National Eating Disorders Association

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How to bring up the topic of ED to a friend?

I want to know the best way to approach my friend as I suspect she has an ED.I know it's such a sensitive subject and don't want to offend her. Have any of you approached someone that you suspected had an ED? If so, what would you suggest is the best way?

Bit of background: I've known this friend since primary school. She's always been a healthy weight. When I moved away to uni a few years ago, we lost contact. However, more recently we've been able to meet every 3 months or so.

I first saw her again at the beginning of this year and immediately noticed how thin she looked, none of her clothes were fitting her anymore, they were falling off her.

She's a self confessed "foodie", loves trying new foods, loves cooking and her Instagram is all about new recipes and restaurant ands she's tried. I've been out for meals with her and she's cooked for me. I've not noticed anything out of the ordinary, she eats the same amount as me and doesn't go to the toilet quickly after.

She is quite active, she likes to do rowing once a week. But no major rountine excercise every day. And she does get tired quite easily, but she works very hard and has a lot of exams to revise for.

The most recent time I saw her was the scariest. I could see all of the bones in her arms and shoulders. I could see her spine and her face looked very gaunt. I'm scared for her, I'm worried that she is seriously ill and could end up in hospital...or worse.

We got on to the subject of body image and she said that women have too much pressure on themselves to look a certain way and if women want to look skinny or fat, they can. But she didn't bring anything up to do with eating disorders.

I just know it would be rude to assume she has an ED...and also it's hard for me to bring it up because we do only see each other every few months.

I would really appreciate any advice!

Hi SandyHair!

Welcome to the forums, you have come to the right place :) I want to congratulate you for looking into how to help your friend. It's such a hard topic to bring up, but I can tell that you care for her so much - enough to have that difficult conversation. I have never brought it up with someone myself, but I can remember the exact moment someone brought it up to me during my eating disorder, and it changed my life. My friend told me I looked skinny, and I replied with a shy "thanks," but then he said " look TOO skinny. I'm worried about you." and from that point on, I realized I needed to make a change in my life or I was going to put my health in serious danger. Something as simple as that sentence was enough. So my advice would be to bring it up in a way that doesn't necessarily accuse her of having an ED, but to maybe say that you have noticed she's been getting thinner and thinner and you're concerned about her health? If she seems to get angry at your comment, you could say you are only looking out for her, care about her, and are there if she ever needs anything. Try to keep things as positive as you can. It sounds like her comment on body image could have been a cry for help, without her even realizing it. I understand your concern over not wanting to bring it up in case she doesn't truly have one, but from personal experience, I hid my eating disorder well (as do many others who suffer from them). Most of the people that I've told, now that I'm in recovery, said they had no idea. Looking back, I wish someone would've said something sooner, to help me realize the danger I was in. Maybe your friend is waiting for someone to notice, and to help get her on track to recovery. And if not, at least she knows you care about her health. :) Good luck, keep us posted!


Hey SandyHair.

Dear SH,

Gina has given you some wonderful advice. EDs are odd things, and as she said, some people can be in fairly serious trouble, but not really quite realize that they are in trouble, even though their ED may already have a strong hold on them.

The "food interests" that you mention can be typical too. Everyone is supposed to be "eating healthy" these days, so what could possibly be wrong when they attempt to follow this course? And yet people can still get in trouble, no matter how knowledgeable they seem to be about foods and nutrition.

And yet just as Gina said, it can be really difficult to approach someone about this. Even people who have EDs themselves will often talk about how hard it is to approach someone else who they suspect has the same problems that they do.

One way to approach this is through writing your friend a letter. The kind that you send in the mail. This gives the person time to think about what you have written, and time to consider how they would wish to respond.

And I do think it's fair if you mention what you've noticed. While one would think that the person would be understanding by now that they might be in trouble, as a result of weighing themselves and how their clothes fit, it's quite common for such folks to still view themselves a "fat" even given the fact that the math says just the opposite. So having the input from a caring friend can often help them with their perspective.

At the same time, the last thing that people want is to cause worry for their loved ones, or worse yet, to be a burden on them, so try not to convey your own distress in terms which may seem too graphic. Anyone would worry of course, but if your worries begin to feel too overpowering, it may be best to vent your concerns here, or to an understanding friend, rather than dumping them on your friend.

As Gina also said, your friend is fortunate to have someone as caring as yourself, so while you may not be able to "rescue" her, you can still play an important role, simply through being someone safe and trustworthy that she feels she can talk to.

Again, situations like this can be delicate it's true, but given what you've noticed about her physical condition, it's likely that she's beginning to question her situation, no matter how "healthy" she may have viewed it in the past.

In any case, I do hope you can keep in touch here. It's just us folks here on a screen, but still, it can be good to have someone to talk with sometimes.

Bob J.

Helping a friend

Please, talk to her. It is so much harder for her parents or even her doctor. Often, friends are able to convince sufferers when no one else can. Tell her you are concerned about her being too thing. Educate yourself on the dangers, and then educate her. Tell her you will stand by her through treatment. Involve her other friends if necessary. She may push back hard, and really hate all of you at first, but if she comes through she will love you and appreciate that you saved her life.
Good luck!