She's my friend and she needs my help.

Tips for reaching out to someone who may have an eating disorder

1. Gather information from experts like school counselors, nurses, teachers or other health care providers about eating disorders, and get a list of professionals who can help in your community.
2. Select a time to talk when you will not feel rushed and when you will not have to be interrupted.
3. In a direct and non-judgmental way, describe to the person the specific observations (e.g. evidence of binge-eating and purging, preoccupation with being "fat") that have aroused your concern.
   1. Avoid labels like "I just know you are bulimic," and avoid vague judgments like "There's something wrong with you, you're too thin."
   2. Describe specific situations you have observed like "I've noticed you are leaving the table after each meal and going to the bathroom."
   3. Keep your statements brief and allow the person time to respond.
4. Express your concern for the person's health and well-being, keeping the focus off of the way she or he looks.
5. If the person discloses information about his or her problem, listen carefully and with empathy.
   1. Do not criticize her/him by saying something like "That's crazy," or "Can't you see what you are doing to yourself by not eating?"
   2. Keep the focus of the conversation on the possible existence of a serious problem, not the detection of an eating disorder.
6. Conclude the conversation by offering the names and phone numbers of professionals who the person can contact about this issue.

Remember to communicate the following to the person:

• You care about the quality of the person's life and what they do, not what they look like or their eating habits.
• You are concerned about the specific attitudes and behaviors which you and others have observed.
• Early intervention is very important! The earlier someone gets help, the faster they will get better.
  
  

Guidelines for what to do if you are faced with anger, denial, and resistance:

• Avoid an argument or any type of emotional confrontation. Do your best to repeat the evidence you have observed, repeat your concern, and repeat your conviction that something must be done.
• Avoid scare tactics. You will only push the person away if you threaten her or him.
• Terminate the conversation if it is going nowhere or if either one of you is becoming too upset. Inform the person that you have plenty of reason to believe that something is wrong and if she or he wants to talk further, you are available.
• Do not promise to keep the matter a secret. Promise to keep it discrete, but there may come a time when you need to talk with someone about what is happening.

(back)

 

Eating Disorder

Signs of Disordered Eating and Exercise Behaviors

Psychological/Emotional

• Critical of self and others
• Difficulty concentrating
• Preoccupied with weight, shape, food and exercise
• Comments on fat often
• Isolated
• Worries about what other people think
• Mood swings
• Depression or sadness
• Feels tired, weak and cold

Physical

• Noticeable weight changes - loss or gain
• Excessive exercise
• Stress fractures
• Swollen glands in neck or face
• Tooth marks on hands from vomiting

Abnormal Eating

• Denies hunger
• Ritualistic eating behaviors (e.g. will only eat after dark or when alone)
• Only eats fat-free foods
• Goes to the bathroom after meals
• Evidence of binge eating (food wrappers)
• Evidence of vomiting (smells in bathroom)
• Evidence of laxative or diuretic use (packaging)
• Eats a lot of food quickly and out of control
• Skips meals
• Cooks for others but will not eat

(back)