My neighbor has an eating disorder. How can I help?

February 23, 2009 9:22 AM

My neighbor has an eating disorder. How can I help?

I'm almost completely certain that the girl who lives in the apartment below mine is bulimic. I can hear her throwing up. This has been going on for months, and it seems to be getting worse. (Back in December it was only about once a day. Now it happens at all hours of the day and night.) She wasn't doing it when I first moved in (September), and when I met first her she was thin, but not alarmingly so (I'm pretty sure she's a trainer at a nearby gym). The last few times I've seen her she's looked very thin, sickly, and pale. (I want to make it clear that I'm not jumping to conclusions here.)

The thing is, I really don't know her. I've only spoken to her briefly a handful of times, and only then about mundane apartment-type things. I really feel like I have to do something, though. It's killing me to know that there's someone so nearby who's hurting herself and I'm not doing anything to help. I'm considering writing her a letter, but what do I say? I know a decent amount about how eating disorders work and affect people, though I have no first- or secondhand experience. I don't want to put any pressure on her or stress her out and potentially make things worse. I also worry that if she knows I can hear her, things might escalate and she'll to hide it and make things even more dangerous for herself.

So, what can I do? Outside of letting her know that someone cares, I don't even know what my goal is here. If I should write a letter, what should it say? Advice from people who have been there will be much appreciated.

posted by phunniemee to human relations (34 comments total)

You could have a pregnant neighbor. She could be undergoing chemo. I don't think you have much evidence to go on and I don't know what you'd accomplish by confronting her.

I think your fears that you might put pressure on her or stress her out and make things worse are correct. I'm sorry, but it just doesn't seem like you have a dog in this fight.
posted by kate blank at 9:27 AM on February 23 [4 favorites has favorites]

I think your fears that you might put pressure on her or stress her out and make things worse are correct. I'm sorry, but it just doesn't seem like you have a dog in this fight.

I don't know, how can you listen to someone throwing up every day and not worry about it? It's true that we don't know what's wrong with her, but if she's not bulimic or has some other problems I suppose it would be embarrassing for her, but not the end of the world.
posted by delmoi at 9:33 AM on February 23

You could try to be someone who has some reason to care. I would not be impressed if my neighbour whom I'd never really interacted with told me how very much she cared about me, and how she was listening to my home sounds and judging them. That's at best an impersonal level of caring and doesn't warrant some kind of personal response.

If you'd like to help her out, why not see if the two of you would be good as friends and see what happens next. Invite her out for tea or coffee, tell her you're buying flowers for your balcony and invite her to join you. You can't immediately jump to a deep friendship, of course, but at least after some time you will have a better basis to decide what, if anything, you should do. But not everyone wants new friends, and not everyone wants to be saved, and in the end, this is her life, and you're just a stranger.
posted by jeather at 9:34 AM on February 23 [6 favorites has favorites]

None of your business in my opinion unless you become friends with her.

Seems odd that the puking sound is so loud though. Most people that I've known that have had bulimia developed a pretty quiet "stealth" puking. I guess you have super paper thin walls and this isn't a case of having your ear against the floor?
posted by zephyr_words at 9:37 AM on February 23

I can imagine it would be very distressing to hear or see a person self-destructing right under your nose. The fact that she isn't a close or even a casual friend leaves you with little options. Another neighbor of yours might be a drug addict. I'm sure there are a few alcoholics in your building. How would you go about helping them? You can't. Addiction and eating disorders are not something that is going to go away with a concerned neighbor's loving thoughts or gestures. Bulimia is something he and her close friends and family will have to deal with.

I can very much understand your distress and concern, but there is nothing you can do but to remain friendly in the lobby, try to get to know her better, and help and support the people you do know.
posted by Fairchild at 9:41 AM on February 23

I'm almost completely certain that the girl who lives in the apartment below mine is bulimic

You have absolutely zero proof of this. Or are you a psychic detective? There are many conditions that can lead to nausea and vomiting.

Its none of your business and you'll embarass yourself and her when you confront her with your "proof" and she tells you she has stomach cancer or is being treated for a severe ulcer. She'll also be creeped out that you sit there and listen to her go about her business.

I want to make it clear that I'm not jumping to conclusions here.

