So, your friend has an eating disorder. 

Or, at least, you think she/he does.

You don’t know because it’s not like they’re telling you. I don’t know anyone that just goes and is like “I’m gonna vom now for the x time today. Will you hold my coffee?”

You just sense it.

I say I have eating disorder telepathy. I can watch someone from a mile away, and have this intuitive knowledge if they struggle.

Maybe, that’s the majority of the country and I’m giving myself too much credit.

But, it’s the way I watch their discomfort unfold around food. The way their eyes narrow; breathing appears tighter.

It’s the way they avoid looking at food – or talk to someone a mile a minute to escape having to actually eat.

It’s the slight comments “Oh! I ate before I came.” “I’m not hungry – I’m on a diet.” “I can’t eat that!”

Nobody is the same, so I’m generalizing here.

But, I just … I know.

Possibly ’cause I lived it. Possibly cause someone’s discomfort automatically makes me uncomfortable (It’s the empath in me, I’ll say – as I pat myself on the back for being such a “giver.” lolz)

Anyway, so you think your friend has one?

Now, what the hell do you do?

Do you coddle? Do you ignore it (probably most of us do ’cause it’s uncomfortable otherwise. AND WE HATE DISCOMFORT.)

I was on a UVA law panel on eating disorders last weekend when someone raised their hand. (P.S. shout out to Dr. Colleen Reichmann below and Prosperity Treatment Center)

“What is your advice if you think your friend has an eating disorder?”

All three of us on the panel froze.

The other two looked at me. (I’d generally been the one to answer the “human” aspects of eating disorder stuff.)

“Oh shit,” I laughed – as the room snorted.

“Man, this question is hard,” I admitted. “There’s no one answer.”

How can there be? Our friendships and relationships all look different.

The way people respond to accusations or love or support varies.

I spoke with my best friend, Kim (ya know – that best friend. The one you have since childhood.)

Recently, I interviewed her about her experience being the best friend of someone with an eating disorder. Below is an email interview, along with four tips to walk away with during this NEDA eating disorder week.

 

 

• As kids, how would you describe our friendship and was it affected by my relationship with food?

You as a child are fairly similar to how you are as an adult. You’ve always been a social butterfly with the biggest smile and loudest laugh. You know that cheesy song by Kesha, “now the party don’t start till I walk in”? That’s you. Your eating disorder never changed that. In contrast, I was more introverted and shy. Now, our friendship has grown into something more relaxed and I do think that is because you allowed us to be so close during your recovery process.

As kids, our friend group still jokes about how you wouldn’t let us to eat the meat in the Chili’s Skillet Queso whenever we would eat out. (That was the cool thing to do back then.) We’d order the Queso to split, and you’d literally throw a fit if any of us dared to eat the meat in the Queso- please keep in mind you did not actually want to eat the meat, you just didn’t want any of us to have it. It was definitely a control thing looking back, and while we laugh about it now, none of us ever thought twice about what it might actually mean. Truthfully, I doubt you did either.

Tip #1: Eating disorders do not look a certain way. They can have similar behaviors, but different ways of manifesting and growing. It’s not your job to know that. No point looking back wondering “how did I miss that?” You don’t know an eating disorder till you “know” it. 

• When did you begin to notice my eating patterns change?

You always food quirks (Linds refused to eat the ends off of French fries and instead had a pile of sad fry ends on her plate at lunch during middle school) but I knew that by beginning of high school your eating patterns were becoming unhealthy. I mean, you ate an entire tin of Cinnamon Altoids a day.

I have this vivid memory of you calling while I was at a Friday night football game, and when I snuck away to answer, I listened to you break down in tears, sobbing about how unhappy you were and how sick you felt. It was actually the first time we had openly discussed anything close to this and I was blown away. I knew that you were weird about food but I was so wrapped up in my own world that I never thought you could have had an eating disorder. From that point on though, I tried to be supportive but it was challenging since we no longer went to the same school and had different groups of friends.

• Did you ever feel resentful that I had an eating disorder? (During/After)

I don’t think I’ve ever felt resentful toward you per say that would be incredibly unfair, but I do think there have been times – more so in recovery and when your blog was blowing up – that I have felt like your eating disorder took over our friendship.

When you were in rehab and immediately afterwards it was the forefront of all conversations – And that made sense. I was happy to be there and do whatever you needed. You don’t stay friends with someone for almost 25 years now and not see them as a member of your family.

However, it was hard sometimes to know how to manage conversations during recovery- were we talking about it TOO much? Was it bad to linger on it? Should I change the subject or would that upset you? I didn’t want to seem like I was dismissing your feelings or making you feel like you needed to just “get over it” already, but there were times where I felt like it was ALL we ever talked about. To me it was more in the vein of “I have nothing else to say, no more supportive and genuine comments on this topic that I haven’t already said. I don’t know what else I can say to be helpful or to make you feel better right now in this moment.”

It has been a learning curve as we navigate the recovery path together. I had no knowledge or education about eating disorders prior to this, so you taught me so much and in turn that helped me learn how best to respond to you whenever you are going through a rough patch.

