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With Eating Disorders

How To Help A Teenage Friend with An Eating Disorder

Experts say the peak time to develop an eating disorder is between the ages of 11 and 13. So, if you are a teenager, you may have a friend that has an eating disorder. Here are some tips on how to help a friend that you suspect has an eating disorder.

  1. Learn as much as you can about eating disorders before confronting her. Be careful to not assume she has an eating disorder.
  2. Tell her you are concerned about her and suspect she might have an eating disorder. Offer specific observations, like, “I heard you throwing up in a bathroom stall twice last week at school.”
  3. Suggest she be evaluated by an expert. It’s doubtful she’ll be receptive but it is important that you tell her. Offer to go see someone with her.
  4. Hand her a list of resource numbers. The National Associated Disorders (ANAD) has a toll-free hotline (1-847-831-3438). They provide counseling over the phone, a network of free support groups, and referrals to health care professionals. The National Eating Disorder Association has a toll-free Referral Helpline at 1-800-931-2237.
  5. If your friend gets angry and refuses to talk about the problem, don’t push her. End the conversation immediately.
  6. Tell a professional (nurse, guidance counselor, coach, teacher) that you suspect your friend has an eating disorder.
  7. Realize you’ve done what you can at this point. You can’t force help on someone who doesn’t want it.
  8. Know that simply telling your friend you’re worried, and that you love and support her, definitely matters! When she is ready to get help, you may be the very person she goes to. You can then share the contact information listed in this article.

How To Help A Friend With An Eating Disorder

What Is An Eating Disorder?

Anorexia nervosa is characterized by restricted eating and refusal to maintain normal body weight; persistent fear of being fat; feeling fat when one is not; absent or erratic menstrual cycles in females.

Bulimia nervosa occurs when there are recurrent episodes of binge eating and a feeling of lack of control over eating; regular use of self-induced vomiting, laxatives, diuretics, fasting, or exercise to prevent weight gain; persistent over-concern with weight.

Eating disorders are often associated with high achievement orientation and perfectionism, a need for control, poor self-esteem, and feelings of shame. The person (female or male) may become depressed or suicidal. The causes are still unclear, but are probably complex and multiple, including psychological, biological, and social factors. Without treatment, eating disorders can become chronic and progressive and may threaten life and health.

What Can I Do?

If you and others have observed behaviors in your friend or roommate that are suggestive of an eating disorder, you are in a position to help.

  • Make a plan to approach the person in a private place when there is no immediate stress and time to talk.
  • Present in a caring but straightforward way what you have observed and what your concerns are. Tell her or him that you are worried and want to help. (Friends who are too angry with the person to talk supportively should not be part of this discussion.)
  • Give the person time to talk and encourage them to verbalize feelings. Ask clarifying questions. Listen carefully; accept what is said in a non-judgmental manner.
  • Do not argue about whether there is or is not a problem – power struggles are not helpful. Perhaps you can say, “I hear what you are saying and I hope you are right that this is not a problem. But I am still very worried about what I have seen and heard, and that is not going to go away.”
  • Provide information about resources for treatment. Offer to go with the person and wait while they have their first appointment with a counselor, physician, or nutritionist. Ask them to consider going for one appointment before they make a decision about ongoing treatment.
  • If you are concerned that the eating disorder is severe or life-threatening, enlist the help of a counseling center staff member, or a relative, friend, or roommate of the person before you intervene. Present a united and supportive front with others.
  • If the person denies the problem, becomes angry, or refuses treatment, understand that this is often part of the illness. Besides, they have a right to refuse treatment (unless their life is in danger). You may feel helpless, angry, and frustrated with them. You might say, “I know you can refuse to go for help, but that will not stop me from worrying about you or caring about you. I may bring this up again to you later, and maybe we can talk more about it then.” Follow through on that – and on any other promise you make.
  • Do not try to be a hero or a rescuer; you will probably be resented. If you do the best you can to help on several occasions and the person does not accept it, stop. Remind yourself you have done all it is reasonable to do. Eating disorders are stubborn problems, and treatment is most effective when the person is truly ready for it. You may have planted a seed that helps them get ready.
  • Eating disorders are usually not emergency situations. But if the person is suicidal or otherwise in serious danger, GET PROFESSIONAL HELP IMMEDIATELY.

Reprinted with permission by Dr. Morcia Herrin. For more information please contact: Dartmouth college Nutrition Education Program (603)650-1414 or: Eating Disorders Awareness and Prevention, Inc., 603 Stewart Street, Suite 803, Seattle, WA 98101. 206-382-3582

I Think She has an Eating Disorder! Now What Do I Do?

  • Throughout the whole process of detection, referral, and recovery, keep the focus on the goal of feeling healthy (physically, emotionally, psychologically, relationship wise) .
  • Don’t make promises you can’t keep. (i.e. don’t promise you won’t “tell,” if you feel the person’s health is in danger.)
  • Be aware of community resources and what to do in an emergency.
  • Know your limits. Do not get over-involved in terms of trying to offer “therapeutic” advice. These are complicated, dangerous, and often difficult-to-treat disorders that generally require a whole team approach to treatment. You do no want to become a substitute for professional care.

