How to help a friend with bulimia

Photo: Grimesec/Flickr

Despite spanning 10 years, my eating disorder sometimes feels very far away. Just as with many things, I have tucked it elsewhere to keep myself safe from falling back and potentially worsening the existing consequences it left behind. Still there are days when I remember it clearly, even fondly; after all it was my most reliable friend and confidant for a decade. This was because I made it so, however, not because I didn’t have people who loved me.

In fact, I had numerous wonderful humans who tried to get me to stop binging, purging, and harming myself, but I refused. I refused for a long time–so long that I drove many of them away, but there were plenty who nevertheless helped in my recovery, whether it was by listening, encouraging my abilities, having faith in me, holding my hand in doctor’s offices, or simply believing me. We have gone over the many things you should never say to somebody with an eating disorder, so now, let’s talk about how you should (and should not) go about helping your friend.

1. Believe her.

When people do not take you seriously, it increases the insecurities you already feel. Reaching out to a friend, family member or anybody else is hard; when they believe you and truly try to understand where you’re coming from, it can make all the difference in the world.

And just a note, I will be using female pronouns for this story, but of course there are millions of men in the United States who suffer from eating disorders, so the same advice goes for any gender of friend you have.

2. Ask her what she needs.

She may say “nothing,” but this (A) shows you care about her personal feelings and (B) opens the door for her to come to you for help should she want it, immediately or otherwise.

3. Do not question her illness.

One of the reasons we desperately need more eating disorder narratives besides the thin, white perfectionist’s is because there are still people out there who believe you can’t have an eating disorder–at least, not an effective one–if you’re not skinny. There are women of all races, weights, sizes, abilities, religions, shapes, habits and ages who have eating disorders, and dismissing your friend’s issues just because they don’t fit a narrow mold of what an ED “looks like” will only make her feel worse.

4. Do not comment on what she’s eating.

I cannot tell you how many times multiple exes (and a few friends, too) would make negative comments on what I ate. Examples:

  • “You wouldn’t feel the need to throw up if you didn’t eat so much.”
  • “If you feel fat, you should probably stop drinking so much ginger ale.”
  • “That’s disgusting” (with reference to a quick meal I got because my blood sugar was low after I had avoided eating in front of my ex for an entire day, and when he said this, I immediately regretted eating at all).
  • “It’s so easy to eat healthy, you should do that instead of throwing up.”

Gee, you’re right, I never thought of simply eating healthy and the fact that I binge and purge isn’t remotely related to the manifestation of my PTSD. No, it’s simply because I one day said to myself, “Hey, eating healthy is hard! I should get an illness!”

Believe me, it probably took a fair amount of energy and stress to work up to eating in front of somebody else that day. Don’t make it even harder for her.

5. Also, don’t tell her to “just eat.”

For people with eating disorders, the idea of “just eating” isn’t the same as being hungry, walking to the fridge and consuming food. Instead, the eating consumes you, making it nearly impossible to “just eat” without any emotion attached.

6. Give her attention, but make sure it’s positive.

I had people in my life who thought I “just needed attention.” To be fair, this wasn’t entirely untrue; I did need attention because I was drowning in my illness. I was throwing up blood, causing my body permanent medical problems. I clearly needed some form of attention, but I could not articulate what kind.

The problem with the way a few people dealt with being close to me at the time–though I would never hold it against them, as it was a circumstance they never asked to be in–was the type of attention they would give me. Either they would encourage the disordered behavior, which I simultaneously loved and hated (because I simultaneously loved and hated myself, and saw the disorder as me), or they would yell at me if I admitted to having thrown up. This led to numerous tearful confrontations and, oftentimes, quite a bit of hugging later.

Nobody is built to understand why their loved ones do terrible things to themselves, so I know now not to find any of those people at fault; they just didn’t know how to cope with my frightening, dangerous and erratic behavior. But if you are currently in a situation wherein your friend is sick, don’t yell at her (and obviously don’t encourage her). When you chastise somebody for hurting herself, she feels more guilt–and that guilt leads to more disordered behavior.