You are. There are thousands of causes of vomiting and nausea. You are picking the one that fits in with your worldview (its a girl so it must be bulimia!!) and medical ignorance.
posted by damn dirty ape at 9:53 AM on February 23 [3 favorites has favorites]

Some other details:
-we are both in our early 20s
-there are four small units in our small converted house apartment building. No lobby, no balconies, really not even any common area.
-the puking is not that loud but loud enough. I gave up on attempting to NOT hear the puking months ago. Sometimes, when it's clear that other people are over there, she'll run the water. I can hear that, too. I can also hear when the people who live in the building next door to ours do laundry. Very, very thin walls. This isn't something I'm straining to hear just to create drama.
-she is not pregnant. It's my experience that these women get larger, yes?


But thanks, everyone, for the input so far. There's a lot to think about here.
posted by phunniemee at 9:54 AM on February 23

First and foremost, you don't know what her situation is. Diagnosing your neighbor with a serious disorder based on sounds through the floor is tricky business.

Secondly, you are - for all intents and purposes - a complete stranger. If you approach her based on the insignificant amount of information you have, I think it's likely that she'll respond badly.

If you want to be a good neighbor - well, Fairchild has already nailed that pretty well.
posted by DWRoelands at 9:54 AM on February 23

She could have a number of diseases and disorders unrelated to bulimia. You don't know her. I could be wrong, but I sense you might be a little too eager to help her and maybe you should seek another outlet.

Otherwise, this is creepy. You should help her if there's a fire or if there's sounds of domestic violence going on, but whatever she does or doesn't do to herself in her own apartment is her own business. If you hear her throwing up and it sounds violent, by all means go downstairs and knock on the door and say you heard someone getting sick and you wanted to know if you should call an ambulance.
posted by anniecat at 9:57 AM on February 23

the puking is not that loud but loud enough. I gave up on attempting to NOT hear the puking months ago. Sometimes, when it's clear that other people are over there, she'll run the water.

Honestly, on the rare occassion I throw up, I run the water so the vomit flows down the drain. Also, it's soothing to hear water when you're ill.

Some pregnant women lose weight before they start to gain it because their morning sickness is all day sickness. She could have any number of diseases.
posted by anniecat at 10:01 AM on February 23

I don't think our interactions with strangers have to be limited to "Thanks" for holding the door, and "What a cute sweater" when you like what they are wearing. That's especially true if you are genuinely concerned for this person's well-being.

I think Fairchild is right that eating disorders and addictions are often very similar, but I disagree that you have to be close with the person to deal with them. I'm an alcoholic. And it wasn't friends or family who helped me recognize that. It was a loose acquaintance who repeatedly asked about my drinking because he was genuinely concerned.

Your role IS limited by the fact that you aren't close to this person - but it isn't limited the way others are suggesting. (Seriously people, Kitty Genovese dies every day because of this "it's not my place" kind of thinking.) Your role may simply be to set things in motion with a "Hey, you haven't looked so hot lately - I don't know what you're going through but please tell me if you need any help with grocery shopping or errand running or anything; you look wretched." Or you may choose to go more direct with a note under the door to the effect of, "I can hear you throwing up every day. If your health is poor, please let me know how I can help with chores or errands. If you are making yourself throw up, please seek help. You deserve better."

FWIW: This alcoholic never would have responded to generic concern. I had to hear loud and clear from that friend that a) I had a problem; b) he knew I had a problem; and c) that I deserved better.
posted by greekphilosophy at 10:08 AM on February 23 [6 favorites has favorites]

Medications can have the effect, also. My roommate was on Acutane, and she had a terrible time keeping food down. Once she finished the meds, the puking ceased immediately.
posted by WowLookStars at 10:10 AM on February 23

I'll go against the crowd here and say that yeah, it definitely sounds like an eating disorder. I lived in an all-girls dorm during college and it was a scenario that was far too common.

I think you should just leave a note saying that you've heard her getting sick frequently and are concerned for her health, and include the name and number of a local woman's health center and/or eating disorder support group. If you're wrong, it's not going to harm anything, she'll just think she has a nosy neighbor. If you're right, there's really not much you can do, and it's likely not to have any effect at all, but it might give you a little peace of mind.
posted by emd3737 at 10:27 AM on February 23

It's just none of your business. My neighbor yells in pain every time he takes a poo. Sometimes he just says "OUCH!". Other times he screams "Oh my god, my ass! Not again please.... OOOOOWWWWWW". This has been going on since he moved in almost two years ago.

