Expert: Joanne - 3/27/2008

Question
My best friend Anystan and I are coming to the end of our freshman year of college. We have been friends for five years now and I probably know her better than anyone.  Over the course of the year, I have noticed some changes in her habits and some are beginning to concern me.  She has definitely made some changes to her normal lifestyle that have resulted in fairly obvious changes to her physical state.  Since starting the school year last August, she has lost three pant sizes and is still slimming down.  I know that she is definitely more active now than she has been in the past and her eating habits have changed and I attribute her weight loss mainly to that.  But since she began losing weight, I have noticed that she has developed some less than healthy habits. She lost the first two pant sizes relatively quickly, but the third went slower.  She began to get frustrated with the fact that she wasn't slimming down as quickly and started taking diet pills and reducing her food consumption, sometimes eating only once a day.  She doesn't talk obsessively about her weight, but she is very conscientious about it.  After some pleading I convinced her to stop taking the pills and made sure that she wasn't limiting her eating so much.  I figured it was just stress getting to her and for a couple of months, everything seemed normal again.  But recently I have noticed that she has begun severely limiting her eating again.  There are times when she makes excuses not to eat with me, and there are days when she eats nothing more than a granola bar.  She is also tired alot, sometimes falling asleep in class, and I have noticed a few times that she gets really jittery and shaky. There have also been a couple of episodes where she has nearly fainted for no apparent reason. She doesn't mention her weight, but she gets defensive when I mention how little she seems to be eating and insists that she just isn't hungry. I also know for a fact that she has started taking diet pills again, though she denies it when I ask her about them.  Before we got to college, she never showed any signs that she might possibly have an eating disorder.  But the changes that have occurred this year really worry me.  I know that stress and other factors can cause similar changes, but I just don't think that they are the reason behind all of this. I haven't exaggerated any of the situations that I have described; this really is what I have noticed. I just want to know if I need to confront her about the possibility of her having developed an eating disorder, but I want to make certain that I am right in my assumptions before I do anything. Any insight you have will be greatly appreciated. I really am worried about her and I would hate for something to happen, knowing that I could have and should have done something to prevent it.

Sincerely,

Heather

Answer
Heather

I'm sorry to hear that you have such concerns for your friend.  Sadly, it is quite common for young people to develop eating disorders when they go to college.  The moving away from your family into a Hall (I'm assuming that you are staying within your campus or something!) full of other people that may be concerned about their appearance, or the sudden freedom to choose what you eat and when.

College can be a very frightening time.  Needing to build new friendships, plan for yourself, develop your independence, and well really become an adult!  For some people, this can be very daunting, even if they wouldn't admit it.  College can be very stressful and demanding, and some people develop eating disorders as they find some of the behaviours  help them 'cope' with the new situation they find themselves in.

Unfortunately, you can not force her to get help.  She needs to want to seek that before she can be helped.  But it may be good for you to voice your concerns for her health.  Be careful not to be accusatory, or use phrases that could make her feel guilty, but encourage her to be open, knowing that she will not be judged.

Remeber that eating disorders (if she has one) are not really about food, so your focus shouldn't be on eating and food, but try to get her to talk about her emotions and anything that is upsetting/stressing her.  It may be worth trying to encourage her to see a counsellor in college if you have one, or even a Doctor if she is willing to fo that far in order to be formally assessed and treated if you do think that this is an eating disorder.

Eating disorder or not, her eating patterns definitely aren't healthy, and that needs to be addressed.  The fact that she seems to be hiding things or lying to you makes me think that this is more than just a 'diet' or anything though, and possibly slightly more than stress as people that aren't eating simply due to stress tend to be more open about how little they are eating and are maybe more concerned about how little they are eating.

You just need to be there to listen to her and support her.  But don't let this become to much for you in that you end up ill, or struggling in classes due to the stress that this can possibly cause you.  Do not feel bad for asking for help for yourself if you need it.  Sometimes it is worth even you talking to a counsellor about how you feel about this in order to make sure that this doesn't begin to affect your life.  You can't be expected to become so deeply involved in this that you have nothing outside of this friendship!  So I would say feel free to talk about this with other people, just be wary of giving away your friend's identity!

Joanne