What to do for yourself:
No matter how you look at it, whether you have eating issues, distorted
eating behaviors, or an eating disorderif you are bothered
by ways that
your relationship with food may be harming you, then you should do
something about it. Find out the facts about eating disorders;
find out who
you can talk to about your questions and concerns. Friends, family members,
an R.A. or a teacher may be a good place to start to draw support around
you, but you will probably get the most knowledgeable, objective and
accurate information by going to someone who has training and experience
helping students with eating disorders. This would include counselors
psychotherapists, medical doctors, nurses and advanced nurse pracitioners,
nutritionists and other specialists. Family and friends can be enormously
helpful, but remember that they may not know how to help, and they may
not at all understand why food and eating are such emotional, conflictual
things for you. It can be easy for them unwittingly to say or do the wrong
things, so the more you are able to
hold on to your own resolve about your concerns, the better you can guide
the people you turn to (and yourself) to some good solutions.
The hardest step to take for some people is that first
time you voice to
someone else that something is not right with you and your eating. For
others, the hardest part is admitting and then acceptingdeep downthat
something really is wrong and that you need help with it. For yet others,
hardest part is giving up the unhealthy behaviors and attitudes about
eating: when you let go of your "symptoms", you may be scared
be able to handle other parts of your life.
In fact, you will feel stronger and more in control to the extent
decide to look after the welfare of your self and your health.
This is not
easy, but will be easier if you have the help of some good allies along
and if you can remind yourself that what you want deep down is to feel
about yourself and who you are in the world.
You say you have gone for help, tried these things, but it wasn't
use? After all is said and done, there is no one solution to reverse
an eating disorder, and some solutions that work for others may not work
you. This is not your fault; neither should you lose faith in people or
approaches that still might help. When eating issues and eating disorders
on for a long time, or when they are needed for some reason psychologically,
they can become firmly rooted in a person and it can take time and hard
work to extricate those roots.
Sometimes a variety of interventions or treatment approaches are
necessary, either simultaneously or over time. Medical exams,
counseling and nutritional guidance are the most common interventions
person could need. Group therapy, self-help groups and medication also
play a role in a person's recovery. In certain instances hospitalization
eating disorders program is necessary. Hospitalization may be medically
necessary, but it also can be extremely useful from a simple practical
point: time in a specialized and comprehensive hospital program should
a concentrated impact in altering the course of a person's eating disorder.
Remember that this will take time and tolerance and a belief in
yourself. With society and the media's constant messages, never
reinforcement you get from friends, guys and others, that 'thin is better',
are up against an awful lot. Keep heart and good luck.
For a friend:
You are worried about your friend, your roommate, your girlfriend;
you think she (or he) may have an eating disorder. You don't know
what to do, but you want to do something. Maybe you are afraid to confront
your friend. Or maybe it is complicated because, on top of your worries
for your friend, you are also feeling frustrated or disturbed at what
you see happening, nervous about creating conflict, fed up, or just plain
helpless about what can be done. It is normal to have any and all of these
reactions to someone with an eating disorder, especially a person you
care about, whom you want to see get well.
While eating disorders are growing unfortunately "common"
among young women, and even young men, the behaviors that manifest themselves
in an eating disorder are really quite unnatural. Human beings
are not meant to starve themselves, or force themselves to vomit, or exercise
their bodies to the risk of collapse or injury. To see someone you care
about in the grips of something so unnatural, which clearly is hurting
them in personal ways as well possibly as physical ways, can be quite
awful. You see how caught up they are, out of control and unrealistic;
yet how fiercely they are holding to their regimens and secrecy, how threatened
they are to have these questioned or interfered with in any way. This
is very difficult, and can cause quite uncomfortable tensions between
you and the person whose behavior is troubling you. Find a way to
talk to your friend!
Nobody likes confrontation, but that is exactly what you are going
to need to do with your friend in order to broach your worries to him
or her. There are some common rules of thumb that may help you
to make this first direct talk go well (for both of you). They are as
(Please note that the Do's & Don'ts below apply equally
to women and men who have eating disorders. For the sake of simplicity
and clarity, however, and because women with eating disorders outnumber
men, we have used the feminine pronoun in our statements.)
