What is my duty to intervene with anorexic stranger?

March 14, 2010 8:45 PM

I went to high school with a girl who I came across on facebook. She's clearly got an eating disorder. What on earth do I do?

I went to a big high school - over 6000 kids - so while I sort of recall this woman, I don't know that our paths ever crossed. From what I can glean from my yearbook, she was a cheerleader, and in the National and foreign-language honors societies. I doubt she'd know me, even by name; I flew under the radar and our activities didn't overlap.

I came across her profile on facebook today, via a friend-of-a-friend, and wow. She is anorexic. And I don't mean, wow, she's skinny. She looks like Karen Carpenter in the late stages of anorexia, or a concentration camp victim. She's going about her life/career/etc. it seems, at least according to the pictures, and it is so terrifying to see her clothes just hanging off of her and her face sunken and mostly eyesockets. Like many women my age, I have known more than one person who suffered from anorexia, and one person who succumbed to the disease. I know that anorexics can be functional up to a point, and that seems to be where she is.

I have no idea what to do. I can't just friend her, and say, "Hey! We went to high school together twelve years ago and I just found your profile, and you need some help! Go Bulldogs!" I briefly considered sending an anonymous note to her workplace, a large law firm, saying that she had an eating disorder and if someone did not intervene she was going to die. Of course, that's a gross invasion of her privacy.

So what do I do here? If she is not getting help, she is going to die. If I don't say anything and she dies, am I complicit in her death? If I were to say something, who would I say it to? What on earth would I say? My instinct, in this situation, is patently useless.

posted by anonymous to human relations (50 answers total)

You have no clue what is going on with her. Stay out of her business.
posted by quodlibet at 8:47 PM on March 14, 2010 [41 favorites]

Absolutely nothing. This is none of your business and you don't even know if she really has an eating disorder.
posted by sugarfish at 8:48 PM on March 14, 2010 [7 favorites]

My first reaction to this is that you're make a hell of a lot of assumptions. How do you know she doesn't have cancer or something like that?

No. Don't send anything to her employer. What are you thinking?

If/when I have a second thought I might be back.
posted by FlamingBore at 8:48 PM on March 14, 2010 [8 favorites]

You do nothing, because you can do nothing. Eating disorders are extremely sensitive and intimate issues. Even loved ones have a hard time getting through to somebody suffering from anorexia, because anorexia is a loved one. The most you can do is contact a relative and express your concern. But as far as she goes, there's nothing you can or should say to her about it.
posted by dephlogisticated at 8:49 PM on March 14, 2010 [2 favorites]

There is one circumstance in which you might do something: if she posts a cry for help on Facebook, something along the lines of, "I feel like I'm totally out of control. I'm barely eating anything, and I don't know how to change," then maybe posting some helpful links or support would be helpful and kind.

But, as is? As others have said, you have no clue what's up with her. You don't really know her. You do not have the sort of relationship with her necessary for anything like an intervention.
posted by Ms. Saint at 8:53 PM on March 14, 2010

You are assuming she has an eating disorder based on a photo. You don't know her life. Perhaps she's recovering from cancer. Perhaps she's not recovering from cancer. Perhaps she has another illness. Perhaps she's a marathon runner and is actually uber-fit and just doesn't photograph well. And, as other people have noted, even if she does have an eating disorder, you can't help her.

Good for you for wanting to help, but really, this is a case of There Just Isn't Anything You Can do.
posted by anastasiav at 8:53 PM on March 14, 2010 [2 favorites]

If I don't say anything and she dies, am I complicit in her death?

This comes off awfully selfish.

I briefly considered sending an anonymous note to her workplace, a large law firm, saying that she had an eating disorder and if someone did not intervene she was going to die. Of course, that's a gross invasion of her privacy.

It's a jump-to-conclusions mat. See, it has all these "conclusions" that you can "jump to".

Seriously, you've made up all kinds of stuff in your head and are considering invading this woman's personal life in an extremely creepy way. Sending an anonymous letter to her employer? That is, literally, the stuff crazy people do. You need to close Facebook and go outside for a while.
posted by Mikey-San at 8:55 PM on March 14, 2010 [25 favorites]

Piling on: don't do anything. It won't help and you don't even know she has an eating disorder in the first place.
posted by ishotjr at 8:55 PM on March 14, 2010

The problem with anorexia nervosa (which she probably has if she's that underweight- she wouldn't meet criteria for bulimia nervosa unless she was average or above average weight) is that, unlike many other disorders, it's egosyntonic- its goals are consistent with who the person wants to be, even though getting there is miserable. If you point it out to her, she will just push back farther, deny that she has a problem, explain it away, etc.

