National Eating Disorders Association

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Supporting my best friend post- in patient treatment

My two best friends and I have known one another for about ten years. Recently my friend, Mariah (not her real name), has revealed that she has been struggling with BED for years, probably since childhood. Our other friend, Carrie, and I had long suspected there may be an issue but we had never discussed it with her. This is a struggle she has kept extremely private for a long time.

Well, Mariah recently was told by her doctor that she needed to pursue in patient therapy for BED or he/she could not see her anymore. She checked into a local facility for three weeks during which we had no contact with her. After reaching out to her sister to check in, we both sent supportive emails to her and heard back shortly after that she is beginning the next phase of treatment. She will attend the facility 12 hours a day, 7 days a week for another 3 weeks but can communicate with us in the evenings.

WE NEED HELP! What is the best way to be supportive during this sensitive time? Check in frequently? Infrequently? Ask when we can get together or not? Talk about "normal" things so she doesn't feel pressured to constantly update us on her recovery? We have tried a little of each and are at a loss. We are getting one word responses, answers to some questions...its really difficult to gauge what is best....

Any and all advice is welcome! We want to be supportive and don't know how.

Hi MSteel,

Welcome to the forums! It's clear from your post that you and Carrie are dedicated friends. It's great that you're reaching out and trying to learn more. I totally relate to where you're coming from; when my sister entered ED treatment I felt like I was walking on eggshells and I was so worried I would say the wrong thing or somehow make things worse. In some ways, every individual is different so there may or not be blanket rules for the kinds of things you "can" or "should" say. Some things you'll just have to feel out with your friend and see what feels right and see how she and her family respond. Regarding how often you should check in, what if you and Carrie ask Mariah what she would prefer? You could ask her if once or twice a week is okay, or if she wants to be in touch more often. You can let her know that you want to be there for her but that you also don't want to overwhelm her or make her otherwise uncomfortable. If you give her an "out" and let her know you won't be offended, she may be more honest about what her wants and needs are. I think you could let her know that you'd love to be able to get together with her when she feels up for it, but also that you want her to do what's best for her health. In regards to what to talk about, I agree that choosing non-ED and non-treatment topics might be nice. She's spending a lot of her day in treatment so she might like a break from those topics. I can relate to your frustration and uncertainty--my sister reacted similarly and wasn't very talkative. It's possible that the ED or other health issues are making Mariah less sociable than normal, and she may generally feel uncomfortable or ashamed about being in her current situation. Even though it's clear that you and Carrie care about her, EDs and mental health issues in general are associated with a lot of shame and stigma, so many people can feel embarrassed about needing to seek treatment or about drawing attention to the issues they're dealing with.

I hope this answers a few of your questions! I'm not an expert or anything, these are just my opinions based on my experience. You might also talk with Mariah's sister or other family members and see if they have suggestions or if they know Mariah's preferences. It's definitely a complicated situation, but it's so great that you're doing your best to be there for your friend. The fact that she's seeking treatment is a great sign; remember that recovery is possible!

Here are some resources from around the NEDA site that might be helpful for you: (It's not just for parents! It has some great info on what to do and not do.)

Good luck! Please feel free to post here anytime you have questions or need support. We're here for you. :)

Thank you so much Kelsey, I

Thank you so much Kelsey, I truly appreciate your response. You make a great point, that her feelings of embarrassment due to the stigma surrounding this disease are probably contributing to her being less social than normal. I have been hesitant to reach out to ask her preferences for how we reach out to her etc. because I was scared that even posing the question would be "wrong" and offend her. Reaching back out to her sister is a good suggestion, and honestly I should probably just work up the nerve to ask my friend how to best support her. I am really proud of her for seeking treatment, and want her to feel open to talk about it with us if she chooses to.

It is probably relevant to note that I am a social worker and Carrie is a nurse. I don't work in direct practice anymore, but I think our experiences influence how we talk to Mariah. I am trying hard not to sound too clinical when we talk...and preventing Carrie from asking for her bloodwork haha :) We are trying!

Thank you again! It felt really good to connect with someone else with a similar experience.

Close to home.


I saw that you had some experience in the helping profession, so I just wanted to mention that at least in my experience, it seems like it's a lot easier to support people who we know through our work than it is to support people we are personally close to.

I'm not quite sure why that is, but it may be something that you're noticing too. Maybe it's that we worry that somehow all of this will have an effect on our friendship ? If we somehow don't do or say the right things. Like there's more on the line when it's our friends, you know ?

I'm kind of in the same position myself - I found out that a close friend was in some medical trouble. It's sure to have an effect on her, but like with your friend, I'm hesitant about what I might say.

So what I came up with is something like this… " I know these are difficult times, but no matter how things go, I want you to know that I hope it won't get in the way of our friendship. "

Because ( among other things) I do think that's what we worry about, you know ?

Bob J.