I've considered ways to let him know I can hear him, but I haven't thought of anything that wouldn't make seeing him in the hallway extremely uncomfortable for both of us (he's a young professional, always in a suit, btw). However, I view this only in the context of privacy, not that I need to "help" him in anyway. Maybe I'll leave a note when I move this summer.

I have no problems calling the police during violent domestic arguments, if I think some one is at risk. But offering unsolicited advice about someone's health, even with the best of intentions, is just not cool.
posted by kimdog at 10:29 AM on February 23 [3 favorites has favorites]

-she is not pregnant. It's my experience that these women get larger, yes?

Yes, but you know, almost any other possible condition that would cause nausea and vomiting would also cause weight loss. I've seen it happen to a lot of friends going through treatment for wide varieties of illnesses. It doesn't mean she's not bullemic--sure, of course she could be. Lots of people are. It just means that it's too presumptuous an assuption to confront her with, especially as you hardly know her.

I think the best you can do is say something like "hey, are you feeling alright? You look pale"/peaked/something vaguely indicating illness but not necessarily implying anything specific. And then let her know that you're available to help her out if she needs it. She may come out and tell you exactly what's ailing her, or she might not. But it's her call and at least she knows you're a friendly presence.

There are a very small number of loosey-goosey people in the world who can somehow get away with a blunt but friendly comment like "OMG I hear you throwing up are you OK???" But I think the fact that you're thinking before speaking at all means you're probably not that type.
posted by lampoil at 10:30 AM on February 23

It could also be winter phlegm. I know it sounds gross. During winter, I often wake up with a little ball of phlegm, which takes me a few minutes to cough it up, and includes making some throwing-up-ish sounds since it's nestled deep down, and I don't want to go about the day with the feeling of something stuck in my throat. Some people, though not sick, still get winter phlegm throughout the day.

She could very well be throwing up food, but it may also be something else. Unless she is someone you interact with regularly, I would mind your business. If you want to get to know her, invite her out to coffee or lunch or something (perhaps if you want to put your worries to rest). Do not confront her about having an eating disorder - you simply do not know this.
posted by raztaj at 10:40 AM on February 23

How can I help?

How do you want to help? Seriously, what do you want do? Be a shoulder to cry on? Someone to talk to? Someone who will drive her to the therapist? You need to have an idea of the level of involvement that you want to participate in.
posted by Brandon Blatcher at 10:48 AM on February 23

"Hey, you haven't looked so hot lately - I don't know what you're going through but please tell me if you need any help with grocery shopping or errand running or anything; you look wretched."

Please don't say this. If she does have an eating disorder, it will probably reinforce all of her thoughts that she's not thin enough yet. Commenting on someone's appearance is not the way to offer help with an eating disorder. And if she doesn't have an eating disorder, especially if she has some other illness that she's trying to cope with, you'll have just ruined her day by telling her that she looks bad. Do not say this.

I'm voting for mind your own business.
posted by decathecting at 10:58 AM on February 23 [3 favorites has favorites]

Unless they are a loved one, or harming you or somebody that cannot stand up for themselves, keep out of your neighbors business. What consenting semi-rational adults do to themselves is their own responsibility.
posted by HFSH at 11:30 AM on February 23

It's very kind of you to want to help, but I don't know that you can. Someone once left me an anonymous note when I had reached a worrisome weight and appearance, and it was completely mortifying and actually accelerated things somewhat.

If she does indeed have an eating disorder, telling her she looks terrible or sick will not have the effect you want it to have. If you tell her she looks sick — and I am speaking from personal experience here — she will only hear that she is reaching some measure of eating disorder success. I loved hearing from people about how sick I looked and how worried they were about me, and it steeled my resolve even more. And then I felt embarrassed and guilty at how much pain I was causing other people, and that caused me to retreat into my eating disorder as a coping mechanism even more. There's no way to win.

I'll go against the general opinion here as well and say that you're almost certainly not wrong about whether or not she has an eating disorder. (Bulimia is frightfully common among women in their early twenties.) But I still don't think it's a good idea to bring it up with her as a neighbor. If she knows you can hear her, she'll be horribly embarrassed, and that can go nowhere good.

Still, you can accomplish something by merely being kind to her when you see her. Smile at her in the hallway, say hello, that sort of thing. Eating disorders are painfully isolating and lonely experiences, especially as one's friends lose patience, and small kindnesses can go a long way.
posted by adiabat at 11:52 AM on February 23 [1 favorite has favorites]

You can't help her in a way that would be satisfying to either your morals or her behavior.

