About Eating Disorders

Every year, thousands of teens (and adults, too) develop eating disorders and eating disordered behaviors.

In our image-obsessed culture, it can be easy to become critical of our bodies. Everyday concerns about healthy eating and weight management can cross the line and become eating disorders. This happens when someone starts to do things that are physically and emotionally unsafe — things that could have long-term health consequences.

Some people go on extreme diets and can develop anorexia. Others may go on eating binges (overeat to excess, known as "binge eating"). And others may purge their bodies of the food they've just eaten through forced compulsive exercise, inducing vomiting, taking laxatives, or a combination of these (known as bulimia).

Although eating disorders are much more common in girls, guys can get them, too.

Signs of Eating Disorders

So how do you know if a friend has an eating disorder? It can be hard to tell — after all, someone who has lost a lot of weight or feels constantly tired may have another type of health condition.

But certain signs can be an indication of a problem, such as if a friend:

• Has an obsession with weight and food. It might seem like all your friend thinks (and talks) about is food, calories, fat grams, weight, and being thin.
• Feels the need to exercise all the time, even when sick or exhausted, and might talk about compensating for eating too much by exercising.
• Avoids hanging out with you and other friends during meals.
• Starts to wear big or baggy clothes as a way to hide his or her body and shape.
• Goes on extreme or highly restrictive diets (for example, eating only clear soup or only raw veggies), cuts food into tiny pieces, moves food around on the plate instead of eating it, and is very precise about how food is arranged on the plate.
• Seems to compete with others about how little he or she eats. If a friend proudly tells you she only had a diet soda for breakfast and four chips for lunch, it's a red flag that she could be developing a problem.
• Goes to the bathroom a lot, especially right after meals, or you've heard your friend vomiting after eating.
• Always talks about how fat he or she is, despite losing a lot of weight, and sometimes focuses on body parts he or she doesn't like (hair, skin, arms, stomach) to the point of excess.
• Appears to be gaining a lot of weight even though you never see him or her eat much.
• Is very defensive or sensitive about his or her weight loss or eating habits.
• Buys or takes laxatives, steroids, herbal supplements to lose weight, or diet pills.
• Has a tendency to faint, bruises easily, is very pale, or starts complaining of being cold more than usual (cold intolerance can be a symptom of being underweight).

What's Going On?

Eating disorders can be caused by — and lead to — complicated physical and psychological illnesses. Your friend's body image and behavior may be a symptom of something that's going on emotionally.

Many people feel successful and in control when they become thin, but people with eating disorders can become seriously ill and even die. They might start out dieting successfully and be happy with their weight loss, but then they find they can't stop.

What to Do

• Start by talking to your friend privately about what you've noticed. Explain that you're worried. Be as gentle as possible, and try to really listen to and be supportive about what your friend is going through.
• If your friend opens up about what's going on, ask how you can help. Tell your friend you want to help him or her get healthy again. Try not to make statements like "If you'd just eat (or stop working out so much), you'll get better." Instead, asking simple questions like "How can I help?" shows you can listen and be supportive without judging.
• Find out as much as you can about eating disorders from reliable sources. Many organizations, books, websites, hotlines, or other resources are devoted to helping people who are battling eating disorders. Learning more can help you better understand what your friend is going through. Share what you learn with your friend if he or she is open to it, but don't preach or campaign.
• Try not to be too watchful of your friend's eating habits, food amounts, and choices. It can be tempting to try to get a friend to eat more, but eating disorders are complicated so it often does no good (and it may push a friend away if he or she thinks you are judging or lecturing).
• Know your limits. Being concerned and trying to help is part of a good friendship. But don't take it on yourself to fix things. This is one time where telling a friend what to do or how to act probably won't work.
• Focus on inner qualities. Try not to talk about food, weight, diets, or body shape (yours, your friend's, or even a popular celebrity's). Focus instead on people's strengths — like how someone has a great smile, helpful nature, or talents in something like math or art.
• Offer to go with your friend to a support group or be there when your friend talks to a counselor.
• If your friend isn't getting better and isn't getting help, it might be time to talk to someone else. Try talking to your parents, the school guidance counselor or nurse, athletic coach, or even your friend's parents. This isn't easy to do because it can feel like betraying a friend. But part of being a good friend is doing everything you can to help.
• Remind your friend that you're there no matter what. Listen and be supportive. Sometimes you'd be surprised how asking simple questions like "What would make you feel better?" can lead to a great conversation about how you can help your friend heal.

People with eating disorders often have trouble admitting that they have a problem — even to themselves. They may feel guarded and private.

It can be hard trying to help someone who isn't ready or doesn't think help is needed. Try not to get angry or frustrated. Remind your friend that you care. If your friend tells you it's none of your business or that there is no problem, you might have to talk to someone else about it.

Reviewed by: D'Arcy Lyness, PhD
Date reviewed: April 2011