• Shows unusual swelling of the cheeks or jaw area, has calluses on the back of the hands
and knuckles from self–induced vomiting, teeth are discolored or stained, or looks
bloated from fluid retention
How to Help a Friend
If you are worried about a friend’s eating behaviors or attitudes, it is important to express
your concerns in a loving and supportive way. It is also necessary to discuss your worries
early on, rather than waiting until your friend has endured many of the damaging physical
and emotional effects of an eating disorder. In a private and relaxed setting, talk to your
friend in a calm and caring way about the specific things you have seen or felt that have
caused you to worry.
What to Say—Step by Step
Set a time to talk. Set aside a time for a private, respectful meeting with your friend to
discuss your concerns openly and honestly in a caring, supportive way. Make sure you will
be some place away from other distractions.
Communicate your concerns. Share your memories of specific times when you felt
concerned about your friend’s eating or exercise behaviors. Explain that you think these
things may indicate that there could be a problem that needs professional attention.
Ask your friend to explore these concerns with a counselor, doctor, nutritionist, or other
health professional who is knowledgeable about eating issues. If you feel comfortable
doing so, offer to help your friend make an appointment or accompany your friend on
their first visit.
Avoid conflicts or a battle of the wills with your friend. If your friend refuses to acknowl-
edge that there is a problem or any reason for you to be concerned, restate your feelings
and the reasons for them and leave yourself open and available as a supportive listener.
Avoid placing shame, blame, or guilt on your friend regarding their actions or attitudes.
Do not use accusatory “you” statements like, “You just need to eat.” Or, “You are acting ir-
responsibly.” Instead, use “I” statements. For example: “I’m concerned about you because
you refuse to eat breakfast or lunch.” Or, “It makes me afraid to hear you vomiting.”
Avoid giving simple solutions. For example, “If you’d just stop, then everything would be
fine!” Express your continued support. Remind your friend that you care and want your friend to
be healthy and happy.
After talking with your friend, if you are still concerned with their health and safety, find
a trusted friend or medical professional to talk to. It could be helpful for you, as well as
your friend, to discuss your concerns and seek assistance and support from a professional.
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