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• There is nothing you can do to make someone eat or stop vomiting (using laxatives, etc.). It's frustrating because there is only so much a friend can do. Love cannot cure anything, especially an eating disorder. Your only responsibility is to try to get your friend to meet with a professional who treats eating disorders.
• Get support for yourself or you will "burn out". Talk confidentially to a friend or counselor.
• Remember that getting help early can lead to full recovery. With treatment there is hope for getting better even if the problem is very serious.
• Remember that the frustration, anger and annoyance you feel at times, are the same feelings that your friend often experiences.
• Let your friend know that you are concerned about her/him, that you care and that you are frightened.
• Encourage your friend to talk to a physician, counselor, nurse or parent.
• Try to discuss her/his feelings, such as anger, sadness, low self-esteem or loneliness.
• Do not comment on your friend's appearance, even if asked. If you say, "you look too thin," you may reinforce her/his striving to be thin. If s/he gains weight, don't comment on it. Even saying "you look healthy," may be "heard" be your friend as "you look fat." Comment instead on how your friend appears emotionally, not physically.
• Don't discuss what your friend should eat or how s/he should change her/his behaviors. This will probably turn into a power struggle and you will most likely lose. You might want to comment on how much energy s/he devotes to exercising, thinking about food, or worrying about her/his body, but do not comment on the specifics of what s/he does.
• You don't always have to confront someone. You can just be there as a friend. Over time you can slowly comment on her/his feelings and eventually suggest talking to a medical practitioner or counselor. You might take several weeks to do this.
• Once your friend has sought professional help don't expect her/his behavior to change immediately. Recovery from an eating disorder is often a long, slow, and frequently uneven, process. Ask your friend how you can be most helpful during her/his recovery - people differ in the kind of support they want so don't make assumptions about what is and isn't helpful. Maintaining open communication between you and your friend is most important.
Colby College Counseling Services Patti Newmen 2005 (rev.)