What
do I say? What do I do? Who can help?
If you have a friend with an eating disorder, or you worry about
what might be an eating disorder, you are not alone. Some estimates
are that as many as 1 in 3 college women have struggled with weight,
food, body image, disordered eating or an eating disorder by the
time they graduate from college. Certainly, among your friends and
acquaintances there are women and possibly men who have eating concerns.
Perhaps
you have become aware of your friend's problem because you have
observed their weight changes, or you feel uncomfortable with his
preoccupation with dietary restriction, or you have become aware
that she abuses laxatives or vomits to purge herself of what she
eats. You feel concerned and wonder how to bring up the subject.
You worry that your friend will feel "accused" or "diagnosed"
and will be angry with you. It's important to keep in mind that
hearing honest concern from others helps break denial and often
is the first step on the path to acknowledging the problem and getting
help.
What
can you say?
First of all, you can make sure your friend knows that you care
about them. You might say:
"I'm here for you if you need me. I know you're struggling
with a lot of stress lately. Let me know how I can help."
You may
want to go further and share with her/him what you have observed
and talk about your specific concerns. For example:
"I've
noticed you've lost so much weight and that you're still dieting
and losing. I'm worried about your health."
"It
seems like we're always talking about weight and food and exercise.
You seem so worried about it and so unhappy with the way you look.
I'm worried that maybe you don't feel too good about yourself and
that maybe you're depressed."
"I
heard you throwing up 3 times last week. I know when that happened
before you said you had the flu. I'm really worried that it's more
that. I'm scared something will happen to you."
What
can you expect?
Your friend may deny or minimize or may say "I used to have
a problem but I'm better now," or she may acknowledge the difficulty
and want to talk about it. If she denies it and wants to avoid it,
you may have to be satisfied to have expressed your concerns directly
and let it be, for now. Let her know that you are still her friend
and are there to talk if she wants to. If your friend's constant
discussion of weight and
what s/he eats interferes with your relationship, you may have to
put some limits on that behavior. Those topics can be declared off-limits
in your conversations with each other. If you are disturbed by your
friend's restrictive eating, for example, you may decide not to
have meals together.
What if there are medical concerns?
If you are concerned that your friend may be in some medical jeopardy
and feel you must do more than just express your concerns to them,
you may need to ask for additional help -- from family, a medical
provider, or other professionals. You can also talk to a dorm counselor,
a Dean of Student Life, Psychological Services, Health Services
or Health Education for more advice.
What
if they will talk about it?
If your friend is willing to talk and be open about the problem,
it's important to listen with empathy and without judgment. It may
be hard to understand why someone who is attractive and well-liked
would think they are "fat and ugly" or why someone would
feel they needed to vomit if they had been "bad" by eating
a chocolate chip cookie. It is so tempting to try to use logic,
reality, and reason to talk someone out of these "irrational"
ideas.
One of
the most helpful things you can do is facilitate the person's accessing
professional help. For Brown students, this is where Health Education,
Health Services, and Psychological Services come in. At Health Education,
a registered nutritionist is available to see students individually
to help evaluate their nutritional status and eating patterns. Health
Services provides medical evaluations and Psychological Services
evaluates the overall eating disorder in the context of the person's
current and past life, providing treatment recommendations.
What
is not helpful?
One thing is almost NEVER helpful: monitoring what someone eats.
To be told what to eat, how much to eat, to be watched while eating,
etc. would create a problem with food for any of us. Imagine how
it affects someone who is literally thinking about food all the
time. Resist the pull to monitor, comment or advise about eating.
What
can we do about cultural attitudes about weight?
There is something else we can do to help friends who are suffering
from eating disorders; something that can enhance our well being
and that of the community at large, as well. We need to do all we
can to eradicate "fatism." It is a form of prejudice and
discrimination just like racism or sexism. It is based on the assumption
that there is only one "right" or acceptable way to look.
It equates thinness with attractiveness, intelligence, ambition,
success, and worthiness. There is no room for variety, for difference,
for valuing how we REALLY look instead of how we're "supposed"
to look. What a wonderful world it would be if we focused on how
each other FELT instead of how we looked. What if there were other
ways to know deep inside we're O.K., besides how much we weigh,
or how small our waist is, or how big our biceps are? It will take
a lot of effort on all our parts to change the way we think. Let's
start now. We can create an environment where our self-doubt and
unfulfilled longings don't have to be expressed in a war against
our bodies.
Resources at Brown
Located on the third floor of Health Services.
Confidential information or care is available through individual
appointments or phone consultation with a Nutritionist to discuss
the many types of eating concerns you may have regarding yourself,
a friend, roommate or teammate. Health Education also offers workshops,
pamphlets, and reading materials covering these and related issues.
There are no fees for Health Education services.
Located at the corner of Brown and Charlesfield streets.
Confidential information and care is available by appointment. Care is available for initial, current
or past disordered eating patients. There are no fees for medical
care at Health Services. However, there may be fees incurred if
laboratory tests, medications, specialist or emergency hospital
care is needed.
Located on the fifth floor of J. Walter Wilson.
Confidential appointments are available at Psychological Services
for students concerned about their eating issues. Guidance is also
available for those who are concerned about a friend, roommate,
or teammates' eating. Services include crisis intervention, short-term
psychotherapy and referrals. There are no fees for appointments
at Psychological Services.
Links
you can use
This site includes definitions, statistics, warning signs, causes
and frequently asked questions.
This site provides general information about eating disorders and
body image concerns, tips for helping a friend and referral sources.
Provides information and treatment resources for all forms of eating
disorders.
Articles from the ADA on eating disorders, including The Female
Athlete, Compulsive Eating and Anorexia.
Disclaimer: Health Education is part of Health Services at Brown University. Health Education maintains this site as a resource for Brown students. This site is not intended to replace consultation with your medical providers. No site can replace real conversation. Health Education offers no endorsement of and assumes no liability for the currency, accuracy, or availability of the information on the sites we link to or the care provided by the resources listed. Health Services staff are available to treat and give medical advice to Brown University students only. If you are not a Brown student, but are in need of medical assistance please call your own health care provider or in case of an emergency, dial 911. Please contact us if you have comments, questions or suggestions.
