The signs are all there. Your friend is intensely afraid of being fat, she talks nonstop about how many calories are in her food and what she weighed this morning, and she's starting to avoid situations where she's expected to eat. While you don't know for sure, you start to get worried that your friend might be developing — or already be suffering from — an eating disorder. 

It's a tricky subject. You want your friends to be healthy and you want to be fit with them, but what happens if your best friend starts to take it too far? Do you stand up and say something? Do you risk hurting your friendship or making her angry and pushing her away? 
 
It's worth it to speak up even if you're not sure, says Bonnie Brennan, clinical director of Eating Recovery Center’s Adult Partial Hospitalization Program.
 
"I think that it is a mistake not to address your concerns with a friend for fear of hurting his or her feelings," Brennan says. "If a friend does not have an eating disorder and is offended by your inquiry, that emotion will usually last a very short time, even a few minutes. On the other hand, if you are correct about your friend's eating disorder, you may be saving a life, as eating disorders have the highest mortality rate of any other mental illness."
 
With numbers of those suffering from eating disorders on the rise and societal pressure to be a certain size at a fever pitch, it's estimated by the National Eating Disorders Association (NEDA) that as many as 10 million females and 1 million males in the United States are fighting a life and death battle with an eating disorder such as anorexia or bulimia, and millions more are struggling with binge eating disorder. That's why the theme to this year's National Eating Disorders Awareness Week — which is this week — is "Everybody Knows Somebody." 
 
"I often have patients lament that no one ever challenged them or said anything," Brennan says. "They will admit that they might have reacted angrily at the time but that it is more painful to think that no one cared or that others were afraid of them."
 
Although the signs of an eating disorder vary from person to person, Brennan  says, they can include an intense fear of being fat, weight loss, avoiding situations in which expected to eat food, using the bathroom directly after a meal, excessive exercise, having conversations that are highly centered on food or calories or weight, "having to" prepare separate meals, and fear of not knowing what ingredients are included in foods (such as at a restaurant).
 
So just how do you go about talking to a friend who might be suffering? Brennan recommends finding a neutral setting and time to meet, and then expressing your concerns and asking if anything has been particularly distressing to her lately. 
 
"When speaking with your friend, use non-judgmental language and 'I' statements," she says. "It is OK to point out behaviors and emotions you have lately noticed, but avoid blaming or shaming. Be prepared to listen and don’t try to problem solve. Offer to help your friend find a professional to talk to."
 
If your friend acts negatively or defensively, Brennan recommends reminding her that you care for her and that you'd rather ask about the troubling behaviors than let them go unnoticed. Then, offer to talk when she's  ready and be available if she wants your help. If your friend admits that he or she is struggling, offer to help him or her find a professional, she says. 
 
"Avoid playing the food police," she says. "Rather, ask your friend if he or she needs support if you notice that he or she eats too little or too much.'
 
It's important to also understand that eating disorders are not a choice, Brennan says. They are biologically based mental illnesses, and some people are genetically hard-wired to be more at risk for an eating disorder than others. Furthermore, eating disorders in men is on the rise, so don't rule out the possibility of an eating disorder with your male friends if the signs are there.
 
Bottom line, one of the most important things you can do as a friend is to let your friend know he or she is loved and accepted by you, even if he or she is suffering from an eating disorder, Brennan says. And it's always best to speak up — because it might save your friend's life.
 
Have you ever confronted a friend about disordered eating? Would you? Is there a friend you might talk to after reading this? 

 

Jennipher Walters is the CEO and co-founder of the healthy living websites FitBottomedGirls.com and FitBottomedMamas.com. A certified personal trainer, lifestyle and weight management coach and group exercise instructor, she also holds an MA in health journalism and regularly writes about all things fitness and wellness for various online publications.

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