My first serious topic. My good friend is anorexic. What should I do?

[Blue-Jay]

She's lost 30 pounds in the last three months, after being dumped by her piece of crap boyfriend. She's admitted to me that she knows she has a problem, but has yet to do anything to address it. I've taken her out for dinner on several occasions just to get her to eat, but I suspect that she's puking it back up when she's done. I'm afraid for her. I think she's already starting to have health problems because of it.

What in the hell am I supposed to do? I feel like I'm just sitting on the sideline while she's trying her best to kill herself.

[cally]

1. She needs to get counseling

ASAP. You are not going to be able to solve this without professional help. Can you contact her family or others close to her and make a coordinated effort to get her to get help?

edited: Left out a word

[La_Serpiente]

2. This is an extremely complex problem

I don't think anyone can handle it. Try to encourage her to get professional help.

There is a clinical psychologist on DU, but I forgot his/her screen name.

[Blue-Jay]

4. I've encouraged her to seek professional help.

She said she would, but I don't believe her.

Listen - I'm truly sorry about being a downer here, but I'm at my wit's end. I've always been able to "fix" things, but this is beyond me.

[salin]

10. Find out if she has found names

of places to call for help/counseling (she won't be able to fudge that well if she hasn't yet searched it out.) If she hasn't - validate for her how incredibly scary it must be to know there is a problem... but fear that facing it might feel even worse/more scary than just knowing the problem is there (which is what stops many people from getting help for a myriad of issues.) Help her face down that fear (that getting help seems scarier than the problem itself.)

Ask her what it will take for her to make that first call to get an appointment - and ask her if she would like you to be there (while she calls) to give her the motivation/courage to make that call.

I think that you can help her get to step one.... actually get the info needed to make that call...and perhaps even help push her to make the call. But after that... I don't know that there is much you can do but be supportive and pray that she follows through.

[Military Brat]

3. If she's puking it up after eating, she's bulimic

She might have a double problem. 10 pounds a month is a lot of weight to lose over a guy. Instead of taking her out to eat, how about taking her shopping for clothes? Pick up some items that are her former (normal) size, and see if she can get interested. Show her some photos of what she looked like before, and compare them with how she looks now. Take her out for a "beauty" makeover, a new hairstyle.

Anorexics often have no idea how skinny they really are. Does she recognize that she is too thin, or does she think she looks normal? If you think she has health problems now, just wait. She can lose her bone integrity, her teeth can go rotten, and her organs will literally begin to feed on themselves because they're starving to death and that is their attempt to survive. I am not trying to scare you, or her, but do some research.

If all the above makes no difference to her, if she persists in committing slow suicide, don't let it go too long without seeking professional help.

Best of luck to you and her.

[bleedingheart]

5. she needs to get help before she does herself some permanent

damage....try and get her to a doctor that deals with eating disorders.

[prolesunited]

6. She definitely needs professional help

Has it only been three months or has she had this problem longer and it re-emerged after she broke up with the boyfriend? The fact she knows she has a problem is a good first step, but has she reached the point she wants to do something about it?

If it hasn't been long, her seeking help immediately is crucial. From what I understand, your brain really goes through some serious chemical changes that affects your ability to recover and there hasn't been enough time to do irreparable harm to vital organs.

You can only be there to support her and lend a shoulder, but it's certainly not something you can tackle. Perhaps you can help her research what resources are available in you community and people who specialize in treatment? Does she have insurance?

Here's a good overview of the condition:
http://www.eatright.org/Public/GovernmentAffairs/92_adap0701.cfm

Here's a national organization with lots of info:
http://www.anad.org/site/anadweb/

They also have a hotline:
If you need help, please call the ANAD hotline, 847-831-3438 Monday through Friday 9:00 A.M. to 5:00 P.M. Central Time.

If she won't call, perhaps you can and find out what they would recommend.

It's nice that she has a friend like you. I hope she gets the help she needs.

[Blue-Jay]

7. Thanks, Proles...

I'll look into those links for some more info. I've already told her that I'm not going to stop hounding her until I feel like I can stop worrying. Even though she's an adult, my next step is to rat her out to her parents.

