Every year, thousands of teens (and adults, too) develop eating disorders and disordered eating behaviors. In fact, an estimated 24 million Americans meet the criteria for an eating disorder.
In our image-obsessed culture, it can be easy to become critical of the way we look. Taking good care of our health and physical fitness is important for all of us.
But some people can take being fit too far, which can lead to an eating disorder. Some go on diets that become more and more restricted or extreme, leading to anorexia. Others may eat way too much food (known as binge eating). And people with bulimia may try to make up for their eating by vomiting, using laxatives or other medicines, fasting, or exercising compulsively.
Although eating disorders are much more common in girls, guys can get them, too.
What's Going On?
Eating disorders can be caused by — and lead to — complicated physical and psychological illnesses. Many people with an eating disorder also have problems with anxiety (excessive worry) and depression (feeling sad, hopeless, and withdrawn).
Many people who try to lose weight 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. For some, losing weight feels like an addiction and they continue to restrict their food intake to an extreme degree (in anorexia) or exercise excessively to try to burn off food they've eaten.
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 may have another type of health condition or might have been overweight and deliberately tried to eat better and exercise more.
But certain signs can indicate 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 or burning off calories.
Avoids hanging out with you and other friends during meals and always comes up with an excuse not to eat lunch at school or go out to eat.
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 drink for breakfast and a few grapes 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 (such as the stomach, thighs, or arms) 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 stimulants, diet pills, laxatives, steroids, herbal supplements, or other medicines to lose weight.
Has a tendency to faint, bruises easily, is very pale, or starts complaining of being cold more than usual (this can be a symptom of being underweight).
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, simply asking "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, and 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 try to tell your friend what's best for him or her.
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 your friend away if he or she thinks you're judging, lecturing, or just trying to make him or her regain lost weight.
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. Telling your friend what to do or how to act probably won't work. You can talk to your parents or school counselor about your concerns and get advice on what to do next.
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 is a good friend, has a fun personality, or has 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.
Remind your friend that you're there no matter what. Listen and be supportive. Sometimes you'd be surprised how asking a simple question (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 and worry that people will try to make them eat or gain weight.
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, trust your instincts and be the best friend you can be, even if that means telling your parents or another trusted adult about your concerns.