Instead, sit down and talk to her. Ask her questions. As her to explain her feelings to you and listen. Which brings me to my next point…

7. Listen.

Humans are built to believe that how they do things is the best way–otherwise, they would do them differently, right? Therefore, we also feel the need to constantly advise other people (hi, Samantha Escobar At This Very Moment). If your friend comes to you and needs help with her eating disorder, you should sit and listen. If she asks for advice, give it if you feel confident in doing so in a sensitive, proactive manner, but if she doesn’t, then let her just talk. When you have the amount of shame that an eating disorder typically results in–from my experience, huge binges can make you feel as guilty as committing a violent crime would–it feels so good just to have somebody listen to your thoughts and not judge you.

8. Know that it is not entirely about food.

In some ways, it is entirely about food: the obsession with eating, the comforting habits, the eating disorder hamster wheel we just keep spinning around in over and over and over. But in reality, your friend needs help with something other than just “eating healthy”; with over 50% of people who have eating disorders fitting the criteria for depression, we know that so many people who suffer from EDs are dealing with problems besides food. Body dysmorphia, depression, anxiety, OCD, Major Depressive Disorder, Bipolar Disorder, PTSD…the list of why people develop eating disorders is endless, and dismissing it as simply a “food thing” that can be changed with a simple read-through of healthy cookbooks will do nothing for your friend.

9. Don’t keep telling her to “just stop.”

That’s not how it works. We all know that’s not how it works, and it’s incredibly patronizing to be an adult and treated like you simply never thought of just stopping. If stopping were so easy, then anorexia wouldn’t have the highest mortality rate of any mental illness.

10. Do not keep insisting that she looks “so good.”

Yes, it is nice to hear compliments, but when you tell somebody who’s already put all of her mind’s focus onto her appearance what you think of her body, you’re reemphasizing how important her body is. Being told “you look so skinny” as a compliment over and over conditions women to believe that being thin is inherently superior and that is what they should strive to be, even if that is not their natural body type and they have to go to unhealthy lengths in order to achieve it.

11. Do not compete with her.

This sounds obvious, but when I had an eating disorder, people would sometimes compete with me to see who could vomit the most, eat the least, and lose the most weight. They had eating disorders, too, and while I did not typically initiate these little ED pissing contests, I didn’t discourage them all that much either, therefore perpetuating these behaviors. Even today, I remain so angry and ashamed at myself for this. Whether you have an ED or not, you should still strive to not actively encourage those loved ones to keep harming themselves.

12. Keep the window open.

Believe me, I know it is unbelievably frustrating when your friend is sick and you can’t do anything about it. I’ve been on both sides of that and believe me, knowing that there is a potential help out there can do amazing things for your hopelessness.

13. Accept that you might not be able to help at all.

Eating disorders are not simple in any way, shape or form. They are frightening and murky and lack any easy “cures.” I know this is so, so much easier said than done, but do not take it personally if you cannot help your friend. Ultimately, you are responsible for your own health and you are not to blame if you cannot improve somebody else’s.

14. Seek outside help if necessary.

I’ll be completely honest with you: four years ago, the idea of a friend going and telling somebody else about my bulimia made me livid. My body, my problem–right?

Except it wasn’t just my problem, because I had become other people’s problems by being a literal danger to myself. I needed help and had I not eventually recovered, I do not imagine I would have survived at the rate I was going. This reality is something that I had to accept and understand as why many of my friends couldn’t deal with my illness and why a few of them attempted to get me outside help. If you believe that your friend is in danger, then you should seek assistance in helping them, whether it is through their parents, their partner, or even medical services.

Honestly, just caring enough to want to help your friend is important. That type of compassion is not to be underestimated, so please, know that simply wanting to be there for your loved one means more than it may seem.

February 23 to March 1 is National Eating Disorders Awareness Week. To read our special coverage on ED topics, click here.