If you and others have observed behaviors in a friend that are suggestive of an eating disorder, you are in a position to help. Here are some helpful suggestions:

  1. Approach the person in a private place where there is time to talk and no immediate stress.
  2. Present in a caring, straightforward way what you have observed (behaviors) and what your concerns are. Tell him or her that you are worried and want to help. For example, "You've lost a lot of weight recently and I'm concerned about it. I'm here to listen if you want to talk." (Friends who are too angry with the person to talk supportively should not be a part of this discussion.)
  3. Give the person time to talk and encourage them to verbalize feelings. "Tell me more about why you feel that way..."
  4. Ask clarifying questions. Listen carefully; accept what is said in a non-judgemental manner.
  5. Do not argue about whether there is or is not a problem - power struggles are not helpful. Perhaps you can say, "I hear what you are saying and I hope you are right that this is not a problem. But I am still very worried about what I have seen and heard."
  6. Provide information about resources for treatment. Ask them to consider going for one appointment before they make a decision about ongoing treatment.Offer to go with the person and wait while they have their first appointment with a counselor, physician or nutritionist.
  7. If you are concerned that the eating disorder is severe or life-threatening, enlist the help of a doctor, therapist, counseling center, relative, friend, or roommate of the person before you intervene.
  8. If the person denies the problem, becomes angry, or refuses treatment, understand that this is often part of the illness. Besides, they have a right to refuse treatment (unless their life is in danger). You may feel helpless, angry, and frustrated with them. You might say, "I know you can refuse to go for help, but that will not stop me from worrying about you or caring about you. I may bring this up again to you later, and maybe we can talk more about it then." Follow through on that - and on any other promise you make.
  9. Be realistic about how much influence you might have. If you do the best you can to help on several occasions and the person does not accept it, stop. Remind yourself you have done all that is reasonable to do. Eating disorders are stubborn problems, and treatment is most effective when the person is truly ready for it. You may have planted a seed that helps them get ready.
  10. Eating disorders are usually not emergency situations. But, if the person is suicidal or otherwise in serious danger, GET PROFESSIONAL HELP IMMEDIATELY. Call CAPS at 723-3785 for a consultation.
This materialis adapted from "How to help a friend," copyright 1996, EDAP. All rights reserved. This material was reprinted with permission by Dr. Marcia Herrin and Dr. Heidi Fishman from the Dartmouth College Health Service. The material is copyrighted and may be reproduced or used for educational and non-profit purposes only, with acknowledgement of Dr. Herrin, Dr. Fishman, and EDAP.