With that said, the greekphilosopy did lay out what you can do. You can help her find rock bottom. She'll hate you for it; an extreme consequence may be her filing a restraining order, but she'll know that she isn't fooling everyone and that you aren't going to stand for her shit. Yes, I realize that's a confrontational statement, but if you can't stand to listen to her kill herself and you are 100% convinced that THAT is what is going on, and you morally can't live with yourself to sit passively by - confrontation is your only option. Either that or move - seriously.

Tell her friends, tell her guests, tell her family, and tell her. They may ALL hate you for it and they may all unify against you, but if you don't, well... the you'll need to learn to live with no action. And when I say unite against you, I mean 'restraining order' unite (that can be the .

Last time I dealt with someone with an eating disorder (that I knew had an eating disorder), I spent 9 months though trying to help them find rock bottom, about $15K on treatment for them, and walked away a bitter angry person. Her family lost their house (as I have since found out). She lost what she thought was her future husband, an eyeball (really), the ability to ever drive again, and the trust of her family.

Seriously though, if I were in your shoes, I'd move out and avoid any part of it. People with eating disorders are seriously messed up, and I can safely say that I'm probably still a little messed up because of dealing with them. There's a reason counselors with eating disorder patients also usually are pro with borderline personalities...
posted by Nanukthedog at 12:50 PM on February 23

I had a (close, male) friend (not a boyfriend) with bulimia. I told him how concerned I was, I encouraged him to seek therapy, I offered to be available to listen any time of day or night - and nothing I did got him off the path of self-destruction. I'm not saying all cases are like this, but if a close friend has a hard time encouraging someone to get help, I don't know what a virtual stranger could do. I also know how horrified he would have been if one of his neighbors had said something.
posted by desjardins at 12:52 PM on February 23

Do not tell them they look sick. This is actually on lists "eating disorders: what to say, what not to say" lists. Don't say give compliments on her looks either. Appearance and body image are touchy subjects.

There are a few fairly recent metafilter posts about eating disorders that might give you some insight. (Short on time or I'd pull up the links.)
posted by salvia at 1:25 PM on February 23

Maybe donate time or money to a charity / treatment program for people with eating disorders. That might assuage the guilt of not being able to do anything for this particular person.
posted by Durin's Bane at 1:27 PM on February 23

Drawing from my very limited experience:

People who find themselves plagued by these conditions usually attempt to be very secretive about it. They successfully hide what they are doing not only from people at a distance, but in many cases from people they live with. Meaning that the consequences manifest in physical symptoms that people can eventually see, but seldom are they caught in the act.

Of the four individuals I have known throughout my life that have suffered through this ailment, the two I know to have sought help did not do so until they realized they were no longer successfully hiding what they were doing. That what they were doing was impacting not just his or her life. It wasn't until they were confronted about it that they were motivated to find help.

Every situation is different of course, but my guess is that if you were to politely approach her with the knowledge that you can hear sounds of a human in distress she will realize that what she is doing is essentially a public act and the situation will change. It probably wouldn't be a good idea to broach the subject of 'getting help,' but rather to simply alert her that her choices are effecting your standard of living and essentially forcing your concern. At that point she will either continue unabated, continue in a more clandestine manor, or attempt to change the way she's living. It is at that phase you will have to decide if you are willing to involve yourself more should it continue.

I would like to clarify that I personally have never confronted, nor been confronted, about a situation such as this. It is also important to remember that every situation is different and thusly a perfect answer will never be found on some webpage bullet list. My one suggestion is that if you care about her well being then do something. Neighborly concern--not to be confused with things like snooping--is something that is rapidly disappearing from our society and I applaud you for your humanism...you've already done more than most would. Good luck with whatever comes next.
posted by Gainesvillain at 2:01 PM on February 23 [1 favorite has favorites]

I'm writing this under the assumption that your neighbor does suffer from bulimia - and the above posters are right, it's certainly a possibility that she doesn't.

That said, tread lightly and realize that you may not be able to help. One of the problems with eating disorders is that, in most cases, the drive to continue the disorder trumps all. If she realizes you're aware of her disorder, it's possible she'll change her routine to hide her symptoms from you. You may stop hearing her vomiting in her apartment bathroom, but it could be because she's now running into the alley to throw up. People with full-blown eating disorders can sacrifice friendships and relationships to their disease. It's more difficult still for a relative stranger to help.

