Anorexia and a Best Friend

Dear Good Friend,

Let me start by saying that just the fact that you are reaching out says so much about what a great friend you are. You clearly are concerned and want to help. Next, I'm going to give you some basic information about anorexia and then the warning with some specifics on what you really want to know - What can you do to help. 

First - To be diagnosed by a mental or medical professional, someone needs to have one or more of the following: 

• Refusal to maintain a body weight that is at or above the minimum normal weight for their age and height
• Intense fear of gaining weight or becoming fat, even though they are underweight
• Denying the seriousness of having a low body weight, or having a distorted image of your appearance or shape
• In women who've started having periods, the absence of a period for at least three consecutive menstrual cycles

Some have a combination of these symptoms while others barely meet criteria yet still are at risk. When I say risk, it's not just risk of having anorexia, it's a risk of the affects (complications) on the body and mind from having anorexia. These complications often take months (or longer) to occur so many suffering from anorexia to not experience immediate affects. Here is a list of some of the most common complications (most of which we never hear about in the media):  

• Death
• Anemia (low number of red blood cells which move oxygen throughout body)
• Heart problems, such as mitral valve prolapse, abnormal heart rhythms and heart failure
• Bone loss, increasing risk of fractures later in life
• In females, absence of a period
• In males, decreased testosterone
• Gastrointestinal problems, such as constipation, bloating or nausea
• Electrolyte abnormalities, such as low blood potassium, sodium and chloride
• Kidney problems

Now, let's talk about what you can do as a caring friend. Some of these are obvious while others may seem strange or forced but have been proven to work. Most importantly, talk with your parents and never feel like her behavior is your fault or responsibility. Her choices may impact you but are not for you to control. Here are some things you can control:  

• Remind your friend what a healthy weight is for your body, especially at times when you or she sees images that may trigger her desire to restrict calories.
• Don't visit pro-anorexia websites. These sites can encourage your friend to maintain dangerous habits and trigger relapses. Anorexia isn't a lifestyle choice. It's a disease.
• Acknowledge that your friend may not always be the best judge of whether she is eating enough or are at a healthy weight. If you (or your parents) are worried enough, talk to your friend's parents. Your friendship may suffer but you may help her avoid a much larger issue later on. 
• Identify problem situations that are likely to trigger thoughts or behavior that may contribute to your friends anorexia so that she can develop a plan of action to deal with them. 
• Look for positive role models. Remind your friend that ultrathin athletes, models or actors showcased in women's magazines may not represent healthy bodies.

Ultimately, be careful with your own need to help or fix your friend. If her health defines you, she has too much control over your life. Your friend is likely very sick and needs help from a professional. You can definitely support her but never take responsibility for her choices and health. Please reach out to adults you trust and ask for support. They can contact an agency like ours (www.fonthillcounseling.com) for professional support and help your friend get the help she needs.