Mary Kate Olsen is among the celebrities who have admitted to coping with an eating disorder in the past. Image via WENN.

Do you have issues with your no-longer-best girlfriend? Is your coworker driving you crazy? Megan Carpentier is here to give you the life advice that you don’t want to hear, told in the way you absolutely need to hear it.

I’m becoming concerned about one of my co-workers, who I’d like to think I’m friends with. Things have gotten really stressful over the last couple of months in our office, and we’re all working like fiends, coming in early, staying late, everyone knows the drill in this economy. Over the last few weeks, my co-worker keeps “forgetting” to eat, and her bathroom visits are epically long. It probably goes without saying that she’s lost a ton of weight, and is getting to the stage where she looks really obviously unhealthy. She’s never admitted to having an eating disorder, but I don’t feel like I can just sit by and watch her do this to herself. What do I do?

I am an extremely blunt person, and over the years I have learned (the hard way) that there are some situations where being the bull in a china shop can actually hurt more than it helps. This is one of those situations — as I’ve learned, telling someone they need to see a shrink (even when they do) is often not the thing to say to get someone to go.

So, I asked a friend who suffered from an eating disorder what helped and what hurt — and what someone could have said or did say to help her realize what she was doing and that she needed help. This is what she said:

First, kudos to you for caring about your colleague and wanting to help her. I am alive and healthy today in part because of the support and reality checks some of my colleagues gave me several years ago when I was sick. Megan is right, though, that this is a situation where well-meaning people can sometimes hurt when they’re trying to help. So it’s important to have a sense of boundaries and what you can and can’t (or shouldn’t) do.

Here are some things that you CAN do for your colleague:

  • Let her know you care about her: This is probably the most important thing. And that you care not just in the context of her weight/eating, but about who she is and how she is doing overall. It sucks that you’re going through a stressful time at work right now, but it actually gives you a lot of openings and opportunities to show you care by asking her how she’s doing, commiserating over deadlines/shitty days, etc.
  • Reaffirm reality: One of the particularly insidiously things about eating disorders is the way they screw with your sense of reality. When I was sick, I frequently felt like I was trapped in a war between an eating disorder voice inside me that relentlessly echoed the distorted reality, and my own feeble voice telling me something was very wrong. You can help by GENTLY helping to remind her what reality is, while also being careful to avoid things (like diet and weight talk in the office) that buttress the distorted reality.
  • Keep her connected: Eating disorders can be isolating–help keep her from being isolated by being a friend, inviting her to participate in activities, asking how she’s doing, commiserating over shared frustrations at work, etc.
  • Be ready to support her if/when she does reach out for help. But remember, ultimately the onus is on her to reach out.

It’s really important that everything you do here come from a place of sincerity and honest caring for her well-being.

In general, I would not advise approaching her from a place of confrontation, or an attitude that you can make her admit she has a problem or get help. In my experience, people with eating disorders (including me in the past) tend to feel threatened, get defensive and withdraw when pressed in that way–and that can do more harm than good. Sometimes it’s necessary for family members or therapists to play a more aggressive/confrontational role, but it’s not an appropriate thing for you as a colleague to do. So if you would find it threatening, or accusatory, or feel it violated a boundary if someone said/did it to you, don’t say/do it to her.

If you feel like you know her well enough, and you’re comfortable, you may want to approach her directly with her concerns. Do this in a time and place that is not threatening, when she is not stressed about something else, and in a way that doesn’t make her feel ambushed. Do it one on one, not with other people around. Here’s what you can say:

“I care about you. I’m concerned that you [have lost a lot of weight lately/look very thin/seem to have less energy than usual lately — whatever feels right to you]. Are you okay? Is there anything I can do to help?”

And that’s it. Don’t press her beyond that, don’t expect a response (but obviously be there and listen if she has one), don’t expect her to admit anything, don’t argue with her, don’t expect immediate results. Follow up by caring about her and engaging with her.  I would specifically NOT advise raising issues around food or bathroom visits. Ultimately, you want this to be about HER and your concern for her, not about food. And you certainly don’t want to be the food police. You also want to avoid making assumptions about her behavior that may be wrong (TMI warning: severe constipation is a common result of severe undereating that can result in long and unpleasant bathroom visits even if someone is not purging).

And don’t get discouraged if you do this and don’t see any change. Ultimately, she has to want to get better from within herself, and until she wants that, nothing anyone does can make her. Just keep caring for her in the ways you can–you would be surprised the way that little things can add up and ultimately make a big difference, without you even knowing, long after you actually did them.

I can only add one thing: I lived with a good friend who suffered from an eating disorder, and even her disease was in remission, her disordered thinking about weight and beauty continued. One of our acquaintances, a life-long underminery type, used to come by and watch T.V. so that she and my roommate could “bond” over how beautiful the thinnest actresses were. For someone like me, the underminer’s behavior was eye-rollingly annoying; for my friend who had survived an eating disorder, it served to reinforce the standards of beauty she needed to let go of in order to be healthy.

It’s really easy, even in casual ways, to reinforce the attitude that beauty and weight are inherently linked, and we’ve all been saturated in a media culture that posits that thin is pretty (and everything else is not). So, even if you can’t immediately assist your co-worker with beating her disease, you can help her (and yourself, and everyone in your life) by being cognizant of the ways in which you reinforce and parrot the stereotypes about beauty and thinness and stopping yourself when you can.

Good luck to both of you.

If you have a problem with a friend, relative, coworker, or other person in your life, email Megan at advice@thegloss.com. If you have a problem with your boyfriend, you should probably just try talking to him.