I would approach this as jeather mentions above - be friendly, maybe invite her to do something every now and again, but don't bring up that you suspect she's purging or that she looks sick.

However much or little you attempt to help, though, she could get sicker. Keep in mind that this isn't your fault and it's not your sole responsibility to save her. If you can be a friend or a confidant to her, that's wonderful, but you might not be able to be, and even if you are you can't force or convince her to recover.

This has got to be a difficult situation for you, phunniemee, and I wish you and your neighbor the best.
posted by Metroid Baby at 2:42 PM on February 23

You have no idea what is going on with her. Make friends and maybe you'll find out. But she might have some kind of constant puking disorder so you might get stuck with her puking on your shoes.
posted by daisydaisy at 2:45 PM on February 23

and what happens when he makes friends with her and finds out she has a bad ulcer? "Sorry, I wanted to get close to you only to be a hero and help you. Now that I know you are fine, I find you terribly unintersting and please keep it down when you puke at night. Im trying to sleep. KTHX!!"

If the poster wants to do good and help someone asking for help, there's no shortage of volunteer opportunities in the world. Visit volunteermatch.org and put in your zip code.
posted by damn dirty ape at 2:53 PM on February 23

I've been bulimic for about 14 years. How bad I am with it kind of varies, sometimes I throw up everyday, sometimes once every few weeks. Like someone upthread said, I have developed the stealth puking ability as most bulimics do. Now, I'm pretty open with it and not ashamed so if my neighbor that I barely knew came to my door and asking questions, I would kindly tell them that I appreciate their concern but it's none of their business. Their concern for me wouldn't hinder my habits in any kind of way. If 14 years of skrinks, medication and love and concern from countless family members and friends doesn't have an effect, then one more person isn't either. Most people with eating disorders aren't as open as I am about it, and she may become mortified that you can hear her in the act. Then, of course, she would soon learn to develop the stealth puking ability. This is all assuming she even has an eating disorder. My advice, mind your own business and do not confront her about it.
posted by MaryDellamorte at 3:10 PM on February 23

Maybe she had gastric bypass surgery. My friend had it 11 years ago and she still throws up a lot. It's really not your business. If this was me and you came to me, I'd view you as extremely nosy and pushy, the neighborhood nuisance type who can't mind their own business and might be looking in the neighbor's windows all night with binoculars. Not accusing you of being that sort... just saying that's how you might come across.
posted by IndigoRain at 3:40 PM on February 23

Since you know that you are unaware of what is causing her to vomit but are worried that she may be killing herself via bulimia, you could make a general statement to her one day that you keep hearing the sound of someone vomiting and wonder if she hears it, too. That's it.
posted by Piscean at 6:02 PM on February 23

I'm going to agree with the people who've suggested that she might have some other condition. A few years ago, I had a friend who was very much how you describe your neighbor. She vomited after nearly every meal, was rail thin, and looked like death warmed over. Turns out she had Crohn's disease.

The best you can do in this situation is be friendly with your neighbor. Perhaps if you get to know her better (in a slow, natural way, not a "You're my latest charity project" way) she will eventually feel comfortable enough to let you know about her health issues.
posted by katyggls at 5:36 AM on February 24

My general rule of thumb is to stay out of people's personal lives and tragedies. If it's true that she has an eating disorder and thus hides the sound of it by turning on the water when she vomits while guests are present, then she is obviously not excited about the possibility of people knowing what she is up to.

If this really bothers you and you're worried that one day you will see her carted out on a stretcher or a body bag, I recommend the anonymous note or letter. Perhaps all it has to contain are the names of some local support groups or other eating disorder help resources.
At that point, if you are correct, she knows she's been found out and the ball is in her court.

Perhaps she will do nothing about it, and you can either assume that she's doomed and you've done your part or that it is something else entirely. Either way, people have the right to ruin their own lives. Showing your concern, albeit anonymously, shows that someone cares without the weight of adding pressure. And perhaps its time to move somewhere with thicker walls.
posted by anniek at 11:40 AM on February 24

I agree with the idea to try to befriend her if you're interested in getting involved in her life, and see what happens.

As for your jump to bulimia, it's possible, but it's just as possible that she has any number of other health issues (such as cancer and is undergoing chemotherapy, etc). Bulmics, actually, aren't always very thin at all.
posted by iguanapolitico at 12:40 PM on February 24