Expert: Meg - 11/15/2007

Question
I have a perplexing situation that I need adive on:
(Sorry, it isn't about me, but my friend, and I am very concerned about him!)

My friend started walking to and from work every day (it takes him about 4 hours each way), and hardly eating anything.  His claim was that he had no time, as he wanted to get home before it got dark; however he wasn't able to really eat anything at home either. (He and his family are at odds with each other, and he tries to avoid them as much as he can) Total he would eat maybe one small meal a day maybe? However, he switched to biking (which got hime to work faster), but still wouldn't eat much at all.

To boot, he has a very erratic sleeping schedule. Sleeping at night translates to 3 hours of sleep a night for him. Sometimes he'll go 3 days with very little sleep (like 1-2 hours a night). In summary, he sleeps and eats very little with a stressful home situation to boot.

Anyways, throughout the summer he has lost quite a bit of weight (I had been gone 2 weeks when he kicked this "high exercise, no food" regimen into high gear) and this made me worry about him when I got back. (I'm a recovered anorexic, so I was sure he fell into it too, or was borderline anorexic) Whenever I saw him, I had him eat meals with me and gave him rides (so he wouldn't have to bike so often) thinking it would help.

Not to throw anything else on top of all this, but earlier in his life up until the summer he had been bulimic also. I'm not sure how often he would throw up, all I know is he has done it. When I found this out (I had bulimia also) I told him if he threw up again I would have to throw up also.  He promised me he wouldn't throw up again, and so far, he has held true to his promise. I know it was a horrible thing to make/force someone promise something and expect them to go with it, but I couldn't think of any other way to get him to stop.

Starting in the fall, he got kicked out of his house, and had a hard time finding somewhere else to live. He is living with his grandmother now (so he relocated), but I imagine that would have been extremely stressful to him. (I promise this is part of my question, I just want to get all my bases covered to get an exact answer.)

About 2 months ago he started to worry about his weight also, realizing loosing a lot of weight wasn't good.  Since he moved into his grandmother's house (basement to be exact), he now eats regular meals, snacks, and doesn't throw up at all yet he keeps losing weight! Also, it now only takes him 10 minutes to bike to work, and that's all the exercise he tries to get.  Other than that, he doesn't work out excissively (or hardly at all) thinking that would help him gain weight.
Could the stress be effecting his recent weight loss also?

For example, he has eaten 3 (big) meals a day and basically stopped all excess exercise; yet he still lost a pound over 2 weeks!  

I guess what I want to know is if it is normal or not.  Should he be losing weight at all? (He wants to gain, not lose) He said he talked to someone he knew that was in medicine; and given his condition, he would have less than a year to live if his weight kept dropping.  Is there anything that can help him, without hospital intervention?  I am really worried about him, and want as many solutions as possible to help him.

Thank you
(And I'm sorry I wrote so much!)


Answer
Hi Emily,

Thanks for your question and I hope that I can be of some help.  You sound like a really caring friend and its great that you want to provide support and help to your friend.  He is very lucky.

It does sounds like your friend is having a lot of stress right now in his life.  Its hard to know if the stress alone is causing his weight loss or if there is some other reason.  I would first suggest going to a doctor for a check up to see if there is any extraneous physical problem going on that could be at the root of his weight loss (for instance, a thyroid problem or diabetes).  Sometimes, the physical abuse that one puts his or her body through with anorexia can trigger such conditions and so its important to rule out any medical cause.  

It is possible for excess stress to cause some weight loss, but I'm also wondering if perhaps he is using his eating disorder to cope with all that is going on.  I know its difficult for you to know exactly what is going on, as the only information that you have is what he is telling you.  And, as you are probably aware from your own experiences, oftentimes an eating disorder lives in secrecy and can cause the sufferer to construct a web of lies to keep the problem a secret.  So, its possible that he is not eating as he says or is purging.  

I am also wondering if you are doing okay with your recovery.  The reason that I ask is that its very common (and easy) for people suffering with an eating disorder to get pulled into anothers drama and thus take the focus of his or her own situation.  I know that as I was in early recovery, I would often find eating disordered behaviors with friends and loved ones and spent a lot of time worrying about them while I was still not out of the woods.  Even if you are fully recovered and doing well, I would encourage you to be a support for your friend but remember that only he can get better and make healthy choices for himself.  What you can do (and are doing) is to let him that you care, that you're worried and that you want to help him in whatever way he feels would be best.  

I would encourage him to see his medical doctor first.  Then, you might want to help him find some sort of therapist or counselor who can help him deal with all of the excess stress that he has in his life right now and that might be triggering his eating disorder.  Also, you might help him look up a free support group through ANAD (www.anad.org).  Perhaps, you could even go with him once or twice so that its a little less intimidating.  Finally, I would find a time where you can sit down with him and let him just talk.  Tell him that you're concerned and want to help and that he can talk and you won't interrupt, judge or give advice...just listen.  That alone can be a tremendous help as so often, eating disorders thrive on secrecy and isolation.  Being able to open up to someone and be fully honest about his feelings and what is going on is a big step towards getting help and getting better.

Remember, as horrible as it is to watch someone you care about suffer, ultimately his health is his decision.  Its so hard to take a step back and let someone make his own decisions, but you will drive yourself crazy if you don't.  

You really sound like such a caring and kind person and your friend is very lucky.  Please let me know how it goes and feel free to write again if anything in this note is not clear or if there is anything else at all that I can help with.

Take care, okay?
Meg