If you noticed, those who are close to her and in a position to actually do something about it will have noticed too. I know it's hard to not be able to help someone who is in dire need of help, but this is really one of those times where you can't.

If anything, what she needs now is loving people who support her. It wouldn't be the worst thing in the world to send her a note saying you found her on facebook and just wanted to say hi, maybe mention some funny memories from school, but for the love of god don't mention how she looks or that you think she has an eating disorder.
posted by emilyd22222 at 8:56 PM on March 14, 2010

I don't mean she probably has AN, I mean if she has an eating disorder it's probably AN.
posted by emilyd22222 at 8:56 PM on March 14, 2010

If it's so obvious that she has an eating disorder, don't you think her family/friends/coworkers have already noticed? This woman has a life and people who know her; they are not sitting idly by waiting for a well-intentioned stranger to express their concern before they jump into action.

Everyone is going to be very harsh on you in this thread. Your need to do something is admirable, but you do not know this woman. Friendly strangers can never solve a deep psychological problem anywhere but in Hollywood.
posted by lilac girl at 8:58 PM on March 14, 2010 [14 favorites]

Everyone has said "no" resoundingly enough that I think you get the point, but double-consider:

There are many reasons someone could be that skinny. As mentioned above, a very bad illness. You have no idea what's going on and you are literally the last person who should get involved.
posted by Solon and Thanks at 9:01 PM on March 14, 2010

no
posted by zombieApoc at 9:06 PM on March 14, 2010

Do you stop women on the street to deliver critiques of their body weight and diagnose them with eating disorders based on your total non-knowledge of their situations? Would you want that sort of intrusion on your own person from strangers?

No?

Don't do it on the Internet. The rules really aren't that different.
posted by fairytale of los angeles at 9:07 PM on March 14, 2010 [11 favorites]

You're not even friends on Facebook - she's one level up from a stranger on the street.

There are almost certainly people closer to her who can see that she's underweight, have a better idea of what's going on (FlamingBore's right, what if it is cancer?), and are doing what they can to help her (and how do you know she's not in therapy, or headed to residential treatment tomorrow?). I mean, if you assume she's anorexic from just seeing her picture, do you really think her employer doesn't know?

Consider, also, that people with eating disorders often do everything they can to hide their illness - or just hide themselves - from the people they interact with daily and the people they love. Trying to confront the disorder often backfires. You are nowhere near a position where she'd feel comfortable opening up to you (in any circumstance, but especially if she's severely anorexic).

Your heart's in the right place, and it's terrifying and painful not to be able to do something, but there really isn't anything you can do. Probably the most you can do is talk to her friends and see if you can find more information, check to see if she has a support system in place, but that's really it, and that might not get you anywhere anyway. Sorry.
posted by Metroid Baby at 9:07 PM on March 14, 2010

Obviously no. Christ. She could have another kind of disease and it's none of your business.
posted by anniecat at 9:08 PM on March 14, 2010

As more or less stated, if you can tell so easily from a small picture online, wouldn't it be that much more noticeable to people that she interacts with daily at work?
posted by niles at 9:12 PM on March 14, 2010

I briefly considered sending an anonymous note to her workplace, a large law firm, saying that she had an eating disorder and if someone did not intervene she was going to die.

The fact that you considered this even briefly really worries me.
posted by amro at 9:12 PM on March 14, 2010 [1 favorite]

I briefly considered sending an anonymous note to her workplace, a large law firm, saying that she had an eating disorder and if someone did not intervene she was going to die. Of course, that's a gross invasion of her privacy.

You are way too much into other people's (whom you don't know) business. The idea that you even looked up someone else's employer and considered calling her job -- that's crazy. I would advise you to see a therapist and work through the feelings you have regarding people's problems due to the problems your close friends (and the friend you had that passed away) have or had. Your behavior is extremely disturbing.
posted by anniecat at 9:14 PM on March 14, 2010 [1 favorite]

You can't really do anything for her, except maybe pray if you're religious. Don't feel bad though, your intent was admirable, and I think a few people have gone too far in chewing you out in this thread.
posted by kylej at 9:14 PM on March 14, 2010

Your behavior is extremely disturbing.

Honestly, I think you're going a little too far here in criticizing the OP. She had a pretty normal reaction in my opinion, she saw someone suffering from a disease and she wanted to help them. Mostly people would get similar urges when they see someone clearly suffering. OP, I do not think that you need therapy and that if you still fill bad about this should donate money to some anorexia awareness groups.
posted by kylej at 9:17 PM on March 14, 2010 [1 favorite]

Look at it this way -- if you were able to tell from a single photo, people who are much closer to her and are in a better position to help her would know as well.
posted by bsdfish at 9:19 PM on March 14, 2010

Your behavior is extremely disturbing.