DO's and DON'Ts:
- Prepare yourself: think ahead about what you want to
how you want to say it; check out in advance what resources
you can recommend to your friend; get in touch with any
feelings you are having that could get in the way of being helpful;
educate yourself about eating disorders.
- Pick a time and a place to talk: where both of you are
comfortable, where there is privacy, and when neither of you is
distracted by other things.
- Approach your friend, above all, with an attitude and
expression of caring, appreciation, and belief in her.
Your friend will have confidence and trust in you, to the extent
that she feels respected, treated with kindness, and accepted by
- Convey your worries or concerns: in terms that are objective
and that describe specific behaviors, changes, emotions or
mental states you have observed in your friend that have led to
your concern. Use "I" language. Make clear that you accept
and care for your friend, but that you do not accept or care for
anything that hurts her.
- Encourage your friend to open up with you. She may have
fears about going for help; anxiety about trying to change;
shame about her out of control behavior; maybe even feelings of
betrayal at your confronting the matter.
- You may be met with your friend's anger, defensiveness
and denial. She may blast you with fury, and then turn away
from you and avoid further contact. Or maybe what you say
will be ignored or discarded. Be patient, don't take it
personally and hang in there. Keep in mind that the volume
of your friend's negative reaction is probably a signal of just how
overpowering her feelings of vulnerability and threat are at that
moment in time, and that the loud negative reaction probably
has very little to do with you (even if it does get directed at
- Sometimes more than one conversation is needed. You
don't have to accomplish all your goals for helpfully confronting
your friend in one sitting. You can do it a bit at a time. And
even if all your goals are accomplished in one conversation,
your friend will still need your friendship and support over
timenext it will be around the steps she takes to address her
- It is good to have in mind what you hope to accomplish in
intervening with your friend: what is realistic to expect,
and what not? What is your main priority? It may be
enough of an accomplishment just to speak out loud to your
friend the concern and worry you have about her. Other goals
for helping your friend might include: informing her of resources
you have found where she can find help; getting her to agree to
make an appointment to see a counselor or other specialist who
can assess what she might need psychologically and physically;
or clarifying who else can be told about this who could offer
additional support (for example, an R.A., parents or older
siblings, other peers).
- Remember that your friend is more than just her eating
disorder. She may be very low in self-confidence, self-esteem
and a secure feeling of identity. If the eating disorder provided
some reason for your friend to feel a sense of self-worth in the
first place, you will want to help her to know and feel that there
is much more of interest and value about her than that.
- Although it probably goes without saying, don't approach
your friend in anger, or on the attack. Your feelings are
legitimate, but anger will probably not be conducive to a
- If you and several other friends or roommates make a
joint intervention (this is a common and perfectly fine
thing for peers to do), be especially sensitive: to how
out-numbered your friend may feel; how bothered she may be
to surmise that all of you have been talking behind her back;
how ashamed she may feel at the public exposure of these
evidently disturbing behaviors; or how unloved she could feel to
be experienced as a problem for so many people. The group of
you may want to balance what you each say, soften your
words, and otherwise convey that this is about caring and
concernand not about condemning or dominating her.
- Don't get caught up in discussing how rational or
"normal" or "healthy" your friend believes her eating
behaviors to be.
- Also don't be persuaded by excuses for the behavior,
as "all the girls at the Plex do this", or "I have to
avoid eating all
week, because I eat and drink so much at parties on the
- Don't hound your friend. Don't feel you need to play
detective or watch dog or coach. You cannot take
responsibility for what your friend decides to do with her
eating. Find ways to be present and supportive that respect her
autonomy and independence.
- Don't guilt-trip your friend; and don't judge her.
Although, she is responsible for her behaviors, it is an extremely
tough challenge she is facing, and in all likelihood she is doing
the very best she can.
