How should I deal with my friend's weight issues?

November 20, 2004 11:01 AM

My friend thinks she has a weight problem. It's not quite anorexia, but I'm extremely worried about her. [more inside]

We're sort of dating, but that's more or less irrelevant. I know a lot of women worry about this, but with her it seems to be a bit more serious. She's underweight if anything, but she seems really concerned about it. She longs for the days when she survived on 600 calories a day, and thinks she's disgusting because she's up to 1000. She wouldn't go out to dinner with me a while ago, and I later found out it was because she felt like a pig the day before and didn't want to eat. Can I do anything? I don't want to tell her she's not fat, because I've noticed that doesn't work. I also don't want it to sound like I'm just being nice, because I couldn't care less about that anymore. I just want her to feel better.

posted by borkingchikapa to human relations (20 answers total)

Can I do anything?

Tell her she's "hot." She'll never take your word about "fat." And "hot" is what "skinny" is trying to be, anyway.
posted by scarabic at 11:03 AM on November 20, 2004

I don't agree with Scarabic. (Sorry, S!) In my experience telling someone with an eating disorder that they are hot is the equivalent of telling them "you're doing something right!" which just makes them continue on that path.

Without overdoing it, I would make it clear what you find attractive in others (assuming you're not attracted to broom handles). IE, if/when you're talking about celebrities or models or even people on the street, be sure to emphasize the healthy-bodied people and say "ick. too thin" about the ones that are, you know, too thin. However, it's also important that you be sincere. If in the past you've waxed about the plumpness of Kate Moss, you're out of luck.

In addition, get yourself to a library. There are MANY books on the subject of eating disorders and each person's "case" will be different. In my opinion, much of the problems with the situation are created by people who assume there's a miracle cure for all eating disorders. There isn't. Each person will have different reasons for their behavour. The books will help you a) realize this and b) see more of the symptoms and c) guide you towards (hopefully) a solution. It's very important to nip it in the bud.
posted by dobbs at 11:17 AM on November 20, 2004

It's very important to nip it in the bud.
Very important for her to nip it in the bud. Sorry, but I think you're going to be fighting a hard battle on this one. She sounds really really messed up, and I think she needs more help than her sort-of boyfriend playing savior could provide. Encourage her to get professional help, stand by her, but don't think you're going to be the one to solve this- it's way bigger than just trying to be "hot" (so, yea, I disagree with scarabic, too)
posted by ThePinkSuperhero at 11:37 AM on November 20, 2004 [1 favorite]

I would almost recommend you try and talk her into seeing a psychologist (or a counselor of some sort). One of the best ways to get over something like this is to talk about the problem and get to the root of what the real cause is. Just tell her your worried about her and would like for her to see if she can talk over her issues with someone who knows what they are doing.

She may want you to go with her, she may not. But from personal experience, talking to someone who is neutral about the things is one of the best ways to get help.

One of the hardest things I have ever done was admit I had a problem (in my case it was depression). I have been seeing a psychologist for a year now and its helped me tremendously. I wouldn't be the person who I am now if I hadn't taken that step.
posted by hex1848 at 11:43 AM on November 20, 2004

What's important to keep in mind is that her view of herself and of others is completely distorted. She may look thin to you and the rest of the world but she can't see that. So any attempts to help her that may make sense to you likely seem ricidulous to her. You cannot reason with this because it's irrational. The only help you can give her is to do whatever you can to get her experienced help.
posted by TimeFactor at 11:50 AM on November 20, 2004

Sounds to me like it IS quite anorexia--1000 calories a day is practically starving. My second thought is that you might want to check out the earlier AskMe thread on intervening with someone with a suspected [drug] addiction, because the answers are roughly the same: YOU can't fix her, she needs to want to stop, SHE might not be able to fix herself even if she does want to stop.....so the best you can do is let her know it's not normal, it's concerning you, and if she wants help you'll make some phone calls with her, etc. If you live near a major university, most of them have eating/weight disorder clinics that offer sliding scale (or even free) consultation, evaluation, and counseling. If it's less scary or stigmatising for her, you might suggest a trip to a nutritionist....who will be suitably appalled and hopefully let her know that her behavior is outside the fringes of normal, and the potential health consequences that could result.

