National Eating Disorders Association

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Supporting a friend in need

Hello all,

What is the most challenging part of supporting your friend through an eating disorder? Let us know! Your answers may help other friends in support roles feel they are not alone, as well as help them know what to expect. People in the supporting role need support too!

Thanks!

Erin
Helpline Volunteer

ConcernedFriend82
Everyday ways to help?

My friend (and co-worker) suffers from anorexia. She's acknowledged her condition to me and I've told her I'm available to talk (and sometimes we do talk about how frustrated she is), but I'm not sure what the best way to help is on a daily basis. Our desks are very close, meaning I can't help but notice when she skips lunch (or only has a spoonful of yogurt) and when she ducks out to exercise for hours. More than anything, I want our office to be a place that feels safe and comfortable (and not as though someone is evaluating her behavior), but I also don't want to look the other way while she's harming herself. At the same time, we both have to get our jobs done, and we can't have non-stop heart-to-hearts during the workday.

I'm wondering about these types of scenarios.

1. I'm having lunch/a snack. I offer her some and she declines. Is it ever worthwhile to push a little bit?
2. She tells me she's about to go work out. Do I ask if that's really a good idea?
3. I simply notice that she hasn't had lunch. Is it worth asking her about it?
4. We make weekend plans for brunch or lunch. At the last minute she changes the time and wants to do coffee instead. Worth it to push a bit there too?
5. She makes brownies for the office and then never has any herself. Ever worth it to challenge her on this or apply a little pressure?
6. We've started an office tradition of gathering for lunch one day a week. She joins in, but eats very little. Are we doing enough by simply having a food-based social gathering that she's involved in? Or is it worth nudging her a few more times to try something? Is it ever a good idea to comment on how little she's taken?
7. I'd like to make weekend plans with her. Should I start out by inviting her to a meal? Or just not even try and invite her to something smaller (frozen yogurt, etc.) instead?
8. Is there any other non-threatening way I can do a little something each day?

I realize that there probably aren't easy answers to any of these questions and that they might depend on the nuances of our relationship and her personality, but to the extent possible, I'd love some guidance on this. As far as I can tell, her condition is quite severe and she's having significant health issues beyond simply looking excessively thin. Most of the advice on the web seems to focus on how to approach someone about their eating disorder...not how to navigate it on a daily basis.

Thanks so much for any insight!

ConcernedFriend82
one more question

- I suggest we try XYZ food (something that's still healthy in moderation). She says she doesn't want any because of the fat content. What on Earth is the proper response to this?

My friend is one of the kindest and most thoughtful people I have ever met. I hate seeing her caught in the midst of this!

eghall
You are a good friend

Your friend is lucky to have you in her life. Not only do you appreciate how kind she is, but you care enough to help her. It can be hard sometimes to support and understand someone with an eating disorder so thank you for not giving up on her.

Here is a starting point for helping your friend:
http://www.nationaleatingdisorders.org/family-and-friends

The best thing to talk to her about is getting professional help, as she can't get over an eating disorder on her own. As important as your help is to her, recovery needs a professional treatment team.

As for your questions, I love how much thought you have put into helping your friend! Again, it shows how much you care. Talking with her in a gentle manner will probably be much more comforting to her. I know it's frustrating and hard to understand what she is going through, but try to not get angry or frustrated when speaking with her. It sounds like you are taking a comforting approach with her already. My suggestions to your questions are below, but I am not a doctor and do not want to give you the false impression of that. You can always call an eating disorder specialist with these questions and get some advice from a professional.

Q1: I don't think 'push' is the right word here, although I don't believe you meant it in that manner. You could say something like, "I understand you don't want any of my snack. I hope you know you can feel safe with me and I am here if you need to talk." and leave it at that.
Q2: Instead of talking with her about her working out, maybe you can ask her if she'd like to go on a walk with you instead or check out a new book store you noticed. I know this is during work hours and you may not have the availability to duck out with her, so these options may not be possible.
Q3: Just like Q1 - let her know she is safe in your presence and you are there if she wants to talk about how she is feeling.
Q4: Eating and eating establishments are very scary for her. Coffee shops are safe to her and may be a good place to facilitate a conversation about getting help.
Q5: Try not to add any pressure on her in this situation. A common symptom of eating disorders is a preoccupation with food. It's not unusual for someone to cook 'forbidden' foods and give it all away to others.
Q6: Again, try not to comment on how little she's eaten. What you see as very little, she most likely sees as a lot and may already feel stressed out just being in this situation. A knowing, supportive, understanding smile towards her could go a long way.
Q7: To best connect with her, again maybe trying a different activity will help here. Anything food related is, again, probably very stressful for her. Trying to "force" someone suffering to eat is not suggested.
Q8: This is a great question. Simply being there for her and letting her know you want to help her in any way possible will be helpful to her. Let her know that you understand that she is struggling and you love her. People don't choose eating disorders, and they are not about vanity. Encourage her to find help - a therapist or support group. You can find some in your area on this website under the Find Help & Support tab.