A lot of people who've known victims of eating disorders are familiar with the way in which others will ignore the obvious, what's staring them in the face, until the victim gets so bad that the disorder takes his or her life. This is my knowledge of what occurs in high schools as a former high school girl, but that fucked up environment can make any thoughtful person hyper-aware.

I can absolutely understand where the OP is coming from, even if I think this attempt is misguided.
posted by Solon and Thanks at 9:23 PM on March 14, 2010

saw someone suffering from a disease and she wanted to help them.

She saw someone who looked underweight, decided it was anorexia rather than anything else on the planet that could be private because she has friends who suffered from anorexia, so she considers possibly contacting and telling this woman's (whom she doesn't know) employer that the woman has a health problem that could get her fired if she hasn't disclosed any health problem to her employer.

That's not normal behavior. It's overreacting and dangerous to a stranger.
posted by anniecat at 9:25 PM on March 14, 2010 [2 favorites]

Worrying about other people and being concerned for their health is a good thing. And I understand the desire to help, which is complicated by your physical and emotional distance from this particular person. Sadly, there are a number of things that you can't help with from far away, and anorexia is one of them, in most cases. Just telling her won't change anything, and telling her employers (something that they may well already know) isn't going to change anything either. Think about it for a minute: What do you think her employers could do? They can't compel her to get treatment any more than you can.

I would say that it may do well for you to do some reading about eating disorders and how they affect the person who is suffering from them. I found this site, which seems to provide information for both sufferers and people who are friends and relatives of those who are suffering from eating disorders. Reading more can help you better understand how help can often backfire in these situations, and what types of support are the right types of support.

Ultimately, she is the one responsible for her own life and death. As much as you may feel culpable if she ends up dying, the only person who can really make the decision to get better is her.
posted by that girl at 9:31 PM on March 14, 2010 [2 favorites]

She saw someone who looked underweight, decided it was anorexia rather than anything else on the planet that could be private because she has friends who suffered from anorexia, so she considers possibly contacting and telling this woman's (whom she doesn't know) employer that the woman has a health problem that could get her fired if she hasn't disclosed any health problem to her employer.

That's not normal behavior. It's overreacting and dangerous to a stranger.

She says that she briefly considered contacting her employer and then chose not too, which was a smart choice. Than she recognized that she was so unsure what to do that she asks an anonymous question on askmefi. That seems like a pretty smart thing to do, and in no way dangerous to anyone.
posted by kylej at 9:33 PM on March 14, 2010 [1 favorite]

so she considers possibly contacting and telling this woman's (whom she doesn't know) employer that the woman has a health problem that could get her fired if she hasn't disclosed any health problem to her employer.

Actually, as the question says, she did not consider that.

"Of course, that's a gross invasion of her privacy." is what she said about the idea.
posted by Solon and Thanks at 9:33 PM on March 14, 2010

(well, considered but is not considering.)
posted by Solon and Thanks at 9:34 PM on March 14, 2010

Some possibilities come to mind:

1. Send her a Cake Mania invite.

2. Message her saying "How long have you been sick?"

3. Wonder to yourself: would I approach a perfect stranger in the street and tell them they needed help? Am I that much of a good samaritan? This girl is, after all, effectively a stranger.

4. MYOB.
posted by turgid dahlia at 9:36 PM on March 14, 2010

Also ditto what other people have suggested: this could be something entirely else like cancer or AIDS or one of those godawful things, and all you'd be doing is making things supremely awkward. If you really care then become a genuine friend to her, hook up with her in social contexts, and after months or years gradually make your concerns known.
posted by turgid dahlia at 9:39 PM on March 14, 2010

"If I don't say anything and she dies, am I complicit in her death?"
No, absolutely not. You're scared because you've already seen someone die from anorexia. That doesn't mean you have a responsibility to save anyone else who might possibly have it. Trust that her friends and family are on it, whatever "it" is.
posted by amethysts at 9:41 PM on March 14, 2010

If the problem is so obvious just from looking at her, I don't see why you seem to think you're the only person in the world who's capable of perceiving this and intervening. You can assume that other people are capable of that, and would do a much better job of helping her.
posted by Jaltcoh at 9:47 PM on March 14, 2010 [3 favorites]

I'm a skinny person at the best of times. At the worst of times, after a major illness or surgery, I probably look like your high school friend. Most of my life I've been talked about as a possible eating disorder victim, and I've been called anorexic to my face. (I'm not.)

