National Eating Disorders Association

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How to approach helping my bulimic friend

One of my best friends is 26 and has struggled with her weight and has had a very poor body image as long as I've known her - let's call her 'Cat'. I am looking for advice on how to open a dialogue with her about her secret eating disorder.

Background info: Over the years Cat has gained an alarming amount of weight and I've had my suspicions that she was a binge eater. She has also been heavily dependent on weed since she was about 13 and is quite open talking to me about it/most topics. We talk a lot about mental health issues, as I myself have suffered from medical-trauma related PTSD. Cat has attended Narcotics Anon meetings and quit smoking weed on/off over the years. She is a very intelligent, emphatic and hard-working person with a good job, but she is also an anxious/fearful person and it seems to me like she's self-medicating her insecurities.

Three summers ago (when I was living abroad) Cat suffered a bit of a breakdown of sorts caused by taking too much LSD (at the time, unbeknownst to me, she had started experimenting heavily with her school friends gang whom I don't know well, but gather that they are all basically enablers). Cat's parents found her high on LSD roaming the streets screaming nonsense, and were very worried and took her to spend some weeks in a mental hospital to get her help at that time. I was her only friend who visited her at hospital. The doctors said she was experiencing drug-induced psychosis, but I have a feeling there is much more going on inside her, that from my perspective, didn't really get dealt with during her stay... such as *what* was driving her pattern of behaviour to go off the rails every so often in the first place. Cat's mother is also a recovering alcoholic (30 years sober!) so, unfortunately, addiction definitely runs in my friend's veins!

Present day concern: Despite Cat's brief stay in hospital several years ago, my friend has stayed off all drugs harder than weed but her weight and insecurities have only continued to grow. A few months ago, she moved into an apartment with another one of my close friends (who I will call 'Ann').

The other day, Ann asked to speak to me privately.

Ann said she wanted to let me know that she was overhearing Cat vomiting in her bathroom at night when she thinks everyone is asleep. This information shocked me, as while I had assumed Cat was a secret eater, I NEVER would have guessed she purged/had developed bulimia also. I don't *think* she's been purging for too long, if I were to guess, it probably would have started when she was living on her own for a year before moving in with Ann. Perhaps the shame that Cat was feeling from over-eating spiralled into bulimia?

Recently, Cat has been talking about wanting to live on her own again and in light of knowing this new information, I worry it's so she can be alone to indulge her secretly-guarded disordered behaviours. Clearly, she assumes she is hiding it well from Ann/me/everyone else in her life. Over the last year, Cat has grown very pale and just looks generally very unhealthy... I am very concerned for her now that I know she has bulimia as I know that it is a life-threatening illness.

My problem is that I do not know how to best approach or help Cat.

This is partly because Ann has (unfairly) asked me never to say to Cat that she has regularly overheard her vomiting at night. This seems to me rather cowardly of Ann, since she is genuinely concerned for Cat too, yet seems to have 'passed the parcel' of addressing Cat's problem solely to me and is trying to avoid any conflict/take the easy road basically...

Without Ann's permission to participate in the conversation, I have no evidence or possible way of knowing Cat is a secret bulimic. So if I were to approach Cat on the subject tomorrow, she will most likely deny it vehemently and then quiz me on where I'm getting my information from (Cat is very clever and it wouldn't take her long to suss it out). Additionally, I also don't want to cause a conflict with Ann/Cat's living situation or drive Cat to move out and live alone again (which would be a disaster for obvious reasons). If I can't get Ann's permission to include her name as the one who's heard Cat purging at night, I have no solid 'evidence' and Cat will shut down the conversation... and worst case scenerio possibly even start avoiding talking to me altogether due to her social anxiety/paranoia.

I know that Cat considers me her closest friend, and I know that if I approach her in a loving, kind and non-judgemental way about her secret struggle, she *MAY* open up to me, so long as there's no way for her to flat out deny it or wriggle out of the conversation citing I have no shred of evidence. It greatly distresses me to know that my wonderful friend is hurting herself in this way and much feel totally alone with her battle, given that she opens up to me about literally everything else. I am assuming she must be carrying A LOT of shame about of her struggle and I feel like if I stay silent about knowing about it, I'm letting her illness 'win' and she is so much more than it.

I want to let her know that I'm here if she wants to finally confide in someone about it, and also if she wants to get help.

What advice can others give me on how best ease open a dialogue about her ED and finally let me friend know that I know? Is there any posible way i can do it without involving Ann or am I going to first have to convince Ann to get on board also?

Confronting Friend

Dear ILB,

It's true : Ann has put you in a fairly impossible position. Which is really not fair at all. She's interesting in seeing the matter addressed, and yet is afraid to address the situation herself, so she's asked you to do it, and yet she's robbed you of the tools that you need, in order to do that.

There are several down sides to this from your point of view. If you were to try and confront Cat, while having to hide the fact that you know, then she could just deny it. then there'd be a layer of lying that's been added to the situation, on top of everything else. Which is not exactly the way to help make things better.

What you would rather be able to do is treat the situation from the standpoint that you already know what the truth is, so that the two of you could move forward from there, and would not have to deal with the truth or not of that part of things.

You really don't want to get stuck beating around the bush about this, as that's just a waste of energy that could be better used to help things, so you may have to let Ann know that while you are glad that she told you, you can't really move forward without making use of the info she shared with you.

After all, she's turned to you for help too, you know ? So she needs to allow you to help.

Even if that means telling Cat that you know ( Which you really do need the opportunity to do) and letting her work out for herself how it is that you came to know.

Bob J.