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When a friend has an eating disorder

There is no easy solution to helping a friend with an eating disorder. Sometimes any action you take will seem wrong in retrospect. Whilst it's important for you to be a valuable source of support for your friend, it is also important to encourage her to seek professional help, as eating disorders can have serious medical complications. However you decide to deal with your friend's eating disorder, you should try and remain as understanding, open and compassionate as possible. The guidelines below may be helpful as you decide how to cope with this situation.

What should I do first?
To start with, get a broader perspective on eating disorders by reading up on the subject. The Eating Disorders Association provides brochures as well as telephone support for families and friends. Helpful books include Let me be (Crisp--£10) and Getting better BIT(E) by
BIT(E) (Schmidt & Treasure--£8) both published by Lawrence Erlbaum Associates. This information may also prove useful to your friend once you confront her about her problem.

Once you feel you have a basic understanding of eating disorders and feel confident enough to have a conversation about them, choose a confidential and relaxed setting for the discussion to take place.

Before you speak to her, educate yourself on the five stages one usually goes through when recovering from eating disorders.

• Pre-contemplation. Your friend doesn't accept that she has a problem. She has no motivation to change and would claim that the problem seems to lie in others, not herself.

• Contemplation. She accepts the possibility that she may have a problem, but isn't ready to address it practically. She is ambivalent.

• Preparation. She has accepted the need for change and treatment but is fearful of taking the final step.

• Action. She has made a decision to get help and has an increased need for support. Taking practical action often creates emotional turmoil as the reality of the situation hits home.

• Maintenance. Change has taken place and now the challenge is relapse-prevention.

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