TIP #2: If your friend has come to you willingly with their eating disorder, do not carry that load on your shoulders alone. You are not a counselor or a therapist. Support, love, and try to look at other options for help – ideally, with them. Openly communicate when you don’t have the words to say – or don’t know where to navigate the conversation.

• Eating disorders are encompassing. At its worst, did my eating disorder change our friendship?

Your ED changed our friendship in that there were times beforehand where we would go months without talking. Now we can’t go three days without talking (hashtag codependent). Some of this I attribute to us finally being on our own, figuring out who we are, meeting new people and having new experiences. However, it also meant that we didn’t communicate on a regular basis and so I felt like it was easier for you to hide how bad things had gotten. I wasn’t there to witness you at you worst.

There were times after college, when you were living abroad that I knew it was getting really bad. You complained constantly about injuries from running, and whenever we would Skype I could see how thin you were getting.

I’ve always been the “mother” of our group, constantly wanting to nag and nurture. However, with Linds, it’s basically impossible to tell her to do anything, so all I could do was express my concerns and hope that she would want to change on her own. I knew that was the only way it could happen.

It was scary and frustrating and I definitely felt helpless.

• People often say they feel guilty when they watch their friend go through an eating disorder. Did you ever feel guilty?

You and I are very alike in that we are both INCREDIBLY stubborn and hard headed. So for me, I think I inherently understood that there was only so much I could do for you. You can’t fix someone or change someone who isn’t ready and that was a hard lesson to learn.

I could either harp on you and, in turn, alienate you, or I could be there for you when you felt like talking and hope that you trusted me enough to come to me when you were ready. The guy who gave me my first tattoo told me “hindsight is 20/20” and that has always stuck with me. It’s SO easy to say now what I would’ve done differently but at the time I could only do what I thought was “best.”

• What was a time you felt like you didn’t know what to do/say?

I remember I saw photos from back when you lived in Europe and my jaw DROPPED.  I can honestly say it was the most shocked I’ve ever been. I didn’t understand how it had gotten this bad. You brushed it off with comments about how you were running a lot and how you just weren’t eating as much in Europe (cue rant about Americans and their portion sizes) and honestly I was just too scared to pick a fight about it. I didn’t push it. If I had, would you have gotten help earlier? It’s hard to say but I doubt it. I knew there were others reaching out, telling you variations of the same thing I was, so I’m really not sure.

It’s a funny thing- people on the outside probably think it’s easy to call a loved one out. You talk every single day, how could you not have done anything? But as a young girl, it was incredibly hard.

Tip #3: If you choose to ask your friend about their eating behaviors – focus on the external rather than the physical. Eating disorders, in some form or fashion, thrive on the “physical” recognition of their manifestation. So, instead of “you look so this or that,” ask “I’ve noticed you’re going through something – you don’t seem happy. How can I support you? What can I do to let you know that I’m there for you?” 

• What do you wish you might’ve done differently for you? I.E. Would you have taken more self-care in our friendship? Would you have considered your friendship needs more?

I think this goes back to the hindsight is 20/20 thing. Of course now I wish I would’ve asked you to get help sooner, knowing how amazing this entire process has been for you ultimately. I just think at the time I was confused about what was happening. It’s hard for me to place a lot of responsibility on my teenage self’s shoulders. I wanted to be a good friend but I was  younger and had no clue what to do.

Truly, between the stigma of an eating disorder in our society and how accepting our culture was of girls who don’t eat, I’m shocked that you and I communicated about it as much as we did. Unfortunately, it was completely normal for me to eat a bowl of cottage cheese for lunch and nothing else, then go work out or an hour in high school. It wasn’t just me, so many girls at my school were like this! And no one really talked about eating disorders back then, it just wasn’t a spoken issue. The eating disorder community has changed so much and there’s so much more awareness about it now. These stigmas and behaviors that are almost idealized in our culture needs to stop, because I would hate for young girls to think that not eating is acceptable.

• What advice do you have for anyone who has a friend going through an eating disorder?

Encourage them to open up whenever they feel like it – but don’t kill yourself pushing them to talk. Let them know that you’re there when they want to talk and that you won’t freak out or judge. Check in in a way that lets them know you care and you aren’t just trying to police what they’re doing. Also, don’t be afraid to ask them how they would like you to handle the situation. Lindsey was really good about letting me know what she needed from me during recovery, but not everyone may be able to do that.

As with any relationship, I think open and honest communication is the safest bet. If they try to shut down or push you away, let them know that you love them and want to help them and that they don’t have to go through this alone… but don’t take their illness on as your own.

Your friends can’t read your mind, you have to help them out a little bit. But to someone with an eating disorder – you can’t expect your friends to always have the right words.

Once you communicate together, the support system you’ll have is incredibly important to your friendship.

Tip #4: If your friend is open to your help, ask “what is the best way to support you? Do you want someone to eat with at lunch? Do you want a code word if you’re overwhelmed? What is the best thing I can say if you’re having a moment and you don’t think you can get through it?”