NWR: Help with anorexic friend

astimmel · July 2013

My BFF has become anorexic in the past year and a half. I put off saying anything because she's always been slender, and she was at least eating regularly and still has the energy to run 4 miles a day. Several of us have briefly brought it up, and she's so adamant that nothing is wrong.

In the past 6 months she's just become skeletal. She is now 5'10" and 125lbs. I haven't talked to her because her wedding was June 8th and I knew that if I brought it up before the wedding, the message would get lost in the hustle and bustle of things and she would brush it off. I decided to give her a couple weeks after the honeymoon to decompress and get back to normal.

Her family and friends know it, about 6 people at the wedding approached me expressing concern. Everyone knows it except her dipsh!t of a husband, who doesn't seem to see a problem. Plus everyone is whispering and is very concerned but no one will do anything, even when I ask for help approaching the topic. Which if why I'm asking you guys for help.

They're back from the honeymoon and I want to take her husband out for coffee and point it out to him, since he would have more influence on her than any of us. I'm hoping that it's just because he's just a dumbass and that's why he hasn't noticed, rather than him noticing and encouraging it.

He's very hard-headed and abrasive, and with something like this I'm worried he'll get defensive. My question is, how do I approach this with him? What do I say to make sure the message gets across and we have a plan of action? The entire family and group of friends are the kind of people who sit back and wait for things to happen, rather than taking action. Even with something as serious as this. So I need help finding the words to get both her husband and family/friends on board to actually make a game plan and follow through.

My thought was that I could get her husband to gently encourage her privately, and if she isn't responsive we could try more of a group intervention type thing. Either way, the first step is talking to him. What do I say?

itzMS · July 2013

If she really is an athlete, 5'10", 125 isn't necessarily a dangerous weight depending on her frame. It's certainly too skinny, obviously, by most standards. But she could have been stressed by the wedding, and NOT have an eating disorder.

Also, I don't know any of my friend's weights...so I assume you're just speculating?

I'm not downplaying eating disorders...but I'm not sure if it's your place to get involved at this point.

astimmel · July 2013

I took into consideration the possibility of it being wedding stress, but they were only engaged 10 months and this has been going on for 1.5 - 2 years, and steadily getting worse. Her mom was in the room when she got measured for her dress, and her mom gasped when she undressed because her spine was protruding so much.

Part of the reason why I haven't said anything is that she does still have the stamina to run 4 miles a day and lift weights. But we took her out to dinner for her birthday this weekend and she had 1/3 of a salad and pushed her plate away. It's clear that she's deliberately not eating at this point.

She actually did tell me her weight early on in the dress shopping process, and that was months ago so by now she's probably closer to 122lbs.

manateehugger · July 2013

Yeah, I agree. Not to mention, I've watched tons of brides loss weight before their weddings due to stress and the pressure of looking perfect on her wedding day.

Plus an eating disorder usually isn't characterized by purely weight loss. Bizarre eating habits, erratic behavior, and severe depression usually accompany it. I've unfortunately got a lot of personal experience with eating disorders.

The most that you can do right now is be a supportive friend. If she is struggling with an eating disorder, repeatedly confronting her about her weight usually does more harm than good.

SuperMinty · July 2013

As someone who is naturally the same size you're describing, I would be offended if approached about an assumed "problem." I would be beyond offended if you staged an intervention with my partner.

She may have a fast metabolism. Unless there is a known problem, It really isn't your place to intervene.

manateehugger · July 2013

Only eating part of a salad before your wedding doesn't equal deliberately not eating.

And just because you don't think her family seems to be doing anything, doesn't mean they aren't. Eating disorders are painful and hard for families to go through and not something they share with everyone. As this point, express your concern to her mother (who you said was surprised at the weight loss) and then I would leave it alone.

DO NOT stage some sort of intervention without her family or husband.

astimmel · July 2013

SuperMinty, the thing is that she ISN'T naturally this size. Her natural weight, where she could eat and exercise and easily maintain, is 132lbs. She pushed herself extremely hard to break 130, and the less she weighs the less she eats.

It's not wedding stress because she was on this path well before they were engaged. And there IS a problem because she's getting more and more frenzied and obsessed with it. Not only that, but her entire family and all of her friends can see how much she's changed, and we're all concerned. She looks sickly and she needs help.

astimmel · July 2013

This isn't something I'm going into lightly. I've been careful to observe her eating habits, activity level, and her anxiety when she's prevented from exercising. I've taken into consideration her stress levels, wedding and otherwise.

