I don't know how. That's why I'm asking.

See, I've seen any number of nodes discussing the symptoms and effects of anorexia, and I've read several moving horror stories from people who starved themselves practically unto death. So I understand that anorexia is a serious and potentially fatal disorder. That's why I want to know how to keep someone from developing this problem in the first place.

I'm asking because I'm worried that a friend of mine might be developing an eating disorder. She's 25 years old, 5'7", 145 pounds--not scrawny, but not obese by any stretch of the imagination. She has broad shoulders and hips (as do most of the women in her family) and she's fairly muscular, so she's probably at or close to her healthy weight (her minimum weight at this height was 130, I think, at some point early in high school).

To my eyes, she looks fine. In fact, she's beautiful, and I've told her so. Not necessarily when she's openly worrying about her weight, but at other times, too. But she's not happy. According to her, she's pear-shaped, she's got a fatroll, she's got flabby thighs. It's nonsense...but it's what she thinks.

I really started worrying earlier this summer. We'd be driving around town, and all of a sudden she'd call my attention to a girl walking on the sidewalk. "Look at how thin she is!" she'd say, aghast, and she'd stare as we drove by. Usually it'd turn out to be a 13-year-old with twigs for legs--the sort of girl who happened to grow upwards before growing out. I said to her that this was silly--she was comparing herself to a girl who was not yet done growing. She sounded like she understood...sort of.

About a month ago, she mentioned that her weight fluctuates a lot. She gets herself down to a low weight, experiences insatiable cravings, eats tons of ice cream and cake and other fattening stuff, gains weight, hates the way she looks, then goes on a moderate diet until she slims down again. This isn't healthy.

Then, a few weeks ago, a bunch of us were picking fresh raspberries at a farm near my house. A few of us overindulged and ended up with gastrointestinal troubles that forced us to spend lots of time running back and forth to the toilet. Most of us were feeling pretty awful (and stupid, too), but not her. She was happy! She was down to 134 pounds, her lowest weight since she entered college. She said she'd lost the little fatroll that she'd had for years. She just stood in front of the mirror and smiled.

That scared me. She's ill, she's lost substantial amounts of water and nutrients, she's light-headed, but she's smiling and happy because she lost a few pounds--pounds that she'll quickly gain back when she rehydrates herself. In my more paranoid moments, I envision wheels turning in her head: "Diarrhea...good body. Diarrhea...good body. Hmm...."

So what can someone do in this situation?

I realize it's hard to give advice about people you don't know, and I don't want this to turn into a long GTKY node. I'm looking for generalities, if any exist. What should I say? What shouldn't I say? What are the ways in which well-intentioned people go wrong?

I'm starting a healthy, doctor-supervised diet soon (there's some obesity and heart trouble in my family, and after watching my dad's struggles, I'd rather not put on the weight in the first place). She's expressed some interest in starting one too, and I'd be happy to have her join me (subject to doctor supervision, too) so that she wouldn't fluctuate so much. Of course, a diet might be exactly the wrong thing at this time...but maybe it'd be a way to stabilize her diet while getting her under a doctor's eye.

So I'd be happy to hear any helpful advice.

To that end, let me point out that some responses that aren't helpful. Please do not tell me any of the following:

"How awful! I hope you find help! Of course, I can't possibly relate--I'm 5'7", 110 pounds, and a size 1 model!" Spare me.

"The prevalence of anorexia can only be alleviated by a thoroughgoing shift in the male-female gender/sex dynamic paradigm that results in the utter eradication of the patriarchial objectifying society that we..." Spare me this, too. I know that we should try to reduce the pressure that society puts on women. I'm looking for something I can do for this person--today.

"You pig! You node about porn! You're undoubtedly responsible for the distortion of her body image!" I do node about porn--and if you read those nodes, you'll see that I don't like a lot of it. I have very little porn in my house (most of what I do have is better considered erotica) and I don't leave it lying about where women can see it (that would be disrespectful). Whatever you may think about my reading habits, she is still my friend and may still need assistance.

"You idiot! You said the worst thing you could possibly say. Men don't understand anything." Actually, you can tell me this if you tell me what I did wrong, why it was wrong, and how I could do better. Knee-jerk man-bashing is unhelpful.

"Dear KNB: Make sure she gets help. Signed, Random Noder." Thanks. I know she might need help. That's why I'm asking. How can I help her? What sort of help does she need? What options are available? What resources are out there? What can I do when she doesn't have much of a problem yet?

She sounds like me, as far as size. Those are my exact measurements and weight. I love food, personally, but I truly know how she may feel as far as hating her wide hips and shoulders and thinking that depriving herself of food may change that.
Here are some ideas.
  • If she is like me, her skeletal structure has determined that she is destined to have broad shoulders and hips. No amount of starving herself will be able to change that. Maybe you can jokingly point that out the next time she seems to believe otherwise.

  • Encourage her to eat good food. Comment on how great it is. Find new, cool restaurants. Not hot dog joints. Food is totally kick ass and not something to be avoided.

  • At the same time, encourage her to do healthy things either by herself or with you. The doctor-aided diet sounds cool and she sounds somewhat interested. Yoga is another thing that is fun and feels great, physically and mentally. Do a yoga tape together or join a class. Ride bikes. She may not shed pounds because it sounds like she's at a healthy weight already. But she will feel better about herself physically each time she does these kinds of active things. Belly dancing is something else I'd recommend; not only is it fun and active exercise but it also lends to a woman feeling sexy about her hips and realizing how seductive they are. They have belly dancing classes at the YMCA and other places, as it is slowly starting to become a more trendy method of fun and laid back exercise.

  • Go out salsa dancing. First of all, its all about the hips, and if she gets into it she will start to feel totally sexy. But also, even if you guys don't feel like joining in right away, watching the more seasoned salsa dancers on the floor might be beneficial to your friend. She'll encounter tons of women with her body type who are completely flaunting on the dance floor and bringing men to their knees. I used to waitress at a salsa dance joint and it was incredible how amazing some of these hard-core people were! Its fun to watch and do, and there are tons of like crazy confident women of all shapes.

  • Tell her she looks great in tank tops because of her beautifully defined shoulders. Tell her how nice her neck and legs look because she's so tall. Tell her she looks dope as hell when she wears tall shoes or shirts cut a certain way. In other words, let her know how specific parts of her body are really sexy, due to her more womanly build. Better yet, occasionally point out other women you find sexy who in some way resemble her physical characteristics. Maybe she really will start to realize that her type of body is really beautiful and just a different kind than those skinny chicks. Like I said, I have the same kind of build and spent years and years comparing myself in vain to more slender women. However, I have never had a shortage of men finding my body attractive and at some point I had a realization that wide hips and shoulders really are sexy. What will make the difference in your friend as far as real attractiveness will undoubtedly be her self-confidence.

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