Anorexia? Help!

October 2, 2009 3:21 PM

Anorexia? Is there anything a workmate can do?

A little background: I've worked with a woman on my team for a little over a year and a half now. She's a naturally small person, perhaps 150 - 155 cms tall, and when she came into my team she'd have been about 55 kilos.

Over that period she has been exercising heavily and dieting, and is now probably around 40 kilos. The veins running up her arms are highly visible, and she has heavy, dark circles under her eyes most of the time. She has commented that while she knows she is skinny she "feels fat", and no longer has a period.

Am I right in thinking this sounds like anorexia or a similar diet/body image disorder? Bearing in mind I'm her colleague and not a manager, are there any suggestions as to anything I could say or do that might encourage her to reconsider the damage she's doing to herself? Or at least things I could avoid saying or doing to avoid making it worse?

posted by anonymous to health & fitness (18 comments total)

For the metrically-challenged among us, anon estimates the woman in question to be around 4'11" and 88 lbs.
posted by killdevil at 3:38 PM on October 2

Am I right in thinking this sounds like anorexia or a similar diet/body image disorder?

Yes.

Can you talk to her about it? She may not be very receptive to the idea. Anorexia is a strange thing. Denial is a major feature. It can be very difficult to break through.

Perhaps tell her you are concerned, and let the dialog develop from there. She may not realize that you see it.
posted by Xoebe at 3:44 PM on October 2

In my experience from the other side, no, there's probably nothing you can say or do to help beyond lending your support if/when she asks. Sorry, I know you mean well, but it's the nature of the beast. Be a good coworker and friend.
posted by sunshinesky at 3:49 PM on October 2 [1 favorite]

Oh, I missed this:

Or at least things I could avoid saying or doing to avoid making it worse?

Do not ever make a comment on her weight/size. Saying she's too thin can be as detrimental and encouraging as telling her she's looking healthier when she gains a couple pounds. Both reinforce the problem.
posted by sunshinesky at 3:52 PM on October 2 [5 favorites]

Maybe talk to HR...?
posted by Jacqueline at 4:07 PM on October 2

She has commented that while she knows she is skinny she "feels fat", and no longer has a period.

If she's talking to you about it, I think you can say something. I would stay away from addressing weight or the way she looks, though. If she says that she knows she's skinny but feels fat or that she's stopped having her period, I think you can say "that doesn't sound healthy. Have you thought about seeing a doctor about it?" It's possible that she's looking for confirmation that she has a real problem. But I wouldn't bring it up unless she does, and I wouldn't harp on it.

Do not ever make a comment on her weight/size.

I would actually extend this and say that you shouldn't comment on anyone's weight or size when she can hear you, and that includes your own. If other people in your office talk about dieting and weight, they should stop.
posted by craichead at 4:07 PM on October 2 [7 favorites]

Perhaps tell her you are concerned, and let the dialog develop from there. She may not realize that you see it.

This is very, very thin ice. Having this acknowledged at all can have the opposite of the desired effect. I know it doesn't make any sense, but trust me here. Denial is a major feature, but it doesn't mean she doesn't know what's going on, just that she won't want to admit openly that there is.
posted by sunshinesky at 4:26 PM on October 2

What you describe is definitely a problem, but there could be an underlying issue causing it or it could only (heh, only) be the manifestation of the ceaseless media inundation about what women "ought" to look like.

Hit some pro-ana sites and blogs — the reactions and thought processes of the people involved can be complicated, to say the least, so it would be very difficult for you to predict the outcome of anything you might, or might not, say. Some act as if there is a secret conspiracy to fatten them up, I kid you not.

Unless someone is actively, well, doing whacky stuff (or young and therefore subject to the whims of their parents), it's very hard to force mental health treatment on anyone. You can only offer, and for some, the mere offer causes problems. Anorexia falls into that, despite how lethal it too often can be.