I would never do an intervention without her family or her husband. Her mom isn't comfortable with confrontation. That's why I want to talk to him first.

The salad was just an example, and it wasn't just the one time. It's every time. All of her nails are fully lined with ridges from malnutrition. She's not healthy and she needs help. There is no gray area. She's clearly in trouble. Please, I really need help with this.

ETA: Thanks for the info, TXKristan!

manateehugger · July 2013

Ok first. Slow your roll. Being panicked or overly observant this situation will not help (I'd strongly recommend against pointing out things about her body/eating habits when you talk to her). Don't tell her how malnourished she looks without recommending a solution.

I'll tell you some cold hard truth about eating disorders (please don't refer to her as anorexic pre- diagnosis. As TXKristan said, that's a medical term and ED's all look very different): you can't force them to get help. You can't force her to see a problem.

All you can do is encourage her to speak to a professional. Tell her it can help with wedding stress or anxiety. You can't fix her.

Another resource for you:http://www.saintfrancis.com/Laureate-Psychiatric-Clinic/eatingdisorders/Pages/About-Eating-Disorders/For-Families-Friends-and-School/Care-for-Yourself-and-Family.aspx

http://www.saintfrancis.com/Laureate-Psychiatric-Clinic/eatingdisorders/Pages/About-Eating-Disorders/For-Families-Friends-and-School/Learn-the-Signs.aspx

CLoGreenEyes · July 2013

Maybe I am missing something, but why is it that you won't just talk to HER first without anyone else involved? I think that expressing your concerns directly to her is the first thing to be done - if only so you can say you tried. If things get worse after then, then maybe an intervention is justifiable. I agree that it sounds like something is going on from what you've said here, but it may not necessarily be what you suspect. @Liatris2010 nailed an example below. Talk straight to your friend.

Edited for clarity

astimmel · July 2013

PDKH, I promise I'm not panicked. I've been making mental notes about her behavior for a few months now so that I could be sure I wasn't jumping to the wrong conclusion. I won't point out anything about her appearance or habits when I talk to her. I didn't realize anorexia was a specific medical term, I was using it in a general sense. Sorry for the confusion.

Amapola14, I want to talk to her husband first for a couple reasons: 1) he's the main person in her life and she'll listen to him if he privately expresses concern, rather than involving everyone at once. 2) I'm a size 14, and when I've brought this up in the past she won't take me seriously because she interprets it as "I'm jealous of your body, you need to eat more so you can be fat with me." And she just laughs it off.

So I should try talking with her directly first rather than the husband? I'm sure I sound like a nutcase. I just want to approach this as cautiously as possible and consider every option so that I don't make a mistake and screw it all up.

ETA: Liatris2010, that's true. I'm pretty confident that he's not the problem, but I guess I should play it safe.

manateehugger · July 2013

I didn't mean to imply that you're engaging in chicken-head-cut-offness, sorry. But you have to realize that ED recognition, treatment, and recovery is a very long process. And they never truly go away.

Read through the resources TX Kristan and I gave you. They have good pointers on how to bring up the issue to her. Give her a solution, don't tell we that she is simply too skinny/unhealthy. And be prepared for her to deny the issue (which it sounds like what she is doing right now) or to get angry. It's a slow process. She won't wake up tomorrow realizing she needs help because you said something.

Like I said the most you can really do is encourage her and let her family know you're concerned

wittykitty14 · July 2013

Talk to your friend, and no one else. Be open with her about your concerns, but be very general about them. Don't go into any details about what you've seen unless she asks for them. Make sure to tell her that you're always there if she needs to talk. Don't force the conversation, but leave the door open for her to talk to you later on.

Whatever you do, don't force her. I struggled with an addiction for years. If people wanted to help, and I wasn't ready to listen, then I'd push people away and close myself off. That's the last thing you want to happen with your friend.

I wish I had more advice, OP. Your friend is lucky to have someone like you in her life who cares about her!

CLoGreenEyes · July 2013

@astimmel - you don't sound like a nutcase. You sound like a thoughtful and loyal friend to me.

