(1) Dear Alice,

I've recently just found out that my boyfriend of four years is bulimic... He hasn't told me, but I have put the puzzle pieces together after living with him for the past 18 months... I had even heard him purging in the bathroom while we were on vacation. I'm really struggling with this information and I don't know how to approach him about it... I'm guessing it has been going on for around six years now. How do I confront him about it??

(2) Dear Alice,

I was wondering if bulimics lose weight rapidly, because I have a friend who I think may be bulimic, because she eats, but I think she may be throwing up her food. She has lost 25 pounds in the last month. She binges, and I would like to know how I can help her.

Dear Readers,

Your loved ones are lucky to have someone like you in their lives, who observed a change that concerned you enough to ask for help and learn more about what could be going on. The changes and behaviors you’ve both observed can be cause for concern and may be indicative of disordered eating. Keep reading to learning more about the signs commonly associated with eating disorders and ideas to help you have a conversation with your respective loved ones. It can be a challenge to broach this sensitive topic with someone you care about, but it’s wise to not wait to talk with them about your concerns so that, if needed, they can get connected to resources and get on the road to recovery sooner.

It’s not always easy to tell if someone is struggling with disordered eating. There are many signs that may indicate a more serious issue, including:

  • Being preoccupied with their weight, sometimes with a focus on particular body parts  
  • Being defensive, competitive, or sensitive about their weight and eating patterns
  • Exercising a lot, even when they’re feeling ill or tired
  • Finding excuses not to eat and avoiding social situations where food will be present
  • Using the bathroom frequently, particularly after meals
  • Losing or gaining weight quickly and without explanation
  • Constantly dieting or using diet pills, laxatives, medicines, or herbal supplements to lose weight

Readers, you’ve both observed worrisome behaviors in your loved ones. As such, it’s wise not to delay a conversation about your concerns so that if they’re dealing with disordered eating, they can get to the help they need and get started on the recovery process. It may not be the easiest chat to have with her/him, but with a little prep work and a few tips, you can make a plan to communicate your support and how much you care. Consider the following to help you structure your conversation:

 Before you talk:

  • Learn more about disordered eating and available resources. Do a bit of searching to get up to speed on the latest information on eating disorders. There are a number of great resources online, such as the National Eating Disorders Association. You might also look into services and resources that might be helpful to your loved one. If you're a college student, you can reach out to a number of folks such as your resident adviser (RA), a health care provider at your university or college health center, or a mental health professional from your campus’ counseling services.
  • Set aside time to talk. Ask your loved one about a time that they would be available to talk. Try to find a time and location where the two of you can sit in a relaxed environment with enough time to talk privately.

During your heart-to-heart:

  • Validate your relationship. Convey that you care and that your concern is genuine. You might say, "I value our friendship/relationship, and I hope you know that I care about you."
  • Share your concerns. Use "I" statements to express your feelings about what you've noticed, such as "I'm worried that something is going on with your health." You might also want to talk about the signs and behaviors that are worrying you. Try to be specific with examples of times when you’ve made these observations.
  • Try to keep the emphasis away from weight, appearance, and food. Sometimes the most seemingly innocent statement can be misinterpreted and unwittingly close a door you had planned to open — particularly if your loved one feels judged, shamed, or that you’re making demands about how to move forward. Additionally, try to avoid giving overly-simple solutions, such as suggesting that they just stop the concerning behavior.
  • Share information about the resources you’ve researched if they seem open to it. It’s best to let them know that these are available in a way that doesn’t feel like you’re telling them what to do. If you feel comfortable, you might also offer to go with them to seek out these services or resources.
  • Reiterate your continued support. Let them know that you'll be there for them as a friend or partner when they're ready to take action.

Again, kudos to you for being a caring friend and partner, Readers. With that in mind, it’s good to bring up one last point: though you’ll be taking a big step to help someone you care about by having this conversation, it’s ultimately up to your loved ones to make a change. When it comes to disordered eating, recovery takes time and patience — even for those in supportive roles. As you continue to provide encouragement and support, it’s critical that you take time for self-care. This may mean calling on others for support, including other friends, family members, or even speaking with a mental health professional. It may also mean prioritizing whatever helps you relax and de-stress.

Best of luck,

Alice!

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