- Don't talk loosely about your friend's troubles. When
need to talk, find someone who you know will be supportive of
you while keeping what you reveal about your friend in
- Try to avoid focusing attention on your friend's size,
weight or appearance. Likewise, don't focus on her
achievements (grades, sports events, awards, etc.) Instead,
focus on her inner qualities, strengths, character, interests and
other pleasures. Try not to reinforce the importance to your
friend of things that have to do with performance and
measuring-up. These are traps for a person with an eating
- With all these "don'ts in mind, also don't feel you should
know exactly what to say and do with your friend. It is ok
to not know. You can even say to your friend; "I don't know
how to help; what can I do?"
- Last of all, don't give up on your friend. Believe
in her, and
be open to the ways that you will be touched and your
friendship changed because of this experience you share.
Feel you need additional help?
When in doubt about how to intervene for a friend who you believe has
an eating disorder, get advice for yourself. On campus, there are many
people who could give you guidance: try the Counseling Services, your
R.A., the Women's Resource Center or the Health Services (see the Campus
Resources section of this web-site for a comprehensive list). These people
could help you with your questions about what to do about your friend.
Additionally, there are a great many resources off-campus (see the Off-Campus
Resources section of this web-site), some of which provide in-person advising
and some of which you can access through the Internet.
Remember that this will take time. Your friend needs to
go through her
own process of recovery, and it may not always go the way you think it
ought to. Recognize the limits of what you can do: you can't change your
friend; she has to change herself. Likewise, accept your own limits as
a friend: you may need distance or support at times; you may not be able
to step in in certain ways you wish you could. Tensions could surface
between the two of you; conflict could ease or escalate, or ease again
over time. The bottom line is that you care and that you are doing your
best. In the future your friend will remember this and be grateful.
Guides For Parents, Coaches and
How Can A Professor or Supervisor Help?
A professor or supervisor is in a delicate position due to the nature
of being in a role with the student that is of a superior, with a circumscribed
range of interaction that is usually task-focused. Unlike a parent, coach,
or friend, boundaries are usually more rigid and personal communication
more limited. A professor or supervisor's role in intervening with a student
with eating-related problems is best designed as that of a caring resource.
In this vein, the most useful intervention is to provide initial concern,
validation and support, while clearly directing the student to people
on campus who are in a better position to intervene professionally. Students
seem to respect the authority and advice of their faculty and bosses,
granting them more legitimacy than they do the advice and concern coming
from other people in their lives. This puts you in a rare and opportune
Members of the Counseling Services staff frequently provide consultation
to B.C. faculty and staff who would like advice on how to "read"
and how to respond to a perceived problem with a student. Do not hesitate
to call on us (617-552-3310). The more informed you are, the more at ease
you will feel in understanding your role and how to be most helpful with
How Can A Parent Help?
The best way for a parent to prepare to be helpful is to become informed.
Talking with or reading written material by experts is probably the best
place to start. It is easy to assume that as a concerned parent your instincts
and experience would adequately address most issues. However, eating issues
are highly specialized and usually complex, often requiring professional
consultation. It is important to understand at what stage or phase your
child is at with regard to eating issues, so as to develop some perspective
of your own. There may be a great deal of difference between someone who
is trying different diets or exercise routines and someone who is obsessed
with food and/or thinness to the detriment of their physical or psychological
Eating issues often begin with the wish to lose weight and maintain an
ideal body image. Eating becomes a disorder when the primary reason to
eat or not eat is no longer physical. It is usually not possible to get
someone to stop their eating disorder by simply telling them to stop or
by educating them on proper eating habits. They are usually far from ignorant
about what would be seen as "proper eating habits". The problem
is that there are reasons "behind" the eating disorder that
are personal, private, and probably not very well understood by your offspring.
The eating disorder is your daughter/son's best effort at a solution to
some other problem. Hence, any questioning, disagreement, opinion or confrontation
from you is likely to be met with resistance, denial and avoidance. They're
not going to want to give up their solution. Clearly you are going to
need to call upon your greatest sensitivity, tact and patience as you
approach your daughter or son about this.