Just use what you've observed and have a heart-to-heart with her. "Friend, I have noticed over the past several months that you have lost a lot of weight and have been reacting very differently to food. [Fill in what you've seen here.] What's up?" You can see where it goes from there. She may be resistant and deny that anything is wrong, or she might open up and really talk to you, possibly revealing circumstances you didn't know about (e.g., some sort of illness, though that sounds unlikely). But you can't know for sure until you hear it from her. In any case, you will get more information from this conversation and can decide what to do from there.

astimmel · July 2013

Amapola14 said:

@astimmel - you don't sound like a nutcase.

That doesn't mean I'm not! But at the moment, I don't think I am...too much.

Thanks, everyone. I'll ask her to get together this weekend and spend the rest of the week thinking of what to say.

manateehugger · July 2013

I'd just like to add that the only reason I'd suggest mentioning your concern to her family is because they may already be speaking with her about the issue.

You don't want her to feel constantly harassed about her weight/eating. Or if her family has been attempting to encourage her toward a specific treatment, you don't want to offer contradictory advice.

My sisters' friends tried multiple things, including an invtervention, without speaking to us. And it made things worse and prompted her to shut herself off from everyone but her emotionaly abusive boyfriend who had an ED himself.

Edit: I'll again apologize for implying you're overly panicked about the situation. I'm glad you're concerned. But I cannot stress enough how important it is to calmly approach this situation.

astimmel · July 2013

PDKH said:

I'd just like to add that the only reason I'd suggest mentioning your concern to her family is because they may already be speaking with her about the issue. You don't want her to feel constantly harassed about her weight/eating. Or if her family has been attempting to encourage her toward a specific treatment, you don't want to offer contradictory advice. My sisters' friends tried multiple things, including an invtervention, without speaking to us. And it made things worse and prompted her to shut herself off from everyone but her emotionaly abusive boyfriend who had an ED himself.

Good point. I know her mom is concerned but I don't think she's said anything. I'll ask her. I definitely don't want to overwhelm her if she's already been approached by others. Thanks!

KDM323 · July 2013

If she is truly suffering from an ED this approach will go over like a lead balloon and potentially cost you the friendship. Eating disorders aren't about food...it is a mental illness.

I weigh in, at my highest ever weight, at 128. I am over 5'10" tall. That was a few months ago. Due to a recently diagnosed thyroid disease and trying to find the right treatment and dosage, I dropped 16lbs in one month and completely lost my appetite as a side effect of the one treatment...I was down to 104...and am now back to 112. If ANYONE came to me or my fiance about my weight, claiming an eating disorder as the cause, I would be pissed.

Your friend could have an underlying health issue that you are completely unaware of...and perhaps she does not want to discuss.

Talk to her, express your worry and concern...do not go behind her back and do not profess to know what is "wrong". You don't know what you don't know...and unless you are her doctor, it isn't your place to diagnose her.

KDM323 · July 2013

And one more thing...I have always been ridiculously thin. ALWAYS. I also have had people throw the "anorexic" term out there.

It hurts.

Remarking about a person that is under the "ideal" weight is no less hurtful or rude than remarks about people that are overweight.

I would never think to say to an overweight person "Are you sure you REALLY need that cheeseburger" but I can't tell you how many times someone has thought it ok to tell me how I need "to eat" or said they want to fatten me up, etc.

Keep that in mind.

Peaseblossom55 · July 2013

drexelkathy said:

And one more thing...I have always been ridiculously thin. ALWAYS. I also have had people throw the "anorexic" term out there.

It hurts.

Remarking about a person that is under the "ideal" weight is no less hurtful or rude than remarks about people that are overweight.

I would never think to say to an overweight person "Are you sure you REALLY need that cheeseburger" but I can't tell you how many times someone has thought it ok to tell me how I need "to eat" or said they want to fatten me up, etc.

Keep that in mind.

I've been this way too and it is really annoying and offensive. I try to eat and gain weight but it doesn't happen as quickly as I would like it too.

OP everyone gave some great advice I would try bringing up your concerns to her see how she takes them. I wouldn't try to go through her husband first though. I would check with her family too ti see if they spoke with her too.

tiny speck · July 2013

drexelkathy said:

If she is truly suffering from an ED this approach will go over like a lead balloon and potentially cost you the friendship. Eating disorders aren't about food...it is a mental illness.

