What do you do when you think a stranger has an eating disorder?
{image credit : afgfitness via pinterest}
A few months back, I read a post over on Psychology Today by the woman who fearlessly reminds us to have our cake and eat it too (damnit!), Kate Fridkis. She wrote about observing that skinny woman at the gym, the one who you just know has an eating disorder, and not being able to say anything. She ends the piece,
But to the extent that we still tiptoe nervously around eating disorders and pretend we don’t see them when they are right in front of us, something needs to change. Otherwise, how can we keep going back to the gym, and watching women fade around us? And won’t it be that much easier to quietly start skipping meals ourselves? Knowing that first people will say, “Oh, you’ve lost some weight! Good for you!” And then a few of our mothers and best friends will say, “I’m worried about you.” And after that, no one will say anything at all.
We’ve all seen here there, pounding the treadmill like our grandmothers beat down the dough that was to become our bread. It doesn’t look like she’s had any of that bread in a while. In fact, it doesn’t look like she’s subsisting on anything more than water and the occasional carrot.
So what do you do when you see a stranger with an eating disorder?
Well, the first thing you do is recognize that you actually have no idea if that person has an eating disorder.
Eating disorders don’t just look like the emaciated woman on the treadmill. They can also look like your neighbor, Sarah, who’s eight months pregnant. Or like your teacher, Paula, who most people remark could stand to lose a few pounds. Or like your cousin, Rich, who can no longer sit on regular furniture due to fear of injuring himself. Or like your friend, Amy, who looks just the same as she always has.
We cannot simply look at an individual at know if they struggle with an eating disorder. That would certainly make it easier for those of us whose job it is to tell! But the truth is that we don’t know what’s up unless we understand a number of other factors, like the person’s eating patterns, their perception of their own body, their desire and attempts to control their weight, and much more.
We all know someone who has lost weight following surgery, due to an illness, or related to stress or depression. We all also know someone who has gained weight following surgery, due to an illness, or related to stress or depression. This doesn’t mean that the person wouldn’t potentially benefit from psychological help, but they wouldn’t necessarily be diagnosed with an eating disorder.
The other side of this sticky coin is that many of those who have struggled with disordered eating are very attuned to the signs of a potential eating disorder. Some of the red flags include frequently hiding or eating food secretively, having bloodshot eyes and puffy cheeks, growing fine hair all over the body, doing strange things with food (like mixing items together that seem odd or tearing food apart into little pieces), and isolating from the people that they love. Hypothetically, all of these signs could mean a number of things. But for those with experience having an eating disorder or working with those that do, they send off flares in the brain.
Still, however, we usually don’t have the opportunity to observe whether the girl at the gym is hiding food under her bed or has disconnected from her friends. All we know is that she looks very thin and not so healthy. We don’t want her to die, perhaps especially if our own lives have been touched by the pain of an eating disorder. So what do we do?
Do we leave her a note telling her that we know what she’s going through and a place she can get help? Do we talk to the management of the gym about her compulsive exercise and tell them that they need to address this? Do we wait at her car and stage an intervention? Do we leave her alone and hope for the best? Do we tell ourselves we have no idea what’s going on and try to focus on our own lives?
This is a sticky situation, and I suspect that there are lots of different feelings about what to do. I’m going to go ahead and say that there is no one right answer. There’s only what you think you would do, which is what I want to know.
Thanks for taking the poll if you did, but be sure to also comment below and get the conversation going.
What do you do when you think a stranger has an eating disorder?
Alissa
304 days ago
Thanks for writing about this. I was upset at the gym the other day when I realized the same emaciated woman had been sprinting on the treadmill for nearly an hour. In her mid-twenties, she could have fit right in among the sickest of the adolescent girls with anorexia at the treatment center where I worked. It took me a moment to remember (a) If she does have an ED, she probably knows a ton about it already. (b) I would have been mortified if someone approached me in the throes of my ED, (c) Though I am empathetic towards this woman who may or may not be ill, my uncomfortable feelings were more about me–fear of being triggered, sadness that I spent so much of my life obsessed about weight and food, etc.
