Click here if your friend is already getting help.

If your friend doesn't admit to having a problem and/or doesn't want help, the best way to approach her is to help her see that she needs assistance. However, you'll need to prepare yourself well since approaching a friend with an eating disorder can be tricky.

Remember that an eating disorder is a desperate effort to cope with underlying problems, and although you can see how unhealthy and unproductive it is, for your friend it may feel like a lifeline. That is why it is common for individuals with eating disorders to be upset or mad if you try to help them. They may fear that you are going to take away their only coping mechanisms. Your friend might deny the problem, be furious that you discovered her secret, or feel threatened by your caring. Give him time and space to think and respond.

Before approaching your friend, find out about resources in your community so that you can suggest a helpful strategy. You might first seek advice from someone else, like a counselor at school, or perhaps read more about eating disorders. Choose a safe and private place to talk. Plan ahead for enough time so that you will not be interrupted.

Begin by telling your friend how much you care about her. Next, gently offer some specific observations about her emotional well-being or lack thereof. For example: "You seem unhappy / preoccupied / withdrawn / anxious / fidgety / distant / jumpy / angry, and I'm worried about you." Speak from your heart, using "I" statements. Do not name other people who are also worried about her. That can feel like an overwhelming gang-up.

Then give your friend a few observations about her behavior to explain why you think she might have an eating disorder. For example: "I see you skip meals / I watch you run to the bathroom / I hear you talk all the time about being afraid you are fat, how many pounds you want to lose, what you ate, how much you're going to exercise, etc."

If she becomes upset or mad, stay calm. Do not get angry or panic. Do not engage in a "Yes, you do / No, I don't" power struggle. Remind her that friends tell friends when they are worried about them.

If she insists that she doesn't have a problem, or that she can stop on her own, you can say something like, "You know how it is with alcoholism and denial. The addiction makes it so hard to see you have a serious problem and that you need help. I'm worried you're trapped in a similar kind of situation. Even though I hear what you're saying, I think you're really struggling and you need help stopping. I believe in you and I know you deserve to get help and get better."

Give your friend information about who can help her. Offer to go with her. It may take talking to your friend more than once before she will agree to get treatment. If she refuses to seek professional care, tell her that you are not going to bug her, but that you are not going to stop being concerned either. For example: "Even if I can't convince you to get help now, I can't stop caring." This gives you a foot in the door without being too threatening.

If she gets upset or mad, stay calm and avoid sounding as if your mission is to rescue or cure her. Eating disorders are serious physical and psychological problems, but they are usually not emergencies. However, if your friend is fainting, suicidal, or otherwise in serious danger, seek professional assistance immediately. These words may help: "I don't care if you're mad at me. Friends don't let friends suffer in danger and isolation."

If your friend is getting help for her eating disorder, stay connected to her the same way you would with any friend. Call her, invite her to do things, hang out, and ask her for advice about your life.

When talking with her about herself, it is usually best to focus on daily life events, on her feelings about herself and her life, and on your concern about her. Do not focus on her eating disorder. Her eating disorder is a sign that other issues are troubling her and an attempt to deal with those issues. Moreover, most people with eating disorders are embarrassed about them and feel safer when friends do not try to get involved in the details of the illness.

Avoid all comments - even compliments - about looks, weight, food intake, or clothes. This includes hers, yours, and other people's. Avoid offering her advice on how she could change her behavior. Do not ask her a lot of questions about her recovery, but point out that you're glad to listen if she wants to tell you about it. Remember that recovery takes time.

See also: Finding Treatment