National Eating Disorders Association

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Out of Time, Out of Options

I don't know if anyone has anything they can help with this... but I'm out of ideas and out of energy.

A long term friend of mine has anorexia. For many years she did outpatient therapy, she was hospitalized a few times, etc. She had years where she recovered but then relapsed again. Now she's been tubed for so long I forget how long... more than 5 years, and has never been properly compliant with her orders. This year she's at the point where she goes weeks without taking anything by tube, and would not be alive at this point if it wasn't for the IVs she's taking in her port. I've become her legal next of kin because her family have all bailed at this point and can't be trusted to uphold her wishes if something happens to her or is involuntarily committed again, and even in the latter case the courts and her insurance caseworker seem to make all the decisions, and bounced her around between several different geriatric behavioral wards because it's the only mental health facility capable of keeping her bodily alive. But she got no ED therapy there.

I know people have to be ready to recover before they can do it. I know she SAYS she is ready. The problem is that I don't think she really IS ready. There's always a reason why she's not recovering, and it's always someone else's fault. She gets dropped from programs, terminated by therapists, she left one of the big-name ED treatments in Wickenburg because she got into an altercation with another patient and they wouldn't kick the other patient out so she was "unsafe" and had to leave. She complains constantly that care providers are insufficiently supportive and nurturing and that she is being given inadequate encouragement and positive reenforcement. Her insurance declined to continue paying for her to attend the OTHER big name Wickenburg facility because she wasn't progressing fast enough, even though that's the only place she's ever been CLOSE to pleased with the care at (and even there she says she was mistreated in the form of unjustified accusations of purging which raised her stress levels and hindered her recovery.)

I don't have ED. I have never had ED. She's right when she tells me I just don't understand and can't understand. I want to be supportive, but I'm at a loss. "Support" has now turned into 2-3 hour long phone calls where she goes on for forever about how she thought about this thing, that caused her to think about that thing, that caused her to think about another thing, that made her realize a thing that made her remember a memory that made her feel things that made her upset. It's like I'm her therapist. I'm not. When it's not that it's about how unreasonable other people are being and I can't agree. Her landlord is a jerk because her rent is going up when her lease renews. How dare he. Doesn't he know she lives on SSI? So now she's moving because she can't let him set that precident. (Can't explain to her that everyone's rent goes up at lease renewal time. That's how the real world works, but she's been sick since childhood so she doesn't get it.) Her therapist is a lying no good jerk because she got terminated for 3 no call no shows. Don't they know she's sick? They should have made it more clear. They should have made exceptions. (Yes, but they have those policies in place for a reason AND she just set you up with someone in the same practice that does home visits.)

Before anyone suggests the following:
1) I have set boundaries. I accept her calls only when I know I have the time and energy to deal with them.
2) There are no other friends or family members to share in this. Her family are a huge part of the problem, and any friends she does start to bring in on this sort of thing bail within the year. (Hence the username.)
(I'm pretty sure the only reason that 2 hasn't happened to me is 1.)
3) I am not geographicaly proximal to her. She's hours away by plane, so anything that involves being there actually with her is out of the question. She cannot move back north (they say she wouldn't survive a plane trip) and I am not in a position to pick up my life and move to another state over this. It's perhaps callous, but that's the boundaries thing. I have a career and a marriage and I'm not going to abandon any of it.
4) I have told her repeatedly that she needs to tell her therapists what she's telling me. It ends up in arguments about how I can't understand and she just wants to vent and have support from me. I told her not to vent to me then, because it feels like I'm being used as a therapist... and she hung up on me. That was over 36 hours ago now. I'm scared.


You are the most loyal of friends

I can understand why you are scared. You’ve done all you can possibly do for your friend and can’t think of anything else to do. You’ve shown how much you love and are committed to your friend, which is a testament to your own loyalty and strength. But sometimes we can’t do anything except step back and hope our loved ones can carry on. I know it’s such a helpless feeling. You say you have a family of your own. I hope they are supportive of you and your efforts for your friend. Or perhaps a therapist might be able to help you sort through some of your feelings. I’m no professional, but I’ve been to them, and they’ve helped me a lot.


Hi. I just want to send encouragement your way. What is happening is extremely scary I am sure and frustrating and fearful. You have done your best to help your friend. It is now time for your friend to be honest with her therapist and understand the consequences for her actions and behaviors. It is NOT YOUR FAULT. You need to take care of yourself and your family. That may sound callous, but you are correct in saying you are not her therapist. She just may need a wake up call and you pulling out a bit on your involvement may be the best thing for her. You can not save her. She needs to come to the point where she wants to live and take steps that will promote life. No one can do it for her. Each individual has to come to that point where they are ready to fight for themselves. Seems like she's burnt everyone out and for you to think that your hanging in there for her is going to make her decide to live is a burden you shouldn't have to carry. I hear the hurt, frustration and fear in your post. It is scary to watch a friend die. Slowly. You have done all you can do. I am not saying give up on her. But as you pointed out you area setting boundaries which is so important for you, your family and your friend. If she is venting but not changing anything, not listening to advice, but just wanting to vent, that isn't helping her. Hard to hear, hard to take in, but from my perspective, it isn't helping her from what you are posting. I am sorry this isn't very uplifting but the situation is dire. Something has to change. I know you love your friend. You have done well by her. But maybe it is time to take a break. Then check in on her in a week or two and see how she is. But everyday contact if that is what it is, isn't helping her. Or you. I hope you don't think I am being mean in what I am saying. I lost relationships with my sisters over my eating disorder. My parents have stood by me and I am now in recovery. LONG time coming but I am in the early stages of recovery. And it feels so freeing. Your friend has to find a reason for her to want to live. That has to come from her.

I hope I didn't overwhelm you with all I said. You are an amazing friend. But sometimes friends need to say no.

What do you think? Was I too harsh? I hope what I said was a little helpful.

You are an incredibly loyal friend

Like others have said, you are an incredibly loyal and caring friend. Sadly, you cannot make her recover and she must come to that decision. Those who suffer from ED (or any addiction based disorder) must come to terms with themselves and either find a reason to recover or continue down the destructive crash course of ED. I know you want to help your friend but you must take care of yourself and your family. I strongly encourage you to contact NEDA. They have trained volunteers who can help you through this process. If you are not currently seeking professional help, NEDA can help you find a therapist or counselor. I lost most of my friends over my ED and have realized that true friends never go away. You are a true, loyal friend to her but you have to take care of yourself. I strongly encourage you to contact NEDA. They can help.

Please keep us posted on how you are doing. ED is an uncaring, destructive, life shredding disease. Know that you are not alone.

NEDA Contact:
Helpline 1-800-931-2237
Chat at
Text "NEDA" to 741741