Be there for her, whenever she wants to talk. She's talking to you somewhat, so that's a very positive sign. Watch for the part where she opens up and actively seeks advice. That's about the best opportunity you'll have for helping her, that moment where she reaches out.
posted by adipocere at 4:38 PM on October 2

A psychologist once told me that because anorexia is an obsessive-compulsive disorder, if you say anything to an anorexic girl about her looks or weight -- even if you tell her she's beautiful -- it triggers the obsessive-compulsive part of her mind that constantly reproduces her anorexic behavior. In other words, if you make her think about her looks or weight -- even by paying her a compliment -- she'll just be compelled to do what she always does when she thinks about it. So, unfortunately, the only thing you can do is say nothing at all. Or perhaps you could tell her to seek professional help, as it's the only kind that can help her. This is what I heard, anyways.
posted by frankly mister at 6:10 PM on October 2

There are a number of really good resources online about how to talk to people who you suspect have an eating or body-image disorder. While you may very well get good advice here, this is an area that is touchy enough that I'd trust the professionals and Google around for some of the really good "how to" guides they've put together. (Short on time, or I'd do it for you. In fact, I might have done it for a past question on this topic, so I'd also search the AskMe archives.)
posted by salvia at 6:57 PM on October 2

Since you know she's missed periods, I assume you're sort of close to her. Just be a friend to her, go to lunch with her, keep talking to her. From my own personal experience, being "her," you can't suddenly convince her to stop. But if you can stand it... (I'm not being snarky, it's totally not your responsibility) try to show her she's worth more than what she looks like.

Just do what you can - be kind to her - listen to her.

But honestly, she's not going to stop until she wants to. If she ever has friends come by at the office, you might try to pull them aside and voice your concerns. You're a good person, obviously, but there's not a lot you can do here in my opinion.
posted by Kloryne at 9:16 PM on October 2

i have not dealt with anorexia in particular, but i have dealt with medical issues in work situations, and unless this is affecting her work to a large extent, do not bring it up with hr. it is none of their business. letting hr or her manager know that you think she might be anorexic can only lead to bad things down the line.
posted by misanthropicsarah at 10:52 PM on October 2

On the basis of long experience: don't get invested, there's nothing you can do, avoid the subject, never discuss food or weight or appearance issues with her.

This problem never goes away. It didn't just develop either. She knows exactly what's up.
posted by fourcheesemac at 5:17 AM on October 3

I would agree that if she's talking to you about it, it's totally appropriate for you to express your concerns to her. In fact, I would argue that if she's talking to you about it, she PROBABLY wants you to express your concerns to her. Eating disorders tend to be intensely private and, in my experience, when sufferers begin to bring it out into the open, it's usually -- at least on some level -- a call for help.

If you're only a co-worker to this woman, I would also agree that you shouldn't get SERIOUSLY INVESTED in her situation. Eating disorders are extremely difficult to get over and the relapse rates are high. However, having said this, I would also mention that -- IMHO -- I find ridiculous this implied perspective that unless you can DEFINITELY DO SOMETHING TO FIX HER, there is no point in getting involved AT ALL.

I'm a recovering anorectic. I would not be here today if the people in my life -- some of them close friends/family/partners and others of them just acquaintances -- had not been there to call me out on my bullshit.

Just saying. FWIW.
posted by LittleKnitting at 8:02 AM on October 3

Have you gone for the health angle? No longer having periods (Amenorrhea) is associated with lower bone density and increased risk of fractures, though I think that's later in life. Maybe you could encourage her to get a check up with her doctor to see how she's doing health wise.
I had a friend who was anorexic/bulimic and didn't want to admit it. She'd throw up after going out drinking and I'd mention the need to drink water because stomach acid can eat away the enamel on your teeth. I was hoping she'd connect the dots and rinse her mouth when she threw up when I wasn't around. She'd always talk about having a week stomach. Years later, she did eventually go into group therapy and made a point of telling me about it. I like to think that my talking about being a healthy weight/teeth stuff, etc. had a positive influence on her but who knows.
People have to decide what they want to do with their life. You can make suggestions and be concerned but it's going to be her decision. Don't feel bad if she keeps doing the same thing. The best advice I can give is don't push too hard and gently nudge her to getting herself checked out. I was pretty young when I met my friend with anorexia/bulimia and didn't really know what to do. If I had it to do over again, I think I'd try a little harder to get her to see a doctor.
posted by stray thoughts at 1:07 PM on October 3

No, no. Oh, stray thoughts, almost every person who makes a campaign of offhand remarks about health, weight and responsibility likes to think they're helping their local anorexic/bulimic/fat person. They're not.