Julia H. @ Going Gulia
304 days ago
Glad you brought this up. I’m definitely one of those people who considers herself to be more attuned to the signs of EDs in others based on my own past experiences, and I often feel a sense of obligation to help total strangers who seem to have something bad going on with them. Of course, I completely agree with what you say about how you can’t tell if someone has an ED just by looking at him or her, which is why I’ve never actually approached a stranger about this. Still, though, it always pains me to feel like I should say something.
Bek @ Crave
303 days ago
hmm, you’ve got me thinking. I really like how you addressed the fact that there is no one image of an eating disorder, nor can an image mean one has an ED. As someone dealing with one I would feel for the person but probably not approach him/her. It also depends whether we are friends as well as other circumstances. As terrible as it sounds I would probably just let it be. Even though you reaching out might be the best thing for that person, I don’t know if I could- imagine if you didn’t know for sure…how terrible.
Bek @ Crave recently posted..Hectic- Healthy eating & exercise
PTC
302 days ago
I would try to befriend her because I always want to be friends with people who have eating disorders, probably for all of the wrong reasons. I’d definitely watch her and try to strike up conversations with her, unrelated to EDs, and get a feel for what’s going on, then I’d try to be friends with her if she had an ED because we could totally related to each other.
lori lieberman, rd, cde, mph, ldn
302 days ago
I’ve struggled with this when I’ve seen those behaving in ways that strikes me as disordered–including witnessing seemingly excessive levels of exercise in someone who looks quite unhealthy and underweight.
In truth, our comments would likely only meet our needs, not the needs of the recipient. For the anorexic, having someone comment on how they could use to eat more or exercise less may actually backfire, feeding the disordered thoughts, in fact. For someone dealing with binge eating disorder or bulimia, any comment from someone other than a trusted friend or professional may increase a sense of shame. If it’s a friend, that’s another story; any caring and concerned friend should speak up and address the issue to support them in getting the help they need.
But regarding the stranger, perhaps the best we could do is more general outreach through EDAW and such; perhaps encourage our gyms to shift the focus of their promotional materials from dropping weight and changing physical appearance, to taking care of ourselves and getting healthy.
lori lieberman, rd, cde, mph, ldn recently posted..Who’s Telling You What to Eat?
PTC
301 days ago
I wonder how many people would actually approach someone they suspected had an ED. My guess is no many.
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Dan
300 days ago
Great posting. Informative and useful. Thanks for this golden advice.
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Rita Arens
298 days ago
I think it’s a terrible idea to approach someone you think has ED. I struggled with ED for ten years, and I would’ve bitten the head off of anyone who talked to me about it. Trust me, someone with ED has already been talked to by many people in her life, and if she’s an adult, she has a right to walk on the treadmill without people coming up and talking to her about it. I wrote quite a bit about my ED experiences on my blog and left my email address, and I have 1-2 people with ED email me every week. It’s not a stranger’s place to comment on someone’s health. Why do we think it’s okay to infantilize a woman with ED and not a man with unmedicated bipolar disorder? Would you talk to a man who’s swinging wildly about his mental illness and advise him to get help and that you know how to help him?
I appreciate your writing this post. I obviously have thought a lot about it, and it always bothers me that strangers think it’s okay to tell pregnant women or ED women or women who are behaving in any way that they don’t agree with that the full-grown adult woman is doing it wrong when they don’t know anything about her.
Rita Arens recently posted..Parenting Win: I’ll Take It
Jenn @BeYOUatBeMe
291 days ago
Thank you for this post. I would gently strike up a conversation and encourage her to view sports as a lifetime pursuit, which
means caring for their bodies over a lifetime. Remind her
that she only has one body, so it behooves her to take care of it. I have no idea how this would go over…
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