What you are thinking of doing is not cool. There are literally hundreds of things that could be affecting your distant acquaintance that you have no idea about. Saying "You should get help!" is a great way to tell someone they look awful, and just plain insulting even if you do have an eating disorder.

Seriously, the correct way to talk to someone who looks sick is to ask "How are you?"

And if you contacted my place of work I would take out a restraining order or at least feel threatened because that is some crazy shit. Just don't.
posted by Alison at 9:49 PM on March 14, 2010 [1 favorite]

What? Many people who go on a trip out of the country, and come back looking skeletal due to some bug they picked up. Usually goes away after away a while...how do you know it's anorexia?
posted by The ____ of Justice at 9:51 PM on March 14, 2010

How about before reaching out to this girl, you first update here with a photo of yourself and let everyone here take a crack at guessing what all your medical and psychological problems are, based purely on that one image? We promise to get really personal in our assumptions.

If that idea gives you any pause whatsoever, then you probably should just leave this alone.
posted by hermitosis at 10:08 PM on March 14, 2010 [1 favorite]

Maybe this is obvious, but you said you saw her on Facebook through a mutual friend, so haven't you asked the friend about her, if only for your own peace of mind? Like others have said, if she does have an eating disorder, those close to her have already tried to help her out. If anything, she's already getting help or just refuses to. If her loved ones can't convince her to get help, odds are you wouldn't be able to either. Compassion is good, but there's only so much one can do.
posted by TheSecretDecoderRing at 11:39 PM on March 14, 2010

somehow, I feel like this isn't the right place to ask this question. maybe you should ask the friends in common what they think, or if they know how she is doing, health-wise? I mean, maybe everybody around her is thinking, well, surely someone else has tried to help her, I don't need to, or shouldn't.

I don't know why some of you all are so harsh when it's just a person sincerely showing concern about another person's well-being. The writer says she's known a few people who were anorexic. I knew one and the weird thing was, I only realized in retrospect (former roommate in another city, we weren't friends, I hope she's alright these days). She had a way of going about her business that made it seem perfectly normal and strongly, strongly discouraged any questions or comments.. when the plain truth was, she never ate but a few hundred calories a day and exercised for hours, was a size 0 to 00, and her hair was starting to fall out. And her family turned a blind eye to it too. What I don't know is how she would have reacted - as I said, she was generally very driven and focused and strongly discouraged any personal questions. But to this day I wonder if anyone ever said something to her.. so I also wonder if this woman has similar interactions with people she knows.. if she isn't well but no one ever says anything.
posted by citron at 12:08 AM on March 15, 2010

Ordinarily I'd tell someone in this situation to befriend the person, because if the friendship developed enough the one friend might be able to help the other person, but I am afraid to advise you to do that. The fact that you would even think of sending a letter to this woman's employer, that you've jumped to conclusions about her state of health, shows a lack of proper boundaries and judgment. If you think you can be cautious and sensitive and restrained in your dealings with her, befriend her. Otherwise, you need to leave her be.
posted by orange swan at 4:14 AM on March 15, 2010

I've been the girl who looked anorexic but wasn't (before I had my kids.) I had strangers on the street make comments, everything from "You're so thin, I wish I was as thin as you! Well, maybe not that thin, you kind of look sick." to "Lady are you anorexic?!" and "You need to eat more! You're skin and bones!"

The only thing these comments did was make me feel horrible about myself. I was suffering from health problems, and was actually eating as much as a teenage boy.

I cannot tell you enough that this is none of your business. Even if she is anorexic and is moments from death, there is nothing you can do to help her. I admire your desire to help. (Really, there need to be more people willing to help others in this world, so good for you.) I know that it must be painful for you to see somebody and be unable to help, but you are unable. Any 'help' you would give would probably cause more harm than good. Try to put it out of your mind.
posted by TooFewShoes at 5:58 AM on March 15, 2010

Also, Anonymous, you might not be in a position to help this particular person, but I'd encourage you to do what you can to help others with/at risk for eating disorders. Donate, volunteer, be a mentor for young women, etc. Don't judge yourself or other people on appearance, don't make snotty comments about fat people. Learn everything you possibly can about eating disorders and mental illness in general, and use that to educate others.
posted by Metroid Baby at 6:13 AM on March 15, 2010 [3 favorites]

I just wanted to say that I think it's good that you care. Please don't stop caring, even though there is little you can do here.

If it were me I might drop her a line via Facebook, perhaps saying something like 'You probably wont remember me, but I remember you from school! Hope life is treating you well' and leave it at that. That little act of kindness might do her some good, it might not, but at least you tried.

