Accessing Care

Worried about a Friend

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, Counseling and Psychological Services, Health Services or Health Promotion 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 Promotion, Health Services, and Counseling 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 offer advice 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. 

On-Campus Resources

Health Services Dietitian 401-863-3558
Located on the third floor of Health Services.
Confidential information or care is available through individual appointments with a Registered Dietitian.  Students can discuss personal eating concerns, as well as any concerns they may have regarding a friend, a roommate, or a teammate. There are no fees for these services.

University Health Services 401.863-3953
Located at the corner of Brown and Charlesfield streets.
Confidential information and care is available on a walk-in, or by scheduled appointment basis. 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.

Counseling and Psychological Services 401.863-3476 
Located on the fifth floor of J. Walter Wilson.
Confidential appointments are available at Counseling and 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 Counseling and Psychological Services.

Student Support Services 401.863-3145
Located on the fourth floor of Grad Center. 
Student Support Services can assist with academic accommodations when required for treatment and recovery.

Related Links

National Association of Anorexia Nervosa and Associated Disorders

National Eating Disorders Association 
This site provides general information about eating disorders and body image concerns, tips for helping a friend and referral sources.

Eating Disorders Referral and Information Center 
Provides information and treatment resources for all forms of eating disorders.

The Academy of Nutrition and Dietetics 
Articles from the AND on eating disorders, including The Female Athlete, Compulsive Eating and Anorexia.

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