I have a friend at work - she is 22, shy, low self-esteem.
She does not eat breakfast and refuses to eat anything unhealthy - cake, chocolate, biscuits.
At lunch she will eat maybe an orange or banana. Or she will have a tuna roll, break it into tiny pieces and barely eat any of it. All she drinks is water. She is uncomfortable talking about food with me - gets irritable, avoids eye contact, stutters and goes bright red. When in a group she will not get involved in conversations to do with meals, food in general, diets, favourite foods, or healthy eating (she looks in the opposite direction). She once told me that going out to restaurants does not interest her.
A few years ago she lost a lot of weight but not recently. I've never heard her say that she feels fat or wants to lose weight. She is thin but of a healthy weight. I don't know what her eating habits are like at home, do you think i should be concerned when she's not losing weight? What are your views, should I address the issue?
I know she has a difficult life at home with an alcoholic father and lives alone with him but don't know if that's relevant.
Thanks for your time.
Thank you for taking the time to write to me and I hope that I can help.
Firstly, let me apologise to you for not getting back in touch with you as soon as I would have liked but my offline job role has had me run manic for the last couple of weeks. I had been meaning to respond to you as soon as I received your question but was unable to so I apologise.
Tackling issues around food with someone that may have difficulties discussing it is always going to be difficult and it comes down to the relationship you have as to how far you can investigate the issue and influence change.
There is a fine line between someone who chooses to eat healthily and those who are obsessive to the point where they will actively monitor what they are eating to reduce weight but it is about understanding the person’s behaviour as a whole in order to get an accurate depiction of their situation. For example, your friend could be ‘grazing’, that is, eating smaller portions of food but more regularly throughout the day. This is a tactic used to aid weight loss without making the person feel hungry as you eat every four hours. It could be that the behaviour you have witnessed (not eating large amounts of food and nit picking at the food your friend does eat) is due to something like a diet or irregular eating pattern but this does not necessarily mean that she has an eating disorder or a phobia of food that you should be concerned about.
People that have or have had eating disorders or issues with the food in the past can become very defensive when the issue is bought up. They feel threatened, judged and like they are being attacked which means that they will either retreat away from the argument or become incredibly hostile at the person asking the questions. For people that have an eating disorder, asking questions about their habits and their eating routine can be seen as quite obtrusive into something they deem private and secretive and it is not welcomed.
I once worked with a girl that I knew but not well outside of work and I noticed the same things that you have described. One our breaks, I would be gorging on all sorts of junk and fatty food and she would have a couple of chips and a cup of black tea. I had noticed a pattern of her behaviour that did not just seem to be a one off but something that was almost routine for her and I was becoming concerned about the impact that it may have upon her health. Unfortunately, subtlety was not my strong point when I was younger and I accidentally came out and said ‘is that all you’re eating? Are you sure you don’t have an eating disorder?’. I was abrupt and insensitive (this was before Uni) and I got a response that threw me…’yes actually, I have’. At this point this girl stood up and stomped out of the room leaving me feel both ashamed and embarrassed of myself.
Although unexpected and provoked insensitively, finding out that she had problems with food meant that I could check in on her and just make an effort to ask her how she was feeling. It also helped me to gauge whether or not she was accessing help or need pointing in the right direction. Over time she opened up a little more each time we spoke and I began to see that this was something that she had seemingly managed herself. Had we been closer than colleagues and this earlier on in the cycle, where all the behavioural indicators appeared to point that there may be an underlying issue, I probably would have sit her down and had a private conversation with her but without forcing the issue, so to speak.
The last thing anyone wants to hear if they have a problem is someone nagging at you about how they are concerned about you and they ‘understand’ how you are feeling. The best approach is to offer general opportunities to talk for the person and to listen non-judgementally. Each time you do this, more information will get revealed and you will get a little more insight into how the person is actually feeling which could help you to understand the underlying issues.
Listening effectively to what someone says when asked a certain question can tell you a lot about how they actually feel and perceive themselves and the world, you just have to listen.
It could be a good idea to have a hypothetical situation conversation with this girl and talk to her about how you are concerned you are putting on weight (even though you are not) and see what she says. You are not looking for flattery, you are looking to provoke her into revealing an insight into perceptions about her own body. Does she make out that she is fatter than she is? Does she talk about weight and link it with confidence? Bring up the idea of needing to go on a diet (again, just hypothetically) and see what she says. Pay her a compliment about herself and ask her how she managed to lose so much weight.
Asking the right questions means that you can find out the answers that you want to find out but without coming across as nagging, intrusive or nosey. It also means that she is less likely to think that you are crossing the line and attacking her when actually all you are doing is showing genuine concern.
Some people that have eating issues use eating as a method of giving themself some control over their life when they feel that they lack control in other areas and it could be that watching her father drinking excessively has taken its toll on your friend and she is trying to control something she can when watching something that she cannot.
Whatever the reason, if your friend does have an eating disorder or an issue around food, it needs to be tackled sensitively and gently. You can only help her if she is willing to help herself though and this involves her identifying that she has an issues that she thinks that she needs to address.
The best advice I can give you is to monitor the situation and keep an eye on her for any radical changes. As little as she appears to be eating at the moment, at least she is still eating which suggests that this has not yet become a major issue.
If your friend does exhibit suspect behaviour, then it may be time to get the NHS involved and this may mean that you nominate yourself as the person that will go with her and support her.
Chances are this is nothing serious but it does need to be monitored and as long as she has you keeping an eye on her, I am confident that she will come through any issues that she has and maintain a healthy weight and diet.
I hope that helps.