I'll be thinking about your kindness today, and it will do me good, so you have already helped one person with their problems ;0)
posted by meosl at 6:22 AM on March 15, 2010 [6 favorites]

Something I don't know that anyone's pointed out yet is that telling her she looks sick may be interpreted as a compliment, if she is anorexic. Anorexia warps your thinking in horrible ways.

Think good thoughts for her, but stay out of it, please.
posted by fiercecupcake at 7:18 AM on March 15, 2010

Don't say anything. Eating disorders are very complicated diseases with tons of emotion involved. I lived with someone who had an ED in college and as one of her closest friends, it was extremely difficult, even for me, to say something to her/her parents. I'm very glad I did, but I cannot fathom a complete stranger inserting himself into the situation. It's not appropriate.
posted by kmavap at 8:30 AM on March 15, 2010

If she truly has an eating disorder (which you don't know, because there are other diseases that could cause that kind of wasting), the people in her life are fully aware of it at this point. Either they are helping her, or they haven't been able to help her. And if the people in her life haven't been able to help her, a vaguely-remember high school acquaintance on Facebook (that would be you) certainly won't be able to help her.

If you truly want to reconnect, do it. Maybe she'll choose to confide in you if you strike up a genuine friendship. But if you're only wanting to reconnect to tell her "GET HELP" please just keep on walking. It's really beyond your control, and not your business.

(And please believe I say this as a person who cares very deeply about eating disorders.)
posted by Ouisch at 8:52 AM on March 15, 2010 [1 favorite]

If somebody I barely knew in high school messaged me to assume I had an eating disorder, I would be extremely freaked out and would instantly block them from having further communication with me.

Hate to join the pile-on, but please, please, please stay out of this. You can't save everyone.
posted by futureisunwritten at 8:52 AM on March 15, 2010

Also wanted to chime in with what other commenters have said about your intentions being good, especially given your past experience with A/N.

I'm glad you care about this. I'd also encourage you to either do her a small kindness, like sending a nice message, as someone else suggested, or to do something in your community to help with eating disorders.

There is so much need for people who care about this like you clearly do.

It's kind of weird, but after seeing an actress on television who (to me) looked horrifyingly emaciated, my first impulse was to pick up the phone and sign up for a charity that donates food to people in famine regions, and to start volunteering with an eating disorders organization.

I can't help but think that was a decent decision.
posted by Ouisch at 8:57 AM on March 15, 2010 [1 favorite]

I don't know why some of you all are so harsh when it's just a person sincerely showing concern about another person's well-being.

My gut feeling is that the OP is looking to "save" someone based on some personal need she wants to fulfill. Instead of volunteering with a group or helping her immediate friends and family with problems, she's seeking out a stranger to save. I may be totally wrong, but the idea that she thinks that she might be responsible for this woman's death if she says nothing, only because the girl may have anorexia, the girl she hasn't seen or spoken to in years and years and knows nothing about, indicates that the OP is having overwhelming feelings of guilt and grief about the friends she could not save. It is really inappropriate, which it's good the OP asked the green about before forging ahead, but that a portion of her is trying to justify her behavior is what concerns me. Most of us immediately know that it's not our business, but the OP is trying to figure out how to wheedle her way into a stranger's life to save them because she couldn't help her friends or is done helping her friends and needs a new person to help or save. This really isn't normal in terms of patterns of thinking, and the OP seems to be having issues with feeling inappropriately guilty and responsible.
posted by anniecat at 10:13 AM on March 15, 2010

so while I sort of recall this woman, I don't know that our paths ever crossed

That's all there is to it. Stay out of it, stop looking at her profile. If she does indeed have an untreated eating disorder (as opposed to some sort of cancer or major organ disease or she is anorexic but is already being treated or who knows what) there are people whose opinions she has reason to care about already telling her this. You have no idea whether intervention is necessary and if it is you're not the person to do it.
posted by nanojath at 11:18 AM on March 15, 2010

Whether or not one has the duty to act if another person is in distress is a long running philosophical dilemma and a totally legitimate question to ask imho. Anniecat you are attributing a lot of views to the writer that are just not there, in text of the question we have - she doesn't say anything about guilt, or anything about saving anyone to assuage it.
posted by citron at 2:04 PM on March 15, 2010

Talk about white knight syndrome... Even if you've successfully diagnosed her with a mental disorder over the internet, who's saying only you've been that observant? Most likely, many people in her life have noticed the changes in her and inquired about it (and if necessary, taken action).
posted by mnemonic at 10:08 PM on March 18, 2010