As mentioned above, this isn't the same as someone feeling a little neurotic about having/gaining an extra five pounds--she's got a mental obsession that is very insidious and, in severe cases, potentially life-threatening.
posted by availablelight at 11:53 AM on November 20, 2004

Not quite anorexia? That's anorexia. Full-blown, outright eating disorder. I was diagnosed with anorexia nervosa when I was of a normal weight; it's the behavior, not the size, that's meaningful.

The most important thing about this question is your own statement at the end. "I just want her to feel better." You can't make her feel better, and wishing she felt better isn't helpful either. In fact, trying to deal with this problem without professional experience could just make things worse. If someone told me I was "hot" when I weighed 88 lbs, I would have seen that as encouragement to lose more weight. If someone pointed out skinny models in magazines and said "ick, too thin" that would have done nothing for me because when I see myself, I am not seeing skinny, I am seeing fat.

Please, please follow Pink and Hex's advice. Stand by her, encourage her to get help, and talk to her. It sounds like she's getting past the "secretive" phase and talking a bit about her relationship with food. This is a positive sign, and a good time to get help.

But I'm gonna be honest. Eating disorders don't go away, ever. You can get fat, or be a normal weight, but food will torture you forever. Some months are worse than others, but it will always be there in some form or another.
posted by xyzzy at 12:01 PM on November 20, 2004

1 - If she knows that she's averaging 1000 calories a day, that indicates she is paying an unhealthy degree of attention to her caloric intake.

[[prev] 1.1 - xyzzy's point about this as an emergence from the 'secretive phase' is good, though. She's actually telling someone these things. Not sure what that means.]

2 - If 1000 calories is sufficient (and for some very small people it might be), and she was for some period of time longer than a few days surviving on an average of 600 calories per day, then she definitely had an eating disorder at that time. So even if she's not now (and I happen to think she is, but just for the sake of argument, here), she definitely was, then.

3 - Since anorexia really isn't primarily about appearance, appeals to appearance are pretty useless. Appearance is really kind of a beard for what it's really about, which is control. When she's "disciplining" herself down to 600 calories, she's mastering at least that one part of her existence. Everything else could be shit, but she's in control of her calories.

4 - There are what amount to low-level state of consciousness alterations that happen when you're operating on less than an appropriate number of calories. Libido is often altered, your mind functions in different ways. Alluding to what dobbs said above, the sense of control and the mildly altered mental state can act as mutual reinforcers.

5 - That she "longs" for a time during which she was clearly anorexic indicates that she has not broken out of that mind set.

6 - Pink is right: This is not something you can do yourself. It may not even be something you can help with much at all. It's tempting to play savior, but that's a trap, too: without you even realizing it, you could end up playing a game that exacerbates her problems and introduces you to ones you never knew you had. That's not to say there's nothing you can do; maybe you can marshall her other friends to your point of view, in following xyzzy's suggestions about encouraging her to get help.
posted by lodurr at 12:41 PM on November 20, 2004

Dealing with a significant other's eating disorder is one of the hardest things I have ever had to do (and continue to do). It took me awhile to accept that I simply couldn't understand it and could not rationalize to her why she should simply stop what she was doing ("look! see, it's bad! so you'll stop, right?"). I had her see a therapist, which she says has helped tremendously and thanks me for daily.

I'm not sure how close you are to this woman, so suggesting therapy might be a bit too presumptuous if you have just started seeing each other or something like that.

Everything lodurr said is pretty much right, in the clinical sense, but even understanding all those things will not really help you understand why she does it or how to help her other than trying to make her seek help on her own. And, like someone said above, it's not going to magically disappear one day either... just a slow and laborious battle.
posted by rooftop secrets at 1:42 PM on November 20, 2004

I'd distance yourself, these kinds of people can be a disaster.
posted by angry modem at 2:58 PM on November 20, 2004

Not saying this is the case with your girlfriend, but some people "confide" their mental illnesses, eating disorders, or addictions to their partners, mostly for attention. The underlying problems could be real, but the bigger issue is their need for drama or relationship roleplay (frail princess/brave savior). That's probably not a game you want to start playing.

