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Ask A Therapist: Can I Help My Friend Who May have an Eating Disorder?

Relationships, Ask a Therapist, Body Image, Women's Health
5 min read
two female friends eating lunch outside

Dear Therapist, I’m pretty sure my friend has an eating disorder but whenever I try to talk to her about her eating habits (or lack thereof), she gets really defensive and it never ends well. I’m really worried about her, but I don’t know how to talk to her. Do you have any advice for how to approach someone with concerns about an eating disorder without starting a fight?

Frame therapist Dr. Diana Hu weighs in...

This is such a great question because it’s so tricky. Eating disorders (and subclinical disordered eating patterns) tend to be very isolating and hidden issues, especially from friends and family. Unfortunately, many people do not get the support and help they need because they don’t “look like it,” they deny any issues, and they struggle in secret. Hopefully, the tips below can help you to communicate your concern with your friend and get them connected to support.

8 Ways to Support a Friend Who May Be Struggling with an Eating Disorder

  • Keep the focus off their appearance and eating, and instead on the impact on their functioning. Instead of saying “you’ve been looking X,” try “I’ve noticed you’ve been losing your temper with your friends lately,” or “It seems that you’re more tired and fatigued throughout the day than usual.”
  • When sharing your concern about their eating, come from a place of nonjudgment and gentle concern. Instead of presuming to know what’s going on and what’s in their best interest, approach with an attitude of “I’m worried because something seems off in your relationship with food, and I’d like to help you if you’d like that.”
  • Anticipate resistance. It’s common for people to deny, get mad at, or ignore others’ concern. Let them know that you care for them and would like to help, and bring it up occasionally, allowing for more typical interactions to continue to be the norm of your dynamic.
  • Keep food neutral. Instead of pressuring someone to eat more or to eat certain things, have what you want to eat, with no comments about “good” or “bad” foods, and no expectation about what they will or won’t eat. Adding pressure around food can increase someone’s self-consciousness and lead to shutting down around others and greater isolation. 
  • Check in with their mental health holistically. Ask about how they’re doing with school or work, their relationships, family, stress levels, and/or physical health, and support them in the things they are willing to share. Prying someone open to talk about something you see is an issue isn’t conducive to them feeling supported and seeking help.
  • Continue to be a social presence in their life. Difficulties with food can lead to people withdrawing from their social circles and struggling even more. While they may not be ready now to ask for or accept help, having a community to engage with can be extremely helpful for their overall mental health.
  • Encourage them to seek medical, dental, or therapeutic help. Connecting your loved one to professionals is helpful for making sure things don’t become a medical emergency, and to take some pressure off you.
  • Offer resources that they can peruse on their own. These might include the articles, support, and resources on the National Eating Disorders Awareness (NEDA) website, books such as Anti-Diet or The F*ck-it Diet, podcasts such as Maintenance Phase or FoodPsych, and Instagram accounts such as @drjoshuawolrich, @chr1styharrison, @bodyposipanda, @jessijeannn, or @bodyimage_therapist.

Try to use these steps to continue supporting your friend, while giving them what space they may need. It’s okay to be firm, and for them to react poorly to your concern. Ultimately, their recovery will be a lengthy process, and is not one you can force them to start. It’s likely that your continued presence is more helpful than you might think.

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About the author: Dr. Diana Hu is a licensed psychologist in private practice in Washington. She works with adults on issues of cultural identity, anxiety, stress, disordered eating, and relational issues. She conducts psychological evaluations for adults with attention and memory issues. She also serves as a clinical advisor for Therapy Notebooks. Connect with Dr. Diana or view more from her on her Frame profile.


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