You were young, and it looks like you're talking about someone you actually knew, instead of a co-worker, so the dynamic was a little different. I'm not saying you are the worst of these, but if shaming and hinting and judging cured people with eating disorders, there wouldn't be any in this world. Especially in the office, and in a situation where the person doesn't even know for sure what is causing their co-worker's troubles, needly "helpful" comments are just the poison the OP is trying to stay away from.

Anonymous poster, I am glad that you want to avoid making things worse for your co-worker. Support, a friendly ear, and responding to things she's said to you are great ways to reach out.
posted by Sallyfur at 1:55 PM on October 3

I'm probably going to be repeating what some people said, but here's my 2 cents . . .

Ideally, the best situation would involve you voicing your concerns -- because that's what a good friend does and what she needs to hear -- but not getting too involved. I agree that you should absolutely not say anything about her appearance/weight, or anyone else's. Not even celebrities. Actually maybe especially not celebrities, because that's who many people with ED's compare themselves to, as they are considered the "standard" for beauty, perfection, etc. in our society.

Tell her you are concerned with her health and happiness. One of the causes/effects of EDs is the obsessive, singular focus on weight. If you make that topic the center of your conversation with her, it kind of reinforces her attention on weight. When in reality, the ED is just a messed-up coping mechanism for dealing with much deeper issues. So express your concern with her general well-being -- because this is eventually what she also needs to be concerned about, not just the weight.

But don't put yourself out there too much. You should tell her that you're there for her, but don't try to be her savior. You can't be -- I'm sure you have problems of your own to deal with! It also sometimes happens that someone like your friend can became very needy with people that they see as being extremely sympathetic and/or potential "saviors". If you feel like this has the potential to happen, you have to mentally set up some boundaries or you can get sucked up into a guilt vortex. This is especially important as a co-worker, because you don't want the work environment to be too affected by all this.

Maybe this is opposed to what I just said, but it may also be a good idea to open up about some of your personal issues and ask for her opinions. This may help her feel less isolated and that someone trusts her and "needs" her. Try to form a relationship that's a real two-way street. Many girls/women with anorexia stuff themselves down and try to please others (a stereotype, but often true). Asking her about her opinions/what she would do in your situation might give her the opportunity to come out of her shell a bit, and again, to feel less isolated.

Don't invite her to go eat with you. I think some people think that if they invite someone with an ED to go to lunch they can somehow convince them to eat something. But really the whole situation is horrible for everyone, and just creates stress in the ED'ed person. And the ED'ed person deals with stress by engaging in their ED. Nothing good comes from this! Maybe you could go out to see a movie -- cuz then food is her choice (tho all the junk food might still freak her out). ED'ed people live in their heads too much, so movies are good because they can "escape" for a bit.

I feel like this response has really been a mess, but I think that's because of the nature of this problem. It's so complicated. You're already being so great just asking here what you can do. In the end, one of the most helpful things for someone with this disorder (or any mental illness/addiction) is knowing that someone is really concerned for you -- not for how you look or any other superficial reason. Be a good listener, no matter what you talk about. I think that's the most important thing.
posted by imalaowai at 2:20 PM on October 3

Do not ever make a comment on her weight/size. Saying she's too thin can be as detrimental and encouraging as telling her she's looking healthier when she gains a couple pounds. Both reinforce the problem.

I agree 100% with sunshinesky - even if it sounds like she's asking for comments/feedback on her appearance (by saying that she feels fat although she's thin), it's generally best not to engage.

I think the best thing to do would to be a supportive, nonjudgmental ear. Check in with her - "how are you doing, how are you feeling today?" Listen to her, and respect her boundaries.
posted by insectosaurus at 11:44 PM on October 3