This person wants to help their friend with their problem.

Hello,

I'm sorry to hear about your friend. Her situation is very dangerous and can be difficult to overcome.

Eating disorders are unfortunately very common, affecting about 2% of women and 0.8% of men. In adolescent girls alone, almost 3% are diagnosed with an eating disorder. It may not sound like much, but if you apply these small percentages to the population as a whole, it becomes apparent this is really a big problem. These disorders can be caused by many things: hormonal imbalances, low self-esteem, perfectionism, impulsive behavior, or troubled relationships. It can happen to anyone for any number of reasons. What your friend needs to figure out is what started her on the track she's on right now.

From what you've told us, it sounds to me like this began as an expression of her low self-esteem and insecurity but then became a coping mechanism. She's aware that it is unhealthy and that she needs help, but she doesn't know how to let go and may feel like she has nowhere else to go. This is putting more stress on her, which chances are, is making her turn to her coping mechanism because it's the only thing she feels she can control. She can control how much she eats and when. That feeling of control is what makes her hold on despite knowing it's not good for her. She's in a swirling storm of fear and self-doubt, and so she's desperately holding on to the one thing she feels she has control of.

In truth, she has little control over it. Eating disorders are often compulsory. Her brain is telling her she NEEDS to stay within a certain weight. She NEEDS to skip that meal. She NEEDS to feel the hunger fade away until it's no longer being recognised within her brain. These feelings may have even become a comforting thing for her, hence it being a coping mechanism, albeit an extremely unhealthy one.

Now, as for treatment, therapy is usually the recommended course of action. She needs to talk to someone so that she can work past this. Unfortunately, it isn't something she can handle on her own. As I've said, the more stress she's under, the more she'll lean on her coping mechanism. Opening up to vulnerability is scary for everyone, and when you add the apparent control issues on top of that, it makes for a situation that is only going to get worse if it isn't closely monitored. She needs a support system to hold her accountable and make sure she's on the right track. I strongly encourage her to open up to her parents. I understand how hard this is, and it's alright if she needs some time, but I feel it is extremely important that they know what's going on in their daughter's life. Until then, she can always reach out to the National Eating Disorder Helpline either by phone or instant message. She needs to talk through this. Bottling it up or hiding from it will not make the situation any better.

Should you be the one to tell someone in her stead? A great question. Here's the deal, this is a very hard position for anyone to be in. You obviously care about her deeply, and seeing your friend suffer is awful. You want to protect her and do what's in her best interest, but you don't want to risk breaking her trust and losing her. It's a difficult choice to make, but ultimately, her wellbeing is what’s most important right now. She needs to talk to someone about what's going on, and it will probably take a push from someone else to get her there.

Here's my suggestion. Sit her down and have a serious discussion with her about your fears and concerns for her. Let her know how you feel, and try and get her to understand the severity of her situation. She needs to know how dangerous the waters she's treading really are. If you feel it may help, read over this with her. Try to convince her to talk to her parents or at least reach out to a helpline where she can talk to a person trained to help her. She'll probably give you the same excuses she gave before about how she's scared, and her parents don't understand her, but don't let it end on that. Make it clear that you care about her, and that you are there for her, but she needs real help from people who know how to handle this kind of thing. If time goes on and things don't change, then I'd consider going to her parents, or maybe a school counselor (possibly over email depending on what your school’s doing about COVID). When it comes down to it, her safety is the most important thing. I hope this helps!

Stay strong,

The Advice Column Team