I weigh in, at my highest ever weight, at 128. I am over 5'10" tall. That was a few months ago. Due to a recently diagnosed thyroid disease and trying to find the right treatment and dosage, I dropped 16lbs in one month and completely lost my appetite as a side effect of the one treatment...I was down to 104...and am now back to 112. If ANYONE came to me or my fiance about my weight, claiming an eating disorder as the cause, I would be pissed.

Your friend could have an underlying health issue that you are completely unaware of...and perhaps she does not want to discuss.

Talk to her, express your worry and concern...do not go behind her back and do not profess to know what is "wrong". You don't know what you don't know...and unless you are her doctor, it isn't your place to diagnose her.

Very well said, and I can relate to this too. At 5'6" I weigh about 112 lbs and exercise regularly (primarily running but I also lift weights). I have also started exercising more regularly over the past year and a half (and have lost a bit of weight because of that): to point to this as evidence of an "ongoing problem" would be really presumptuous.

I have always been very thin, often don't have much of an appetite, and I have a medical condition that contributes to this.

I would be furious if a friend tried to intervene with me or my husband and suggested that I was anorexic or had any kind of eating disorder.

ETA: I am also very self-conscious about my bony ribs, elbows, and spine. I would love to have a bit more padding on them, but the way I'm built and how my body works means that's just not likely to happen any time soon.

astimmel · July 2013

Thank you everyone for your input! You Knotties are all-wise and I really appreciate your blunt honesty.

I do understand that some people are naturally very thin, and that it would be offensive to approach someone and suggest that they have an eating disorder. The reason why I'm doing this is that I've known her for 14 years and this is such a sudden change and she's become obsessive about it. It's not her norm.

I'm not going into this lightly. I've waited a long time to speak up because I wanted to make sure that I wasn't just imagining things and jumping to conclusions. I'm prepared for backlash, or worse. I won't point out her food intake or comment on her appearance. I plan to do as you guys suggested and voice my concern, encourage her to see a doc, let her know I'm here for her, and leave it at that. And I left a message for her mom last night so we can talk before I do anything.

Blue & White · July 2013

I would recommend talking to your friend herself. I would also recommend not soon it over food/coffee. Maybe you can see a movie or take a painting class or something. My sister is a recovered bulimic and she would constantly comment on MY calories too. I learned to get along with her outside of food - it allowed me to be there for her.

She will tell anyone that asks though: she wouldn't be recovered if she didnt figure that that she had a problem one day. Really, she told my mom she needed counseling. That first step is the hardest.

Peledreamsofrain · July 2013

Just my two cents from personal experience:

People suffering from eating disorders tend to partner with enablers so they don't have to face or justify their problems. I had a friend whose sister married such a man. She got thinner and thinner and thinner, and he didn't see any problem with it. Even after she lost a baby due to her extreme malnutrition, he reacted with anger to anyone who even suggested she had a problem. The husband is not the route to go (in fact he's possibly part of the problem).

Talk to your friend directly, away from food. Give her the benefit of the doubt that perhaps this is a medical issue she hasn't spoken about. "Stephanie, I love you and have seen a lot of changes recently that have me really worried for you.." etc.

At the end of the day though, if she doesn't respond and continues to harm herself, you have to realize there is only so much you can do. It's her realization to make, and nobody can make it for her.

Belle2188 · July 2013

I think you need to talk to your friend yourself, without bringing anyone else into it. Honestly, if you're saying her normal weight is 132 lbs. and you're guessing she's at about 122 now, I really don't know if I'd consider a 10 lb. weight loss a disorder, especially around the time of her wedding. However, if you're really sure that there's something wrong, sit her down for a talk.

I have a close friend that was anorexic and bulimic. Her habits were scary, and it was making her sick. She would count out 6 almonds and that was all she'd have for lunch. Most other things she would just throw up afterwards. I talked to her myself, offered support, and it took a while for her to get it under control but she's doing really well now quite a few years later. There was a fine line in getting through to her, though, and I had to be very careful to make her feel supported and not attacked. If you feel you need to intervene, be very careful of what you say and how you say it.

I will tell you, though, I was an extremely thin teenager--I'm talking like 70 lbs. (granted I'm only about 5' tall but still, I looked pretty skeletal), and it really made me upset when people would accuse me of being anorexic. I wasn't--I didn't have a huge appetite and I had an extremely fast metabolism. Be prepared for your friend to get a little defensive because if it's not true, that's a pretty offensive accusation.

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