[Stephanie]

8. Are you in college? Or on your own?

You might take the problem to a college counselor or medical clinic. She really needs a doctor first and a therapist second. I would fully support you ratting her out to her parents - her health is at stake and she's not thinking right. This is not a problem that you can fix - she needs professional help. The sooner the better.

[Blue-Jay]

11. Not in college.

I completed my post-graduate work in 1992, and she's a high school math teacher. She's old enough and smart enough to know better. I'm prepared to dog her every step until I can trust her to take care of herself. I'm just that annoying.

[Stephanie]

13. All the more reason then to get her to a doctor.

An adult friend of mine who's dealt with this problem for years is finally turning around with the right medication. Your friend needs to see somebody - doctor, therapist, psychiatrist - before she does permanent damage. She's depressed.

Good for you for sticking with her. The best thing you can do for her is shower her with kindness. Don't judge her, don't monitor her food, don't watch her eat.

This is one of the best treatment centers:

http://www.renfrew.org/

[Stephanie]

15. This brochure has good advice

http://www.renfrew.org/signs-symptoms.pdf

If you are concerned about a friend, loved
one, relative or roommate who shows signs
of anorexia, bulimia or binge eating disorder,
you can help.

Here are some specific suggestions of what you can do:

• Do tell her you want to help. Let her know you
care. Express your concern candidly and sincerely,
but without criticism or judgment.

• Do be sure to pick the right time and place to discuss
your concerns. Find a time and location
that will be free of distractions.

• Do try and get her to seek professional help as
soon as possible. Suggest seeking help from experts
who specialize in eating disorders – a therapist, dietitian
or physician. If she refuses to do this, encourage
her to reach out to another helping professional – a
counselor, teacher, clergy person or school nurse.

• Do learn everything you can about eating disorders.

• Do be prepared to hear her deny that there is a
problem. People often experience eating disorders
as shameful, embarrassing and hard to acknowledge.

• Do respond by saying that you are still concerned
about what you’ve observed. Let her know that
you are there to provide help and support.

• Do be patient. Show caring, support and continued
friendship by listening and attempting to understand
her perceptions about the situation.

• Do watch for signs of deteriorating physical or
emotional health.

• Do refuse to get caught up in arguments or battles of
will with her.

• Do be aware of any prejudices or preconceptions you
may have about thin or obese people, and think about the
way these might be interpreted by an anorexic, bulimic or
compulsive overeater.

Here are some specific suggestions of things to avoid:

• Don’t try to solve her problem or cure the eating disorder
on your own. These are serious issues which
require attention from experts.

• Don’t make comments about her appearance (or your
own). Comments about weight loss may be interpreted
as a compliment and comments about weight gain may
be seen as a criticism.

• Don’t get involved in discussions about dieting, weight,
calories consumed or particular eating habits.

• Don’t compare her to other individuals. In general,
avoid making flattering comments about thin people or
disapproving remarks about obese people.

• Don’t refer to foods as ‘good’ or ‘bad.’ Try not to discuss
food or reinforce her preoccupation with food.

• Don’t try to make her eat or insist that she gain weight.

• Don’t try to analyze or interpret her behavior.

• Don’t agree to keep her eating disorder a secret from
significant others when her health and thinking are
impaired.

[Myra]

14. I think that's a good next step, telling the parents, Blue-Jay.

If a friend was talking about suicide I'd tell everyone
they were related to, and all their friends.

This sounds like it's in the suicide category, just a more passive
form.

She's lucky to have you as a friend.

[BlackVelvetElvis]

9. She needs serious counseling

I have a cousin who is anorexic and bulemic. She's been that way for over 20 years and now she is bedridden (at 52) because her bones can't support her 90 pound frame. Her teeth are also in a very sad state.
It's a very sad situation. Encourage her to seek help now and stop it. Offer to go with her, don't rely on her to do it herself. Talk to her and just be there for her.
Good luck to you.

[NicoleM]

12. A close relative

was anorexic and bulimic for about a year. It almost killed her. She survived, but with permanent liver and heart damage. PERMANENT.

It may sound dumb, but this is how I helped to intervene with her: 1) if you keep doing this you're going to die, 2) Princess Diana was bulimic, it's nothing to be ashamed of, and 3) you need to get help NOW.

It worked. The longer she lets this go, the harder it is going to be to get over, both physically and mentally.