I Think My Best Friend Has an Eating Disorder
Written by Emily Costa
You suddenly notice the person you are closest to seems distant and different.
Maybe they are avoiding dinner at your favorite restaurant you used to go to often. You notice them canceling plans stating they have to go to the gym. Lately they have been making a lot of comments about how they look and how ‘bad’ they have been with eating.
It dawns on you: do they have an eating disorder?
If you are feeling overwhelmed and uncertain, please know eating disorders are difficult to recognize and most people do not know how to address this serious topic. But being here, taking the time to educate yourself, is the first step.
As a friend, you can play a huge role in supporting your loved one through this difficult journey. Eating disorders thrive in secrecy and isolation, so learning how to approach this delicate issue with empathy, support and a non-judgmental attitude is extremely important. In this blog we will dive into an overview of eating disorders and how to best support your best friend on a journey of healing.
Understanding Eating Disorders
Eating disorders are severe mental health conditions related to persistent eating behaviors that negatively impact an individual's health, emotions, and ability to function in important areas of life. They are not a lifestyle choice but are serious bio-psycho-social diseases that can have life-threatening consequences. While on the surface they appear to be all about food and body image, deep down, they are about much more than that.
Let's take a look at the most common eating disorders:
Anorexia Nervosa (AN)
AN is characterized by weight loss or difficulties maintaining an appropriate body weight for height, age, and stature; and, in many individuals, distorted body image. Individuals with Anorexia Nervosa often deny that they have a problem and possess an intense fear of weight gain.
Individuals with Anorexia Nervosa often display noticeable behavioral changes. They may demonstrate an obsession with dieting, counting calories, or portion control, often excluding entire food groups from their diet. An intense fear of gaining weight frequently leads to an extreme commitment to physical exercise, regardless of the weather or personal health conditions. They might also develop peculiar eating habits, such as cutting food into extremely small pieces or avoiding meals altogether. A keen preoccupation with body size, weight, and shape is also common, leading to frequent body checks in the mirror and a distorted self-perception.
Bulimia Nervosa (BN)
BN is a cycle of binging (consuming large amounts of food) followed by compensatory behaviors such as self-induced vomiting (purging), excessive use of laxatives or diuretics, fasting, excessive exercise, or a combination of these behaviors.
People with Bulimia Nervosa often indulge in secretive eating binges, followed by guilt and distress. Frequent bathroom trips after meals, excessive use of mints or mouthwash, and signs of physical discomfort may be observed.
Binge Eating Disorder (BED)
BED is the most common eating disorder in the U.S. People with BED consume large amounts of food quickly, often to the point of discomfort. It's followed by feelings of guilt, shame, and distress. However, they do not engage in compensatory behaviors like those with bulimia.
These episodes often occur in secret, highlighting deep emotional and psychological struggles. Feelings of guilt, shame, and distress usually follow these binges.
Related: How Are Eating Disorders Diagnosed?
Signs and Symptoms You May Notice
Eating disorders are often hidden and can be hard to identify. However, there are some signs to look out for. It's important to remember that these symptoms can vary widely, and a person may still have an eating disorder even if they don't display all the signs.
Unusual eating habits: Frequent skipping of meals, eating in secret, or eating much smaller or larger amounts than usual.
Obsession with weight and body image: Constant complaints about body size or weight. Constantly checking weight or spending lots of time in front of the mirror.
Physical changes: Sudden weight loss or gain, appearing tired or frail, or experiencing frequent illnesses.
Emotional and behavioral changes: Mood swings, anxiety around eating, or becoming withdrawn or secretive.
Changes in social behavior: Avoiding social activities, particularly those involving food, or making excuses to avoid eating.
Excessive exercise: Obsession with physical fitness and exercising excessively, regardless of weather conditions or personal health.
Frequent bathroom visits: Particularly right after meals, which could indicate purging.
Wearing baggy or layered clothing: To hide weight loss or gain.
Dental problems: Frequent trips to the dentist, bad breath, or damaged teeth (caused by frequent vomiting).
Food disappearing: If large quantities of food go missing, it may indicate binge eating.
Eating very quickly or very slowly: Both can indicate a distorted relationship with food.
Preoccupation with dieting: Frequently talking about dieting, reading diet books, or researching weight loss techniques online.
Exploring Common Misconceptions About Eating Disorders
Let’s take a look at 5 common myths about eating disorders to help you understand more about these complex illnesses.
Myth 1: Eating Disorders are a Choice
Truth: Eating disorders are complex mental health conditions with biological, psychological, and sociocultural roots. They are not a lifestyle choice, and people suffering from them require professional help for recovery.
Myth 2: Eating Disorders only Affect Women
Truth: While more prevalent among women, eating disorders also affect men and non-binary individuals. They transcend gender, age, race, ethnicity, body shape, and socioeconomic status.
Myth 3: Only Thin People have Eating Disorders
Truth: People of all sizes can have eating disorders.