Reprinted with permission by Dr. Marcia Herrin. For more information please contact: Dartmouth College Nutrition Education Program at (603) 650-1414, or Eating Disorders Awareness and Prevention, Inc. (EDAP) at 603 Stewart Street, Suite 803, Seattle, W A 98101. (206) 382-3587.

Rules for Family Members of a Person Recovering from an Eating Disorder

  • Rule #1: Accept your limitations. Encourage your loved one to get professional help.
  • Rule #2: Accept the other person’s right to an independent life. Don’t take charge.
  • Rule #3: Don’t purchase (or avoid purchasing) food solely to accommodate the eating-disordered person.
  • Rule #4: Each household member decides individually what he or she will or will not eat. No one should be forced to eat anything or be restricted in what can be eaten.
  • Rule #5: Don’t make mealtimes a battleground. Keep discussion about food issues to a minimum.
  • Rule #6: Be willing to negotiate household chores involving food.
  • Rule #7: The person with the eating disorder is responsible for their behavior whenever it affects others.
  • Rule #8: Do not monitor someone else’s behavior for them (even if you are invited to).
  • Rule #9: Do not use money to control another person’s eating behavior.
  • Rule #10: Do not anticipate someone else’s needs.
  • Rule #11: Don’t make eating out a battle of the wills.
  • Rule #12: Do not play therapist.
  • Rule #13: Do not comment about, someone’s weight and looks.
  • Rule #14: Seek support for yourself.

After Surviving an Eating Disorder: Strategies for Family & Friends. Siegel, M., Brisman, J. & Weinshel, M., 1997. New York, NY: Hamper Collins



  • Urge your child to eat; don’t watch her eat, don’t discuss food intake or weight; leave the room if necessary-this kind of involvement is this anorexic’s way of manipulating you.
  • Allow yourself to feel guilty. Most parents ask: “What have I done wrong? There are no perfect parents or people. You have done the best you could. Getting well is the anorexic’s responsibility. It’s their problem–not yours. Get the anorexic a complete physical check-up to eliminate organic causes.
  • Neglect you marriage, partner or other children. Focusing on the sick child can perpetuate the illness and destroy the family. The anorexic should know that you love and care for them, but no more than the others in the family. Don’t commiserate; this only confirms the child in their illness.
  • Be afraid to have the child separated from you if it becomes obvious that the child’s presence is bad for them or the family. This may be what is needed.
  • Put the child down by comparing them to more successful siblings or friends. The anorexic already feels inadequate. So do not ask questions such as, “How are you feeling?’ or “How is your social life?’ or “How are your friends these days?’ Such questions only aggravate their misery. In general their self-esteem is in good measure a reflection of your esteem for them. Praise is growing soil-criticism kills.

  • Love your child as you love yourself.
    Love makes anyone feel worthwhile.
  • Trust your child to work out his/her own values, ideals and standards. In practice, we all fall short of ideal behavior, we are all petty, mean, envious to some degree. Don’t insist that your child be perfect. Don’t impose abstract ideals that neither of you can live up to. Be flexible.
  • Do everything to encourage the child’s initiative, independence and autonomy. Anorexics tend to feel inferior, inadequate; don’t reinforce these feelings. They display their inadequacy by perfectionism which is sure to leave them dissatisfied with themselves. No one is perfect.
  • Understand the possible long-term nature of anorexia. Anorexics do get better; many recover completely; a few die. Families must be prepared to face months and often years of treatment. There are no counselors or psychiatrists with easy answers.A support group such as a parents’ self help group may make a significant difference to you and your family’s well-being; the group helps you to deal with yourself in relation to your anorexic child. You must make the child understand that your life is as important as theirs.



©1996 Capital Region Association for Eating Disorders, Albany, New York (518) 464-9043.
For more information, contact: Eating Disorders Awareness and Prevention, 603 Stewart Street, Suite 803,
Seattle, WA 98101,206-382-3587, Website:

Nutrition DOs and Don’ts For Friends and Family


  • DO accept the individual’s right to choose his or her own food.
  • DO be willing to negotiate duties involving food.
  • DO allow each family member to make their own food decisions.
  • DO treat siblings fairly and equitably.
  • DO learn about eating disorders.
  • DO make the person with the eating disorder responsible for his or her actions:
    • replacing food that was binged on
    • cleaning up messes (bathroom, kitchen, etc.)
  • DO be a model for good eating habits and positive self image.
  • DO discuss with the person why you are concerned about his or her nutrition and weight behavior-be caring, gentle and non-judgmental.
  • DO be supportive-let the person know you care about him or her and there’s more to care about than just weight and appearance.



  • DON’T decide for the person what should or should not be eaten.
  • DON’T count points.
  • DON’T force the person to eat.
  • DON’T restrict food choices or amounts.
  • DON’T watch the person when eating or make comments about food.
  • DON’T apologize for or make excuses for the person’s eating habits.
  • DON’T make mealtime a battle of wills.
  • DON’T play nutritionist.
  • DON’T give food and nutrition related advice.
  • DON’T read the person’s journal (food or personal).
  • DON’T purchase or prepare food for the person only.
  • DON’T comment on people’s weight or appearance.
  • DON’T blame yourself or others.

Reprinted with permission by EDAP for Eating Disorders Awareness Week
EDAP 603 Stewart St., Suite 803,Seattle, Washington 98101. (206) 382-3587
Courtesy of Nebraska Dietitians, Working With People With Eating Disorders


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