The level of your daughter/son's acknowledgement and acceptance of an
eating problem, will determine how difficult it will be to be helpful.
Some simple suggestions: before raising any concerns, make sure it is
a good time to talk; don't raise these concerns in the heat of an argument
or at a time that is impinged on by any other stressful focus or emotion.
Talk privately, without siblings or distractions at-hand. Present your
concerns in a non-judgmental manner and with a calm but serious tone.
If talking with you is too difficult for your daughter or son, you might
facilitate their talking to another adult. You may need to insist on this
and ultimately insist on your daughter or son seeing an objective professional
for assessment and treatment. Many people who have recovered from an eating
disorder say that it was consistent caring voices that made the difference.
Try to hold yourself in that position, even if it is painful and fraught
Common pitfalls for parents exist. Watch out for your own denial of a
problem. Don't let yourself get into the business of diagnosing your offspring's
problems: you do in fact know your daughter or son better than a doctor
would, but you probably do not know eating disorders better than a doctor
does, and hence cannot know exactly how serious certain signs may be.
Many parents have trouble working out conflict with their children. Of
course this is part of the territory with late-adolescents anyhow, but
with the college-age it can be all the more complicated for you to attempt
to assert caring authority at the same time you are generally endeavoring
to relinquish your authority to the autonomy of your now-adult child.
On top of this, for many parents, as well as their offspring, anger can
be experienced as a very threatening emotion that can tempt you to avoid
or give into matters that really need your sustained attention and concern.
Eating issues are unfortunate and sometimes put a person at risk for
developing an eating disorder. Eating disorders are very serious. The
physical health and mental health ramifications can be severe. The longer
a person engages in symptoms, the more entrenched the problem will be
and the more distorted their whole functioning will become. The earlier
intervention and treatment can be made, the more likely that a young person
will be able to leave their eating problems behind and move on with life.
The longer the problem persists, or the more serious it has become, the
longer and more serious will be the treatment you should expect your daughter
or son will need. In most cases a "team" of professionals should
be involved (a psychologist or psychiatrist, a physician and a nutritionist),
coordinating with each other what they do, preferably all of them expert
and practiced with eating disorders.
How Can A Coach Help?
Coaches are in important positions of influence and should cautiously
respond to weight and eating issues as they relate to athletic performance.
Weight in some athletic sports is a necessary factor in establishing fair
competition among athletes. However, other than in those cases where athletes
must fit in necessary weight categories, coaches should minimize their
focus on student-athlete's weight and appearance.
If you have a concern about an athlete who you think has an eating or
weight issue, think carefully about what the problem is and what the appropriate
kind of response would be for you to make, given your responsibilities
and who you are to the student. Is your concern primarily about the student's
athletic performance; or are you concerned primarily about the student's
physical and mental health? Coaches are in a tough spot when they face
the possibility that changing an athlete's eating or weight could diminish
the student's athletic performance. It may help to keep in mind that,
sooner or later, disordered eating will definitely compromise an athlete's
Approach the student with your concerns privately and in a non-judgmental
manner. Stick to focusing just on your concern for the health of the athlete
and your concern about effects on his/her athletic performance. Allow
time for the athlete to talk about the issue in her/his own words. Remember
your intervention is not a disciplinary measure; empathetic statements
are the only helpful responses. A heavy hand will not be productive. If
the athlete does talk to you, be a good listener and focus on reflecting
back what you have heard. If the athlete wants your opinion, be open about
the limits of your own knowledge or experience with these matters, but
do convey the seriousness of your concern. You are in a prime position
to steer a student to professionals who can make medical, psychological
and nutritional assessments of the situation and contribute what they
have to offer with your own efforts.
You yourself as the student's coach may want to consult with a psychological
or medical professional so as to get a greater understanding of the particular
problem you are seeing, and also for advice on the best course of action
with the given student. If you believe that as a result of an eating issue
a medical problem exists, then it is absolutely necessary to have the
athlete evaluated medically before they compete further. Eating disorders
cause invisible damage that can be quite life-threatening if not attended.