Myth 4: Eating Disorders are Caused by Vanity
Truth: Eating disorders are not about vanity. They are serious bio-psycho-social illnesses that often stem from coping mechanisms for stress or trauma.
Myth 5: You Can't Fully Recover from an Eating Disorder
Truth: Recovery from an eating disorder is absolutely possible. Each journey is unique and requires a comprehensive treatment plan, but with support and treatment, individuals can regain a healthy relationship with food.
How to Best Approach Your Friend
Approaching a friend about concerns related to their eating habits can be a delicate task. It's important that you approach the conversation with empathy, compassion, and open-mindedness.
Use "I" statements to express your worries, for instance, "I've noticed you seem unhappy after eating," or "I'm concerned about how frequently you're skipping meals." This approach makes the conversation about your feelings, rather than placing blame on them, which can be perceived as confrontational.
Avoid commenting on their appearance or weight, as this may trigger further unhealthy behaviors. Instead, focus on expressing your concern for their well-being. It can be beneficial to arm yourself with information about eating disorders beforehand, so you can discuss the dangers and the importance of seeking professional help.
Sample conversation starters could include:
"I've noticed some changes in your behavior that concern me. I care about you and just want to make sure you're okay."
"I've noticed you seem to be uncomfortable around food lately. Can we talk about how you're feeling?"
Remember that it's not your role to diagnose or provide therapy. Your role as a friend is to provide support, express concern, and encourage them to seek professional help.
What to Say to Your Friend
"I've observed that you seem really stressed around mealtimes. I want you to know that it's okay to talk to me about it."
"Remember, it's okay to seek help. We all need support sometimes, and that's nothing to be ashamed of."
"You deserve to be happy and healthy, and if something is making that difficult for you, it's important to address it."
"I don't have all the answers, but I'm here to listen and support you."
What Not to Say
Avoid making statements about their appearance, such as "But you look great!" or "You don't look like you have an eating disorder."
Refrain from shaming or blaming them: "You're being so selfish," or "Just eat normally!"
Don't make threats or ultimatums. For example, "If you don't stop doing this, I'll have to tell your parents or significant other/distance myself from you."
Also, try not to oversimplify their situation by saying things like "Just snap out of it" or "Why can't you just eat normally?"
Getting Professional Help
Encouraging someone to seek professional help can feel tricky. You can start by discussing the benefits of professional therapy, reiterating that it's okay to need help and there's no shame in reaching out to professionals. You could say, "Professional therapists have helped many people recover from eating disorders. They can provide strategies to navigate this challenge that you're facing."
Offer them a list of resources, such as helplines like the National Eating Disorders Association (NEDA) Helpline (1-800-931-2237), or websites where they can find more information, like the National Alliance for Eating Disorders. Do some research and provide a list of local therapists or treatment centers that specialize in eating disorders.
If they are hesitant, offer to be involved in the process. You could say, "I understand this can be daunting. If it makes you feel more comfortable, I can help you make the appointment, or I can accompany you to your first session and wait for you in the car." Remember, your role is to aid them in the process, not to force or pressure them. It's crucial they feel empowered to make the decision themselves.
Dealing with Denial
Encountering denial or refusal to seek help from a friend you suspect is battling an eating disorder can be disappointing and worrisome. It's crucial in these moments to remind yourself that denial is a common part of many mental health issues, including eating disorders.
Don't interpret their denial as a reflection of your efforts. It's an indication of their internal struggle and fear of confronting the issue. If your friend refuses help, maintain your supportive stance. Continue to express your concern and remind them that when they're ready, help is available.
Recognizing Your Powerful Role in Their Recovery
As friends, we often burden ourselves with feelings of guilt or regret when we realize a friend was struggling and we didn't notice sooner. However, it's vital to understand that eating disorders are adept at hiding in plain sight and those struggling often go to great lengths to conceal their suffering. Instead of dwelling on past oversights, it's important to forgive yourself, turn your guilt into action, and focus on how you can be a pillar of support for your friend moving forward.
Remember, it's not about having all the answers, but about being there, offering encouragement, and affirming their courage to confront their disorder. Your patience, understanding, and consistent presence can make a significant difference in their journey towards recovery.
If you want to learn more about Central Coast Treatment Center and how we may be able to support your friend, please reach out to us today.
Emily Costa
Having struggled with an eating disorder herself, Emily is passionate about spreading awareness, education and the possibility of recovery with others. Emily previously volunteered as a Crisis Text Line counselor and with the eating disorder non-profit Project HEAL where she served as their blog manager, their NYC Chapter Leader & a recovery mentor in their Communities of HEALing pilot program completing training by the Carolyn Costin Institute. Emily now enjoys working with various treatment centers, clinicians and non-profits in the eating disorder community providing marketing and design services. In her free time she enjoys spending time with friends, hanging with her dogs, and reading a book at the beach.