Helping a friend with an eating disorder

At any given time, 10% to 35% of college students — the majority female — engage in behaviors such as restricting food, binging, vomiting, over-exercising or obsessing about body image. For many of them, such behaviors are due to concerns about how they look; some use these behaviors to cope with difficult feelings or circumstances in their lives. Obsessing about food, diet and body image can take over a person's life, restrict activities and harm health. Despite these negative consequences, focusing on food and body image may offer a zone of safety and control as well as a sense of meaningful direction, making it difficult to let go of the behaviors.

What are the patterns of disordered eating and distorted body image?

  • Disordered eating
    • Eating and exercise behaviors that interfere with leading a healthy and fulfilling life.
    • They may not be life-threatening, yet they may cause suffering and require intervention.
  • Eating disorders
    Dangerous patterns of disordered eating. The three most common are:
    • Anorexia: Restrictive eating or purging (vomiting, over-exercising, using laxatives) that causes a person to be underweight. This is accompanied by intense concern about weight and/or appearance.
    • Bulimia: Binging (eating a large quantity of food) and purging (vomiting, over-exercising, using laxatives) that does not result in the person being overweight.
    • Binge Eating Disorder: Binge eating without the use of purging. People with this disorder are often overweight.
  • Body Image Disorders
    Body dysmorphic disorder primarily affects men. Those with the disorder are obsessed with making the body more muscular and trying to fix perceived flaws that others don't see. All of the disorders described above can cause serious long-term harm to the body and can be life-threatening. Anorexia has the highest death rate of all mental illnesses. Many people assume that individuals don't die from bulimia, but this is a myth. Records indicate that less than a year after developing bulimia people have been known to have heart attacks or stomach ruptures resulting in their death. People with eating disorders may have the attitude, "This won't happen to me." — but it can.

What are the signs of disordered eating?

  • Eating alone or refusing to eat with others
  • Skipping meals
  • Eating a limited quantity of food, fasting or avoiding specific foods (restricting)
  • Constant talk about being fat, over-concern about appearance
  • Rapid weight loss
  • Over-exercise
  • Extreme guilt about eating
  • Constantly checking in mirrors
  • Isolating from friends for a long time after eating 

How you can help someone you know

Learn about eating disorders. If you are worried that a friend may be struggling with an eating disorder, the first step is to educate yourself about the causes and symptoms. Helpful resources are books, websites and designated staff on campus (listed below). The more you know, the more confidently you can speak with your friend.

Express your concerns in a non-judgmental way. When you do speak to your friend, it's important to express yourself in a caring way. You should be firm and honest about what you see and what your concerns are, but don't patronize or criticize, especially when your friend expresses disagreement or denial. Some tips: 

  • Use "I" statements such as, "I see you doing . . . "or "When you do this, I feel . . ."
  • Give examples of situations that concern you. Stick with what you see and feel.
  • Use words that express that you are worried and concerned.
  • Don't diagnose them as having an eating disorder or treat them as if they have an illness.

Be prepared for defensiveness. Your friend may get very angry with you. Since the eating disorder may be an important coping mechanism, your friend may feel threatened that you are trying to take it away Know that your friend's physical and emotional health, even life, could be at stake; you are doing the right thing. Be prepared, though, for your friend to distance him/herself from you after you discuss your concerns.

Know your limits. Many people with eating disorders say that when their friends take on too much of a care-giving role (act like a counselor, an expert or a parent), they become frustrated and resentful and just become more secretive with their behaviors. It is helpful to take an active role in getting your friend help and information such as medical care, counseling, nutritional counseling, and, in some cases, parental involvement. It is not helpful, however, to try to control their behavior by taking charge or monitoring their behavior. Instead, ask your friend how you can help. 

Consider notifying someone. If you feel your friend is engaging in unhealthy behavior and not seeking help, you may have to decide whether to notify Residential Life staff or your friend's parents. You may want to speak with a counselor for support in making your decision. Your friend may be angry with you, but it is better to lose a friendship than to lose a friend to an eating disorder.

Give them space. Once your friend is in treatment, don't force him/her to talk about his or her eating disorder, emotional issues or treatment. Do offer to listen, however, if he or she wants to talk.

How you can support positive eating habits and body image

  • Help create an atmosphere of acceptance and appreciation for different body types and sizes in your peer group. When speaking about yourself or others, focus on character, not appearance. Avoid making negative comments about your own body or others'. Avoid comparing people in terms of appearance and weight.
  • Compliment your friends on what you like about who they are as people.
  • Actively challenge cultural beliefs and assumptions about body image. Support organizations and magazines that promote people's accomplishments outside the realm of appearance. Don't support magazines and groups that publish unhealthy images of men and women, or treat women and men simply as bodies.
  • Educate yourself and your friends about the negative consequences of dieting and restricting food intake. Restricting food is one of the main precipitants of disordered eating and has been proven to be a major cause of binging, and even weight gain. Healthy eating stabilizes weight and appetite.

Helpful References and Websites

  • National Eating Disorders Association
  • National Eating Disorders Association's information and referral line (1-800-931-2237)
  • - Website for guide books, a resource for information about eating disorders
  • Click on the "eating well" section for information about eating healthy and nutrition
  • The Beginner's Guide to Eating Disorders Recovery by Nancy Kolodny, LCSW - Good introduction to eating disorders, with a section about how to help a friend
  • Food and Mood by Elizabeth Somer, MA, RD - Helpful tool to educate yourself about healthy eating
  • The Adonis Complex, the Secret Crisis of Male Body Obsession by Harrison Pope Jr, MD, Katherine Phillips, MD, and Roberto Olivardia, PhD
  • The Sports Nutrition Guidebook, 3rd Edition, by Nancy Clark - Healthy eating for physically active people
  • Body Wars: Making Peace with Women's Bodies by Margo Maine - Guide for helping women overcome the self-hatred and body dissatisfaction that lead to disordered eating.

This brochure is presented by the Eating Awareness Committee, a University-wide committee whose written mission is to help students maintain healthful and balanced eating habits in order to sustain their academic and personal development throughout their college years and beyond. The committee offers educational programs, consultations, and referrals to treatment services for students and staff on campus. Funding for this brochure came from the Division of Student Affairs.

For more information about how you can help a student with eating and body image issues, contact:

Decker Student Health Services Center

Phone: 607-777-2221

University Counseling Center

Phone: 607-777-2772

Nutrition Services

Julie Lee, Registered Dietitian: or 607-777-5413

Eating Awareness Committee

Campus Recreational Services

  • Cindy Cowden, Senior Associate Director: 607-777-3125