Expert: Nafeesah - 4/20/2009

Question
I am worried that my friend might have a serious eating disorder. (She’s 15 yrs old). It all started about 2 months ago when she started to complain about feeling tired, nauseous and weak. She would always be exhausted, and she would have huge mood swings. She was often crying and complaining about her parents, who I must admit, sound quite strict...but she’s always been a bit of a drama queen, so we knew she wasn’t being treated as bad as she described. Mainly it was just a lot of pressure from her family to get straight A's...literally. She was already an amazing student, but according to her, her parent’s didn’t think it was enough. She was always beating herself up about how she wasn’t as perfect as her sister and how she wasn’t good enough. We gave her thousands of pep talks denying it, and making her feel better about herself, and of course insisting she ate more, because she always skipped meals. We had no idea this was about her weight until she started to show the symptoms. She was exhausted, and you could tell. At the time it seemed like it was the stress of her family that was causing her to avoid meals, and it would pass. It didn't. A couple of weeks after the whole thing started she collapsed while trying to walk up the stairs. When that happened we all knew it was getting serious and she had to get professional help, and more importantly, tell her parents about it. She refused to tell her parents, all she said was that she didn’t want help and she didn’t need it. We watched her loose weight but still refuse to tell her parents until finally she gave in and told them. She instantly regretted it, as her parents now controlled her even more than before. They took her to the doctor, whom she absolutely loathes. She thinks he's completely wrong and everything he says is rubbish. But with time, she started feeling better. You could still see that she was skinny, and that her parents still annoyed her with all the food portions and controlling, but she was happier, and pretty normal. We thought it was all blowing off. Once again, we were wrong. After we got back from the Easter holidays, she seemed so much more self-conscious and attentive of her body image. In the changing rooms she would look at everyone enviously and protest about her 'so called' fat tummy. She was never the smallest of girls, in fact, she used to be a little chubby, but trust me...its all gone now. The only thing that’s stopping her from looking freakishly skinny is her bone structure. Its not normal for her to have the same size legs as someone around 15cm shorter than her. Anyway, now she talks about her weight and her appearance a lot, something she never used to care about before. Now she’s gone back to constantly being depressed and not touching her food. She’s skipped her period for about 4 months now. The doctor is getting more and more worried, and so are her parents. She said she sees them crying, and I think deep down she realises she has to stop, but I'm worried it might be too late, and she is so very stubborn... Today she told me something that scared me a lot, and made me realise that if she refuses to take advice from her parents and her doctor, her friends are the only people that can guide her right.
She said that her body has started puking out food, and when she eats it hurts her stomach. She said that she won’t eat because she’s too fat and it hurts. She said that if her body doesn’t throw it up itself, she throws up on purpose. She even said that she hates her life so much she doesn’t think its worth living. Now I know she can be exaggerated, she has always been that way, but what she said really scared me...and I just don’t know what to tell her anymore. I don’t know how to comfort her...and I don’t know how to get her to eat if she throws it all up later. I'm so scared for her because she really seems to have gotten serious. I have no idea what to do...I’ve never dealt with an eating disorder before.


Answer
The doctor could be concerned since it's not natural for a girl of 15 to go 4 months without a period. Plus your friend is dealing with pressure from home of having her parents press her for good grades and to meet unrealistic expectations to be like her sister and telling her she's not good enough. This kind of stuff after a while can take its toll on someone and cause them to turn on themselves where in the case of your friend its in the form of an eating disorder. She doesnt understand that you're concerned and that eating disorders are dangerous. If she's telling herself that she's fat and she's not that's the end result of people putting things in her mind that make her believe she's something when she's not. How can your friend regret getting help when she was in the best position possible when not a lot of women live to get the help they need since eating disorders kill women and girls every day. Some people look for attention and if they have to BS their way through something it's their way of getting attention, but it sounds like a cry for help.