As a friend, where you can help the most is with love and support. The doctors and treatment team are what is going to help her with the disease. And you deserve support as well while you help your friend, so come on here and talk it out whenever you want! As a former sufferer, thank you for being there for your friend. Your value to her is truly INVALUABLE.

ConcernedFriend82
Thanks so much for your

Thanks so much for your response! I've tried to take the non-aggressive, open-to-talking path, but lately have been worrying that I'm not doing enough. It helps to know that may not be the case!

I should have mentioned that she already is getting help. She sees a therapist and a nutritionist weekly and has a primary care doctor who is very active in her care. Nonetheless, as far as I can tell, she's gotten worse (medical problems have come up and she seems to be eating less, at least in public).

I know I tagged the last question on at the end in a separate post, but I'd love to know your thoughts on that too. When she makes a comment about the fat content in something, I'm inclined to simply nod, and say "ok, that's fine." But I also don't want to suggest that it's reasonable to avoid a food all together for that reason. I worry that she'll think I share that view, and will therefore think it's normal. An additional layer is that I'm naturally thin, and I think she may view us as being the same size (she is substantially thinner than I am at this point).

eghall
You are doing great as a friend!

Hi!

I am so glad to hear she is getting help and that her doctor is so active. It sounds like she is on the right path. During recovery, it is normal for behaviors to worsen and/or change during this time. Encourage her to talk to her treatment team about it and don't be afraid to say something like, "It seems you have been eating less at lunch. Is everything ok?" or "How can I help you with your treatment plan at lunch?" Or you can ask simply her how everything is going in treatment.

As for the fat content question, your response hasn't been wrong. It's very hard to know what to do in those situations and you are such a good person to be so concerned about getting in right. Another thing you can say is "I understand that is scary for you. However, it also has lots of health benefits like..." (such as peanut butter or something like that). She will probably still decline but at least you are helping her see benefits. And if you are eating it anyway in front of her, it shows that you don't share the same view. Again, just giving her an understanding look and saying "When you are ready to have some, I'm here to share with you" let's her know you are there for her.

Although she is thinner than you, it's very possible that she actually sees herself as heavier. People with eating disorders do not see themselves like others do. She probably also doesn't believe you or anyone else sees her as thin.

You are an amazing friend for putting so much care into her recovery!! You are an asset to her and you are doing something to help her everyday. She is so lucky to have you on her side and thank you for being there for her. Please do not hesitate to come on here at any time and ask questions!

kpoms1
My best friend has bulimia

My best friend has bulimia and has suffered with body image and eating since middle school. We're sophomores now and it's hard knowing all this advice and knowing what would help her to recover but also knowing it's not that easy for her and only she can take action. I know that she needs to try to have more regular eating habits but she always says she just doesn't get hungry a lot, and we're super close so i know that sometimes it's true, she just doesn't realize she's hungry until dinner. I know she needs to see her doctor and find professional help before it gets worse but she's scared to because her mom threatened to send her away to a hospital or rehab center if her bulimia is really bad.

It's also hard dealing with all her guilt. She apologizes to me every time she purges and she feels bad bc she doesn't want me or anyone to be worried about her.

michael26
Hi kpoms1!!

Hi there!!! Thank you for trusting these forums with your post!! You are a very faithful and loving friend!! You truly are strong for seeking help for her.

I know how scary it is to navigate finding help while we are still under the authority of our parents. When I was in high school I was also fearful as your friend sounds to be. I can understand that it is very scary to have to find help at a residential facility or hospital, but as her friend, I know it would help her if you reinforce that she is deserving to be free from the eating disorder. Would she be able to use these forums? Can you maybe ask her to see if she would be willing to give it a try? These forums are very supportive!!!

Is there a way that you can share your worries with a school nurse or counselor? They should respect your friend's privacy and not alert her mom unless it is necessary. But, I do feel that your friend should seek a medical evaluation to make sure she is ok. Purging can affect the body in harmful ways, so I think she would benefit from seeing a physician! Maybe you could go with your friend to see a doctor?

How are you doing? I know it is hard carrying around this information sometimes. How can I help?