Assisting a Friend Who May Have an Eating Disorder

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Friends often know us better than anyone else. We share our feelings, struggles, and beliefs with them. Because friendship comes with such close bonds, you may be more likely to spot a potential issue with a friend before they fully realize what’s happening. Eating disorders are relatively common among college students, and this brochure’s purpose is to provide information in case your concerned that a friend may need help with their eating habits.Please be aware that an eating disorder can only be diagnosed by a professional. The symptoms listed below are merely thoughts and behaviors to be mindful of when talking to a friend.

Signs of  an Eating Disorder

Use the checklist below to help identify your concerns. The presence of one or more of the signs listed below may indicate a problem.

Behaviors

  • Restricting calorie or food intake
  • Eating episodes where the person seems out of control
  • Compulsive or excessive exercise
  • Vomiting
  • Drug use to control eating or weight gain
  • Rituals around food (such as not allowing food to touch lips; cutting food into small pieces)
  • Frequent weighing
  • Counting calories

Emotional

  • Mood swings
  • Guilt about eating
  • Intense fear of fat
  • Low self-esteem
  • Emotional discomfort after eating
  • Irritability
  • Shame about eating habits

Psychological

  • Perfectionism
  • Preoccupation with food
  • Rigid eating schedule
  • Alternate between being in control of eating and “letting go”

Social

  • Frequently eating alone
  • Eating in secret
  • Avoiding friends
  • Avoiding situations where food is involved
  • Strained relationships because of food or eating
  • Difficulty being assertive

Physical

  • Amenorrhea (menstruation has stopped)
  • Throat problems
  • Frequent weight fluctuations
  • Puffy cheeks
  • Broken blood vessels in eyes
  • Fainting/dizziness
  • Fatigue
  • Hair loss

Things to Consider Before Talking to Your Friend

If your friend has one or several of the behaviors checked, it’s probably a good idea to talk with your friend about your concerns. Before addressing the issue, it’s important to examine your relationship and ensure that you’re the best person to having this conversation with your friend. Things to consider would be if you and your friend have enough trust in one another that they will be okay talking about a potentially sensitive issue. If you’re not sure there’s enough trust to start a conversation, you may want to consider consulting with others who are close to your friend from a place of concern as opposed to judgment.

Before you approach your friend, read up on eating disorders. Write out ahead of time a list of specific behaviors that have you concerned. Consider whether to include anyone besides yourself in the conversation and make sure you’re approaching the situation from a place of concern and care for your friend. Strive to be empathetic and a good listener for your friend. Empathy means both trying to grasp a situation from your friend’s perspective and conveying that understanding in words. Empathy does NOT necessarily mean that you agree, but does allow you to disagree without imposing judgment or shame. Remember, you may view the eating disorder as a problem that needs to be “fixed,” but your friend may be protective of his/her eating disorder.

Throughout the process of talking to your friend (and hopefully locating some help if needed), you can always consult with professionals from a variety of fields such as a psychologist, social worker, psychiatrist, physician, or dietitian). Professionals can provide additional information, help you come up with a plan for whether and how to approach the person you’re concerned about, suggest resources available in your area, and help you take care of yourself in the process. Look for professionals who have past experience or explicit specialization in working with eating disorders. Some of the websites listed at the end of this brochure offer referral services across the country.

Useful Terms

The term “eating disorder” has become a common label for a range of behaviors and feelings. It is very important to remember that all of us fall along a broad continuum of eating behaviors and attitudes.

Body Positivity is characterized by mostly positive feelings about your body shape and size. In this range, your body is seen as a good part of you that can help you enjoy life. For people with body positivity, all foods are seen as fitting into an overall healthy diet, without feeling that some foods are “good” and some are “bad.”

Preoccupation with body shape/size and eating involves frequently thinking about food, eating, and your body. In this range of the continuum, you may find yourself thinking about what you ate at your last meal and feeling that you’ll need to “make up for it.” You may be a little inflexible about what you “allow” yourself to eat. There may be moments when you feel guilty or bad for what you’ve eaten. In addition, you may not like the way certain parts of your body look or you may consistently feel that you could lose a few pounds. In general, however, these feelings do not interfere with enjoying life and engaging in situations involving food.

Eating Or Body Image Distress refers to a level where your preoccupation with eating and body size/shape does interfere with daily interactions and activities. You may find yourself thinking a great deal about food or your looks. In this range of the continuum, you may be fairly rigid in your eating patterns and you may work hard to change your body size/shape. In general, however there is not a great deal of compensating for eating (e.g., vomiting, fasting, extreme exercising) nor is there a significant amount of weight loss.Eating Disorders most commonly refer to Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder.

Anorexia Nervosa involves a significant fear of gaining weight or becoming fat and a restriction of food intake to the point of significant weight loss. Women with Anorexia Nervosa might stop menstruating. People who struggle with Anorexia Nervosa may or may not engage in compensating behaviors such as extreme exercising.

Bulimia Nervosa involves binge eating episodes during which the person eats large amounts of food and feels unable to control the eating. The person may also engage in behaviors (e.g., vomiting, use of laxatives, over exercising) to try to offset food eaten. Bulimia Nervosa describes a pattern where cycles of binge eating and compensating occur at least once a week for three months. People struggling with Bulimia Nervosa often evaluate themselves extremely critically on the basis of their body shape and weight.

Binge Eating Disorder describes a pattern where a person eats a large amount of food, going beyond the feeling of fullness. This pattern occurs at least once a week for a 3-month period, but without inappropriate compensating behaviors.

Want to Know More?

Center for the Study of Anorexia and Bulimia, icpnyc.org/csab

National Association of Anorexia Nervosa and Associated Disorders (ANAD), anad.orgNational Eating Disorders Association (NEDA), nationaleatingdisorders.org

 

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