Otherwise, it sounds like she has an eating disorder, and I'll reinforce the other recommendations for professional counseling. It's really beyond your control. If you keep trying to help, and see that your efforts are in vain, it will start messing with your head.

It's also really really really hard to maintain a healthy relationship when one person is hurting and the other person is her only source of help and support.
posted by crythecry at 2:59 PM on November 20, 2004

Thanks all, there's some good suggestions in here.

Angry modem, I really, really don't want to do that. I've known her for a while before we were "involved," and I don't just want to abandon her.

Crythecry, I can totally understand where you're coming from but I'm pretty sure that's not the case. She's only really talked about it during serious conversation, and only then when I bring up the fact that she hasn't eaten or has an extremely small amount of food on her plate.
posted by borkingchikapa at 4:49 PM on November 20, 2004

6 - Pink is right: This is not something you can do yourself. It may not even be something you can help with much at all. It's tempting to play savior...

If you do try to play savior, try not to beat yourself up if you fail. It isn't your fault.

I'm not saying you shouldn't try your hardest, but ultimately no amount of external force is going to cause the internal change she needs. If she is going to overcome this, then it will be because she wants to.
posted by sbutler at 4:54 PM on November 20, 2004

Seems to me from my vague, fuzzy memories of Weight Watchers, that the prescribed daily diet in that program was 1000 calories. Maybe I'm remembering wrong...
posted by bingo at 5:05 PM on November 20, 2004

Before you talk with her about this, you may want to read up on anorexia. This site has good info, as does this one, and there are many helpful books on the subject. This disorder is very hard to understand if, like me, you can't imagine choosing to starve yourself.

When you do talk with her, be ready for a defensive reaction. It may help if you start by saying you love her and are worried that her dieting is excessive and harmful. Don't start out by saying "you're anorexic," but rather focus on what makes her feel she needs to be thinner.

This isn't "playing savior" in my opinion. If you care about her, it's just trying to be a loyal friend.
posted by naomi at 5:54 PM on November 20, 2004

Bingo, you're probably wrong. I think that the WW diet aims at 1200-1500 calories. Also, that's for weight loss--this woman is already underweight.

600 calories a day is starving. If boringchikapa's friend was a developing nation, the UN would be flying planeloads of grain to her and Alex Trebek would be doing commercials asking Christians to send her the price of one latte per day.

All you can do, bc, is say, as naomi suggests, "I love you and want you to be healthy. You have a real problem around food, and I'm concerned about it. I really want to encourage you to get professional help" and then just leave it alone unless she wants to discuss it with you.

Anorexia is one of those complicated physical/psychological things like drug addiction or alcoholism. Nobody can talk anyone else out of anorexia any more than they can talk anyone else out of drug addiction--the person themselves has to want to make the change, and in the vast, vast majority of cases, they will need a great deal of structured help to do so.
posted by Sidhedevil at 6:28 PM on November 20, 2004

I'd distance yourself, these kinds of people can be a disaster.

Gosh, angry modem, you'd better hope you never become one of "these kinds of people," whatever that means (people with eating disorders, people with mental illnesses???). If your friends are anything like you, you'll be pretty lonely in your time of need.
posted by gokart4xmas at 1:19 PM on November 21, 2004 [1 favorite]

it's angry modem. wtf did you expect?
posted by andrew cooke at 1:46 PM on November 21, 2004

I don't know, I'm kind of with angry modem- I hate having people I barely know meddling in my problems. I hope if I become one of "these kinds of people" (which is very possible, hahaha), that my immediate family and closest friends help me, and everyone else leaves me the fcuk alone.
posted by ThePinkSuperhero at 4:10 PM on November 21, 2004 [1 favorite]

Listen compassionately when she talks about eating and food; don't offer your opinion, no matter what it is. Be a friend. Be supportive just as you would be to another friend. It's amazing how much this kind of judgment-free companionship can do for a person's peace of mind (i.e. 'mental health'.)

Don't tell her she needs psychiatric help. But if she suggests that she's thinking about it, by all means encourage her.
posted by ikkyu2 at 10:18 PM on November 21, 2004