working in the same city. Sometimes we meet for lunch or dinner. It drives me crazy how obsessed she is with food and her weight (which has got to be close to 100 pounds now) and everyone else’s weight, too. I feel sick watching her put on a show about how much she loves something on the menu, only to realize that she will, again, play with her food, pretend to eat, and at most take only a few bites.
Lately she’s been on a kick about how she wants to have surgical implants to make her breasts bigger. Last week we had lunch and she went on and on about a mutual friend who recently gave birth, whose body has miraculously bounced back to pre-pregnancy proportions and who gets a ton of compliments because of it. I feel like I’m constantly on the edge of a meltdown when I’m with her—her obsessions are overwhelming, and so many topics are off-limits. I’m sincerely worried about her general wellbeing and how it fluctuates from day to day.
I want to be a good friend and help her get through this once and for all. But I also find myself frustrated with her because I can’t understand why she has to take it to such an extreme. How do I help her?
Frustrated
Dear Frustrated,
This is a very serious and scary dilemma, and you’re definitely not alone in worrying after a loved one’s wellbeing in this regard. More people die from eating disorders than any other mental illness according to the National Eating Disorder Association. Their website states: “In the United States, as many as 10 million females and 1 million males are fighting a life and death battle with an eating disorder such as anorexia or bulimia. Millions more are struggling with binge eating disorder[s].” These are staggering and heartbreaking statistics.
I think it’s probable that your friend’s disorder is so extreme because she has a mental illness that likely isn’t about food—more likely, it involves a need for perfection, low self-esteem, and a sense of lacking control and power. It may also stem from possible sexual abuse or being bullied. The cultural and societal pressures placed on American women can be overwhelming, especially when they’re combined with complex psychological and emotional issues.
When I was a teen, I became seriously addicted to amphetamines (known as diet pills)—so this issue has long-been a frustration of mine, and I completely understand your concern and yet also why you feel upset. According to NEDA, eating disorders “show up everywhere in the world that aspires to Western standards of beauty.” What can we expect when the current ideal female body size has shrunk to such tiny proportions? Only a small percentage of women over 25 years of age can possibly attain that “standard” without either starving themselves to death or having plastic surgery to unnaturally place huge breasts onto a tiny frame. It galls me that we’ve somehow gone from empowerment through equal pay for equal work to empowerment through plastic surgery.
As you support your friend, here are a few things to keep in mind:
1. Focus on what you see, and how it makes you feel so sad. Tell the truth about how you feel, but remain compassionate and non-judgmental.
2. Without centering on her (or anyone’s) appearance, make your concerns about her overall health known and gently suggest that you hope she’ll see a doctor. Compliment and encourage her strengths, ideally successes and accomplishments that have nothing to do with her physical body. When I consulted Carolyn Costin, author, therapist, and eating disorder expert, she commented, “We have a toxic culture that tells us that it is more important to be thin than be lovable.” Let your friend know that she is loved, and it is completely unrelated to her body.
3. Give her something positive yet relevant to read, like 8 Keys to Recovering From an Eating Disorder, by Carolyn Costin, or refer her to a great blog like Margarita Tartakovsky’s “Weightless” at PsychCentral, which offers tips, activities and inspirational advice about health, eating, media distortion, and body image.
4. Learn the facts about eating disorders. This will help you reason, in a caring but firm manner, against your friend’s manipulations or the mistaken ideas she may be using as excuses.
5. Recognize that you’re in a tough position, and be gentle with yourself too. While your friend’s life could be in danger, you are not responsible for her actions or their consequences; she is. You run the risk of alienating your friend by speaking your mind. However, it’s my experience that you can minimize that risk if you communicate you’re aware you can’t control her, but genuinely want to help.
6. Be a positive role model for your friend with regards to eating, exercise, self-esteem and self-acceptance. Acknowledge that the pressures on all of us to mold ourselves into ridiculous ideals are overwhelming. Become a critical viewer of the media and check in with your own wellbeing; make sure you’re not becoming hypersensitive to body and weight issues due to your friend’s struggles. Refrain from disparaging yourself or anyone else for their appearance, both when you’re with your friend and when you’re not.
I wish you and your friend good health, self-acceptance, and the ability to embrace your inner beauty.
Fran
Have a question for Fran? Email advice@thedailymuse.com
2 Comments on "Help! I Think a Friend has an Eating Disorder"
Fran,
I enjoyed reading your response to “Frustrated.” When I was in highschool, my best friend struggled with an eating disorder that almost claimed her life. After being hospitalized, it seemed she had bounced back and yet we found out a year later that anorexia had turned into bulemia. Years later, she is happy, healthy, looks fabulous, and reminds me of her old self again.
The reason I chose to comment on this particular response though is that, as you said, while it is her friend that Frustrated is most concerned about, she needs to remember the toll it can take on her and their friendship. My senior year riddled with fights, tears, and worry as I watched my friend literally dwindle away as well as our friendship die out. I received a note in which I was partially blamed for the situation which only made me mad. Once so close, I no longer understood her, couldn’t help her, and was denied anytime I reached out. It was hurtful, painful, and scary because at the end of the day no matter how I felt, she was the one severely at risk.
In college we barely kept in touch, but I heard she struggled to find her way and find herself. Now, some 5-7 years later, my friend is back. I think we have both grown into our own person and life. I truly believe she found her happy place and her confidence and now is living life to its fullest. We don’t really talk about those years, we focus on the present.
But I do want to remind your reader that at the end of the day, there really isn’t all that much she can do. She just needs to understand what she has to lose.
Thanks!
Dear Jocelyn,
Thanks so much such a great comment and for sharing this. I think your story demonstrates why this is so serious, and such a dilemma for a friend. Part of the clinical picture with certain mental disorders is denial and you demonstrate that quite well. And yes, I agree, Frustrated does need to remember that there may not be anything she can do in the final analysis. As I said, she must also remember that she isn’t responsible for her friend’s actions OR their consequences. I’m so glad your friend is doing so much better and that you have reunited!
Best,
Fran Dorf, MA, MSW