You’ve noticed your running buddy hasn’t wanted to go out to brunch like you used to. She also has been running even on her usual rest day. She’s dropped some pounds lately, but you thought it was because she’s at the height of marathon training. You finally get her to go out to breakfast with you after a 20 miler and she orders a side of cottage cheese and fruit after you order the large stack of pancakes, eggs AND the bacon. Something just doesn’t seem right. Could she be suffering from an eating disorder?
If you’ve ever experienced something like this, you probably felt a little weird for assuming something’s wrong with your friend, but at the same time it felt weird to say nothing. You don’t want to offend by bringing it up, but also certainly don’t want to act as an enabler by doing 20-milers by her side every weekend and not saying anything as she picks at a few grapes on her plate. As the saying goes, you’re definitely between a rock and a hard place.
As someone in recovery for an eating disorder, I can give you a few pointers when it comes to friends and ED. I’ve been on both sides: a few years before my own struggle I was that someone caring about a good friend with bulimia who was in extreme denial. It takes a lot of balls to be the one to speak up when you’re worried. Almost anyone who brings up the topic to a friend feels like they might be overstepping, but it could help save your best bud’s life in the most literal sense.
First it’s important to know the outward signs of an eating disorder. Before you determine whether to confront a friend about a suspected eating disorder, you must determine whether you think he or she actually has one. It’s particularly hard to tell with serious athletes who, to most people, seem to excessively exercise and might often seem preoccupied with diet and weight for performance reasons. Here’s a story about a male runner with an ED (yes, men suffer from ED too!) and how hard it was for his friends and family to see what was going on. If your running friends is experiencing these signs, it’s worth a chat about it, even if that chat is awkward.
- Dramatic weight loss.
- Wearing loose clothing to hide the weight loss.
- Preoccupation with food, dieting, counting calories, etc.
- Refusal to eat certain foods.
- Avoiding mealtime or eating with others.
- Exercising excessively.
- Making comments about being “fat.”
If you do decide to confront a friend you suspect is suffering from an ED, here are some do’s and don’ts for how to handle the talk.
First and foremost, educate yourself on the matter of eating disorders. Read up on eating disorders to try to understand what she might be going through. A great resource to start is the National Eating Disorders Association webpage. There are lots of types and some are easier to hide than others. Try to put yourself in her shoes. What are her perceived benefits of continuing with this behavior? How can you help her realize that the negatives outweigh the positives? Ninety-nine percent of the time this is what the sufferer has to realize before he or she voluntarily seeks professional help.
Express your concern openly, honestly and in a private manner. Ask how you can help. Suggest professional help in a gentle way (recommend a nutritionist, a therapist, a primary care physician - typically all are included for a complete treatment team). Don’t corner your friend during a workout or bring it up in front of others; use your sense and keep it low-key and private.
Be firm. Chances are your friend might deny the problem. After all, denial is one of the signs of an ED. She might also have a pre-planned list of excuses to rattle off the top of her head. But don’t quickly concede or back away. Be kind, but be stern. Express your sincere and serious concern.
Understand that the person is not looking for attention or pity. Unfortunately eating disorders typically get the rap of being superficial, self-centered and self-imposed. They are mental illnesses. Remember, it’s not about the food. Deep, underlying issues are typically at the root.
Offer to go to an appointment with her. Additional support at initial therapy or nutritionist sessions can be a God send. I remember my sister going to a family support therapy session as I went to one of my first group therapy sessions, my fiance attending an all-day family/support at the Center For Balanced Living and my mom and dad flying out to Arizona to learn more about my eating disorder from my treatment team.
Accuse or cause feelings of guilt. Chances are the person with the eating disorder is trying her best to hide the problem as to not cause any worry for family or friends. Laying a guilt trip, like “you’re worrying me and causing so much stress for your family,” will only make the person feel worse and become more likely to hide behaviors from you. Remember, this is not a self-inflicted disorder! Despite the myths, it’s a mental illness.
Continue inviting the person to social events where the main focus is only food. Most social events involve food, but for someone with an eating disorder severe isolation may occur if social events are centered strictly around a meal. Instead of grabbing lunch, see if she’d like to grab a coffee or go get a manicure. Chances are she’ll be much more comfortable with this and at least agree to go.
Constantly nag about food. Focusing on the food won’t get at the root of the problem. It will likely make her avoid you. Don’t be a watchdog. That’s the job of a healthcare professional.
Try to control his or her actions or take the problem on as your own. Don’t put it on yourself. It’s hard to see a friend struggle like this, but it comes down to their desire to beat this. Like the saying goes, ‘you can lead a horse to the water, but you can’t make it drink.’
Though it can be awkward, uncomfortable, or even painful to bring up, your concern could be the first step to her realization that the problem is real and noticeable. Don’t take the defensive responses personally! As a friend, continue to express that you just want the best for her. She can’t really get mad about that, and underneath it all, I’m sure she’ll appreciate it in the long run.
Have you ever been concerned a running friend had an ED? What have you done to try to help without overstepping your boundaries?