by Alecia (eleutheromanial)

You may have noticed a friend/relative/etc. obsessively counting calories, checking health-food websites, or any other eating disorder-related behaviour. This is a list of recommended steps to take when you have suspicions about this subject.

If you're feeling apprehensive about approaching someone to talk to them about this, the best thing to do is become informed.

NEVER, EVER, EVER JUST IGNORE THE SUPPOSED PROBLEM. At the very least, look into it and privately ask someone else to handle it- NEVER ignore it.

If you're going to handle it, first of all, conduct research. Learn something about what you think this person has or might have. Look out for the warning signs especially. (you can find these by searching "warning signs for__________" and in the next chapter, which is entitled "Signs and Symptoms").

Then, if you've found a behaviour or behaviours that the person is demonstrating, observe. This may not be the easiest, as most individuals suffering from ED's will hide their symptoms, but see if you can spot anything relevant. For example, you may think someone has Purging Disorder, and then you should look out for signs such as going to the bathroom right after meals or snacks, stained teeth, puke breath, etc. It doesn't have to be so obvious that it hits you in the face--look out for the small things that just don't gel.

*never wave a sheet in their face and tell them that they outright have an ED because of this, this and that*

Talk to them privately. Try to work it into a conversation subtly--not deceitfully--and ask something open-ended like, "I've noticed that you never really eat lunch or dinner with us anymore, what's up?" (Or whatever's relevant to their behaviours--try not to say more than one/two behaviours that you've noticed or they may become defensive or hide whatever they may or may not reveal). It's also best not to be too specific (eg. "You went to the bathroom 89.3% of the time right after you ate last week" = what not to do).

Do your best to;

Understand them.

Support them.

Listen to them.

Be gentle with them

Don't be assertive or assume anything. You may have done some research and read up, but they could just as well have an iron deficiency or an intolerance that has stimulated these behaviours or habits--it does happen.

Just tell them that you're worried and explain why. The key to this is being gentle. Often, someone may not even realize their behaviours count as an ED, so you don't want to assault them with things that you've noticed/seen. Before you have this conversation, make sure you know at least a little about what you are talking about. If you jump into this and don't know how to pronounce the word Pica, they may be offended.

Don't bombard them with facts or stats either though, or they can become overwhelmed. I will include a play-by-play of a conversation that I had with a friend about Muscle Dysmorphia that went well so that you know what I mean

Know your limits; make sure that you don't try to fix it for them or be in charge. I'm going to be blunt here; IT WON'T WORK.

This is where it goes two ways.

They could either; open up and explain what's been going on with them- in this case they'd have an ED, or, they somehow tell you that they don't have one.

I'm going to cover what you should do if they affirm your suspicions first, then if not after.

What to do if they confirm your suspicions:

Once they confirm that they think they have an ED, be there for them. There's only a few things worse in the world than being abandoned for allowing someone in on the fact that you have a mental illness. Tell them that they can get through this, and no matter what, DON'T KEEP IT A SECRET. They may ask you to keep it under wraps for a while-- but don't do this. Under any circumstances. If they say that they will talk about it, confirm it after to make sure they actually did.

When they have confided in you, alert a trusted adult as quickly as possible.

For teens, your parents, guidance counselors, therapists, doctors (if you know them), and their parents are a good place to start.

For adults, therapists, doctors, and spouses/siblings, (or other people that they are close to) will be good if you don't feel comfortable enough to do it yourself.

If you don't want to tell anyone that you're close to, let some sort of support person help you. They can inform the parents without you having to become involved. (So this can be doctors or therapists etc.)

From then on, continue to be a source of support. If they're not comfortable talking about the ED, don't talk about it.

They're still the same person, so have normal conversations with them.

Do not, under any circumstances, try to control their eating habits. It won't work, will likely make them worse, and may ruin your relationship. There is a very low chance that you are professionally certified to deal with this, and even if you are, I'd recommend against involving friendships/relatives in your clientele. This is one thing to leave to (parents and) professionals.

However, as much as you can, educate yourself about what it's like. Read survivor stories online or personal accounts if they don't talk to you about it yourself.

You probably have no clue as to how it feels, so attempt to be empathetic and put yourself in their shoes. Even if you have an ED--even if you have the exact same ED--your experience will never have been exactly the same.

Please also don't gossip about it. Other people besides professionals and relatives have no right to know about it, and it isn't your place to tell them--otherwise, ask this person beforehand about what you are permitted to say.

What to do when they shut your idea down:

You've talked to them about it and they have somehow told you that they don't have an ED.
Go with your gut here, but still observe everything that happens for a day or two. If something doesn't feel right or you catch them engaging in an ED behaviour, alert someone immediately.

They could have a legitimate explanation that makes a whole lot of sense, feels right to you, and gives you no cause for concern. In this case, watch a little more, but it's probably fine.

Be careful not to push the issue. They may not be aware, or hiding it. Don't talk to them about it if they've made it clear that they don't want to.

If their explanation checks out but it's not the smoothest in the world, it's probably still best if you observe a little more.

[this is the convo that I had with my friend concerning Muscle Dysmorphia as an example. It's not word-for-word, but pretty close. I changed his name. Oh, and it was when I was fifteen]

Me: Hey Freddy. So uh, you've been at the gym a lot lately, huh?

Freddy: I guess. Not really though. I need to go more, thanks for making me think about it.

*he gets up to leave*

Me: It seems like you go quite a bit to me, and you look really tired.

*he sits back down*

Me: And I heard of this new eating disorder. It's called Muscle Dysmorphia. Apparently going to the gym a lot is a sign of it, and so is drinking/eating a lot of energy or power foods and supplements. You complained about the pharmacy bill last week, right?

*he stops drinking his kale smoothie*

Freddy: Oh.

Me: Yeah.

Freddy: And you think I have it?

Me: Maybe. I'm just worried. You seem kind of distracted to me and I miss the old you. I don't want to assume anything, but the symptoms just kind of stood out to me.

Freddy: What are they?

Me: Like exercising frequently and the reverse of Anorexia, so wanting bigger muscles and stuff.

Freddy: *after a while of awkward silence* Can we maybe talk to your mum? She's cool and knows about Orthorexia because of you and she know my mum, so then they can talk.

Me: Sure.

[Three weeks later, he was discharged from a short-term treatment ward. He hasn't relapsed for four years]

[There was a lot more small talk and umming that happened, but that was the approximate]

In conclusion, if you're ever worried about someone and think they may have an ED, do what you can to help them. Whatever your reason for suspicion was is valid and the reason for suspicion ought to be eradicated before the actual suspicion is.

Be prepared for them not to like you for a while--it'll feel crappy, but you may have opened up their future or even done something life-saving.

To sum it up: be there and be supportive--but don't keep it to yourself. Eating disorders kill hundreds of thousands of people annually and just sitting down to have a conversation could potentially save their life.