How to help a roommate with an eating disorder

Originally Published: May 1, 1994 - Last Updated / Reviewed On: April 19, 2013
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Dear Alice,

I am writing in hopes that your answer to this question will help other readers. A few years ago, when I was in college, I discovered that my college roommate was bulimic. My boyfriend and I found evidence in the mornings that she had been vomiting on a daily basis; she also developed weird eating habits (at 6 A.M., she would wake up and buy two pints of ice cream and eat it all, and then not eat for the rest of the day). We didn't know how to address the problem, and were afraid of hurting her. When we called the Health Service, they took the "my best friend is bulimic" line to suggest that I was bulimic instead! I didn't want to become the food "hall monitor" — are you eating? What did you eat today? etc. — but we tried to include her in healthy meals.

Eventually, some other stress factors in her life calmed down and her binge/purge behavior seemed to subside. However, I've always regretted that I couldn't attack this situation head-on. Do you have any advice for people that might be in a similar situation?

—Signed,

For future reference

Dear For future reference,

Living with someone who has an eating disorder can be incredibly stressful. It is certain that others, similar to yourself, notice unusual eating patterns among friends, loved ones, roommates, partners, etc. that they later learned were signs of an eating disorder. Eating disorders affect people of all ages, ethnic backgrounds, and sexual orientations.

Your helping strategies depend on whether or not this is an emergency situation. If this were an emergency situation, for instance, the person is blacking out, losing significant amounts of weight, sleeping all day, and/or expressing suicidal thoughts or attempts, then do not try to deal with the situation politely or gently. Tell your resident advisor (RA), residence hall director (GA), or someone else who can help to get the assistance and support you need to intervene. If you are at Columbia on the Morningside campus, you can call Counseling and Psychological Services (CPS) at 212-854-2878 or Medical Services at 212-854-2284 for an appointment. CUMC students can contact the Mental Health Service or Medical Services at 212-305-3400. Morningside students can also use Open Communicator to make a primary care appointment. If this were an extreme emergency, you would need to call your campus's volunteer ambulance service, if there is one at your school, which should come with security. If you are at Columbia, you can call CU-EMS, Columbia University's Emergency Medical Service, at 212-854-5555.

If this were not an emergency situation, a good roommate or friend may be the best person to express concern and get her to help. You can choose to speak with your roommate directly, or you can do things that are less direct — such as place pamphlets about eating disorders around the common living areas; you can attend a seminar or workshop on eating disorders, body image, or healthy eating and invite your roommate to come with you; or, set up an appointment with a mental health provider to discuss ways to help your roommate.

If you choose to speak with your roommate directly, pick a time to talk when you are feeling calm and both of you have plenty of time. Choose a time and place where you will not be interrupted. Start off by keeping your observations away from food or her body, and on her non-appearance oriented traits — such as what a good roommate or person she is and/or how much you care about her. Focus on expressing your concern by conveying your observations about her health or behaviors. Tell her that you are worried. Make sure she knows you value her and highlight for her the qualities in her you appreciate.

If your roommate seems receptive to your thoughts, you can mention the following things in your conversation:

What you see that makes you think there is a problem: Be specific about what you see regarding her eating, purging, exercising, or starving behaviors. Your observations, rather than evidence of wrongdoing, can be discussed gently if you focus on your concern. Stick to the issue — if she changes the subject, ask her when would be a better time to talk.
 
How you feel: Use "I" statements to express your feelings about what's happening to your roommate: "I'm upset because I've noticed that you don't eat meals with us anymore," or "I'm concerned because you complain about how fat you are all the time. I think there's something wrong."

What you would like to see happen: Make sure that your goals for the conversation are attainable. Your goal is NOT to stop her from bingeing, purging, or starving. You would most likely end up in an ineffective control battle. A realistic goal is simply to open the door to talk, either now or in the future, and to encourage her to take steps to get the help she needs and deserves.

This may be a difficult conversation, and you can try to keep it from becoming an argument. For example, if you become upset, ask if you can continue the conversation at another time. Also realize that your roommate may need to hear your worry several times before she's willing to have a conversation with you about it.

Remember, regardless of her reaction, you can know that you've tried to help her. She's lucky to have you as a roomie.

Alice