What to Do When You Think a Friend Has an Eating Disorder

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I am regularly asked what to do when someone thinks that their friend—or partner or child or student or other relative—has an eating disorder. Sometimes, this “friend” is likely the person asking; sometimes the person in question is very ill; and sometimes they probably aren’t. Regardless, it is usually difficult to determine how to approach someone with what may be perceived as invasive commentary on their eating behaviors and mental health.

I’ll admit that I am not naturally a confrontational person. I’d much rather let others live their own lives and mind my own business than ask them about their health. However, eating disorders are the deadliest mental illness aside from opioid use disorder, and even disordered eating—which doesn’t warrant a clinical diagnosis but can be akin to an eating disorder—can really damage mental and physical health. Thus, if someone you know exhibits signs of an eating disorder, it’s essential that you speak up.

No one wants to develop an eating disorder or any other type of health problem. So, when you approach someone with your concerns, you must let your concern be apparent and not blame the individual for their problem. It’s often helpful to try to have a calm conversation that allows you to share your worries. I like to start by saying, “I have noticed X, and I’m concerned about you. I don’t mean to be nosy, but I am worried about your health. Is there anything I can do? I want to support you.” “X” may be that a person has lost or gained weight or is exhibiting new exercise or eating habits. You don’t need to list every single observation that you have, but it may facilitate conversation to comment on something you’ve noticed.

One way to support a person with an eating disorder (or, really, any health problem) is to help them acquire resources. You may want to direct your friend to some helpful resources online, such as the National Eating Disorders Association eating disorders screening tool. You may want to let your friend know that you’re aware that eating disorders can be serious—even deadly—and that you care about them getting better and enjoying a healthy future. A good starting point for your friend may be to call the Anorexia Nervosa and Associated Disorders Helpline (U.S. 1-888-375-7767).

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Consider helping your friend to find a way to get professional help. It can be incredibly challenging when you are in the throes of a health problem to navigate health insurance and locate providers. Your friend may need to work with a doctor, therapist, and registered dietitian. Offering to spend some time looking for providers that take health insurance or who have offices nearby can be a big help. Psychology Today's directory allows you to search for therapists by location, specialty, and the insurance they take; it is important to find a therapist with experience treating eating disorders.

It can be scary for people to pursue help for a health problem, and more so when it is a mental health problem. Sometimes people who need help aren’t ready to get it. It’s possible that you could talk with your friend, and they may not follow your advice at all. Try not to take this personally but continue to express your concern and offer support. Most importantly, don’t ever shame someone or make them feel bad for having a problem. This is unlikely to help and may only damage your relationship with them.

Other resources can be found on the website of The Alliance for Eating Disorders. Anorexia and Associate Disorders (ANAD) offers information about free support groups, and the organization F.E.A.S.T supports families and caregivers of people with eating disorders.