When a friend is struggling with body image or eating issues, it can be tough to know how to help. Or you might not even know the signs to watch out for.
That’s why I’m pleased to present my interview with Jessica Setnick, MS, RD/LD, a pediatric dietitian who specializes in eating disorders. As Education and Training Director of Ranch 2300 Collegiate Eating Disorder Treatment Program, she also travels the country teaching professionals to better help the individuals with eating disorders in their care. She’s the author of The ADA Eating Disorders Clinical Pocket Guide and The Eating Disorders Book of Hope and Healing.
Below, Setnick offers insight into how to approach a friend who might be struggling and how you can extend support. She also reveals common concerns she hears while talking to college students, several websites she recommends and more.
Q: What are the most common signs that a friend is having body image or eating issues?
A: Body dissatisfaction is so common that it is often not identified as a problem until it’s severe. But even comments like “I feel so fat” or “I hate my thighs” can signify that all is not well.
It is appropriate to mention any comments that you feel are harmful to your friend’s self esteem, even if they are not to the point of affecting his or her functioning.
The same goes for eating issues. By the time you observe your friend not eating, overexercising in comparison to the amount of food eaten, expressing regret and guilt over food eaten, and/or repeatedly weighing him or herself, it may have been going on for quite a while in secret. It is time to take action and express your concern.
Q: How can you better support your friend through these issues?
A: Sometimes all it takes is an opportunity to vent about frustrations and be heard, and everything feels better. Help your friend step away from the frustrating situation, like leaving the dressing room, or putting down the fashion magazine, or leaving the restaurant or the locker room, and sit down in a quiet place where he/she can express him/herself.
Listen rather than give advice until your friend’s strong feelings have passed. Then help your friend recognize that the experience is frustrating, not the body.
Can you relate to the frustrating experience? Without taking over the conversation, share your frustrations with a similar experience and how you avoid blaming your body for the frustration.
For example, sharing that you hate bathing suit shopping, too, or jeans shopping, or riding in the elevator with a supermodel, or seeing your weight, can be a relief to your friend, as it validates and normalizes his/her feelings, allowing your friend not only to be heard and understood, but to recognize that it’s the situation causing the problem, not his or her body.
This is better than just saying things like, “Your body is fine,” or “You have nothing to worry about,” which makes it sound like you think this is overreacting.
Q: When bringing up your concern to your friend, what’s the best way to do it?
A: If you have been through this process repeatedly with your friend and it seems like it is getting worse, not improving, or starting to affect his or her life in negative ways, it is time to get more help.
Look online for a body image checklist, or use my “How Do I Know If I Need Help?” checklist, and fill it out as if you were your friend. Then take it to him or her and say that you have noticed that a lot of these items describe your friend and you are wondering if he/she noticed that, too.
It is possible that your friend had already been wanting help but didn’t know where to turn. It is also possible that your friend will be mad. Although that will feel uncomfortable, it is worth it to help a friend, and it is also a sign that your friend knows there is a problem but is not ready to admit it.
Then express your concern that body dissatisfaction is taking over and you would like to help your friend find a professional or support group in the area.
Using a checklist helps make this conversation less like a personal criticism and more objective. You know your friend best, so although it can feel awkward bringing up this topic, if you don’t, it is possible that no one else will either.
If you need support, it is okay to talk over your plan with a friend or family member in advance, but it is not ideal to bring other people to your meeting – your friend with the problem might feel ganged up on and gossiped about. One on one is better.
Q: You speak to college students about how they can help a friend. What kinds of concerns or questions do they bring up surrounding this topic?
A: Everyone wants to help a friend themselves. But really the best way to help a friend is to help that friend find professional support.
People also say, “What if my friend denies the problem or won’t do anything about it?” My suggestion is to make an appointment at the college counseling office for yourself.
Tell your friend that you are worried and are going to speak with a counselor about how to handle the situation (you do not have to tell the counselor who you are talking about, by the way). Share when the appointment is and say that he/she is welcome to come with you, but that even if they don’t, you are going because you know something needs to be done.
This way you are accomplishing several things — you are taking care of yourself, you are showing that getting professional support is not a “crazy” or weak thing to do, you are demonstrating how seriously you believe that your friend has a problem, and you are paving the way for your friend to see a professional.
Q: What are your favorite resources on body image or disordered eating?
A: Websites where you can find a professional include www.edreferral.com and www.iaedp.com treatment directories. You can also call any treatment center in your area and ask what outpatient counselors or dietitians they recommend who are skilled in these areas. www.nationaleatingdisorders.org also has a ton of information, and www.bulimia.com has a list of all the body image and eating disorder books that exist!
Q: Anything else you’d like readers to know about helping someone?
A: Being the support person for someone with an eating disorder or body image disorder can be extremely stressful. Make sure that YOU have someone to vent to, whether a friend, counselor, or support group for friends and family members.
It is completely normal to feel frustration, anger, resentment, fear, annoyance, and a million other feelings. Sharing with the friend [who has] the problem is not ideal, because they can misunderstand and think that you are trying to make them feel guilty. Find an outside person that you can confide in.
Thanks so much to Jessica Setnick for her insight!
Do you have any questions about helping a friend who might be struggling with body image or eating issues?