Eating Disorders
How to Help a Friend
with an Eating Disorder

by Edward J. Cumella, Ph.D.,
Director of Research and Education
Remuda Ranch Programs for Anorexia and Bulimia

Many people have friends with eating disorders whom they would like to help. The tips below will increase the chance that your efforts to help will be seen by your friend as the caring gestures that they are meant to be.

First, prepare yourself with information:

• Know the signs of anorexia and bulimia so that you are acting out of clear information rather than uninformed suspicion.
• Learn about the medical and psychological consequences of eating disorders.
• Understand that eating disorders are complex. Recovery is not just a matter of will power.
• Learn what community and healthcare resources are available to help people with eating disorders.
• If you are a person of faith, consider praying that your friend will be open to help and for guidance in your choice of words.

Next, pick a non-stressful time to discuss the problem with your friend:

• Describe your concern to your friend.
• State what you have observed-list evidence of the problem.
• Be compassionate; listen.
• Try to understand things from the person's perspective. Understand that people with eating disorders often make decisions based on their feelings rather than on facts and logic.
• Express your concerns about the person's health and functioning, not just their weight.
• Indicate your conviction that the situation should at least be evaluated by a professional.
• Explain how you can help-with a referral, information, emotional or financial support.
• If you and your friend are people of faith, consider praying together for her well-being and for wisdom in her decisions.

Be ready to:

• End the conversation if going nowhere or if the person becomes upset. But if possible, leave the door open for further conversations.
• Have patience: If rejected, try again later, explaining that you are coming back because you think the situation is serious.
• Respond during emergencies: If the person is throwing up several times per day, passing out, complaining of chest pain, or talking about suicide, get help for them immediately.

There are also some things to avoid-actions or words that could lead your friend to feel as though she is not being heard and to reject your help:

• Don't oversimplify. Avoid platitudes like, "Eating disorders are an addiction like alcoholism," or "All you have to do is accept yourself as you are."
• Don't nag about eating or not eating, or spend time talking about food and weight.
• Don't be judgmental; don't say that what the person is doing is "sick", "stupid", or "self-destructive."
• Don't give advice about weight loss, exercise, or appearance.
• Don't say, "I know how you feel." Instead, you can demonstrate that you understand by paraphrasing what the person has said.
• Don't feel obliged to agree with the person's perspective or beliefs, even though you are making an effort to understand them.
• Don't bring a group of people to confront the person.

Finally, think about ways to take care of yourself during this stressful time. Remember that you matter too, and that good boundaries will help protect your well-being as well as that of your friend:

• Don't make promises you can't keep; don't promise to keep the person's behavior a secret.
• Don't get over-involved. Know your limits. You are not a substitute for professional care.
• Find support for yourself. Talk to a counselor or healthcare professional; attend a support group for family and friends of those with eating disorders.

By following these guidelines, you increase the chances that your desire to help your friend will lead to real change in his or her life. And you are more likely to preserve the friendship and your own balance in the process.

Professionals specializing in eating disorders can be located by contacting Remuda Ranch Programs for Anorexia and Bulimia at 1-800-445-1900.

This article is part of a continuing series of monthly columns. To be notified of updates, please sign up for the HealthyPlace.com Eating Disorders Community Newsletter.

Other column's include:

• When is it Time for a Parent to Take Action?
• Eating Disorders Aren't Always Obvious to Parents
• The Isolation of an Eating Disorder
• Dealing with an Eating Disorder Relapse
• Exercise Bulimia and Its Dangers
• Binge Eating: How To Cope With It
• Pregnancy and Eating Disorders
• How to Help Your Child Stop Vomiting

Concerned about whether you might have eating disordered behaviors? Take the Eating Attitudes Test.

back to top | send page to friend | home