How to help, but not step on a friendship...or sometimes do you have to step on it?

Nurses Relations


A friend that I ride with is very seriously ill with an eating disorder. She is only 1 and it has been going on for quite some time (I noticed the bones sticking out of her hips last summer) but this summer her hips even stick out her back, and you can see all the notches on her sternum her face is so sunken and their is no fat on her body never mind muscle (her body already ate the muscle she had). she was always tall and skinny but now it makes me so sad to even see her. My coach, and many of the parents have approached this girls mother to try and help, but the mother isists that their is not a problem. she sais "I took her to the doctor and he said that as long as she stays over 80 pounds it's ok".

I can't imagine a doctor would ever say that, she has to be at least 5'5 (I'm guessing compared to my height) but my question is how can I help a friend that so desperatly needs it, when even her mother isn't lisening?

I don't see her as much as I used to, but can I help with out losing a friend? (but I feel like if I don't help she won't survive)... but maybe trying to help will help her survive, and ensureing that she has a life is more important, and to maybe prevent her from getting any sicker...?

she is so week I'm surprised that she can even stay on her horse. she had to quite her job at the barn because she can't even lift a pitchfork long enough to clean a stall. watching her ride when everyone else is all flushed from heat and effort, she is green looking like she can't make it around the ring one more time. Her boots are the same ones from when she was 13 and the hang off her caves when they used to be tight (and are meant to be)

when looking at her, I can picture the skelitons in anatomy lab and how all the bones are sitting in her body, I shouldn't be able to label the bumps on bones while looking at someone (with cothes on).

thanx for letting me express this.


693 Posts

I wonder if there is something else going on with her besides an eating disorder -- like a gastrointestinal disease that her mother would know about but they don't want to make public. Sometimes certain diseases -Crohns, for example -- can interfere with nutrition absorption and can make a person appear anorexic.

Of course, if you know that she never eats, then there is nothing to be absorbed in the first place.

I would see nothing wrong in your bringing up your concern over her weight loss when you have privacy with her. Just mention to her that you are concerned that she seems to have lost too much weight, and you what you can do to help her. She may not be open to talking, but at least you have opened the door for her. You can even tell her that you are afraid of losing her.

You are a kind friend to want to help her, and to be concerned about her well-being.


Tweety, BSN, RN

33,566 Posts

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

I'm so sorry to hear about your friend. Basically all you can really do is let her know you are there for her and that you care. Sounds like other people have done tried to intervene.

Good luck.

heart queen

206 Posts

Your post states she's 1 and from the 5 foot description, I'm guessing in her teens. You're in a precarious postion, where many people would take and hands off approach because it is the safest.

If you really, I mean really itend to intervene, you may loose a friendship and possibly save the child. The mom seems to either be existing with herself so far in denial or just plain abussive to allow it to continue, or not sharing the medical condition which may already be known (far fetched though).

I have a daughter with an eating disorder, so I've been there through the burry by head in the sand bit.

I could't get through to my daughter so I enlisted a friend, to approach my d, who was the one to get her to admit to here purging. If this IS an eating DO, the "victim" will do ANYTHING to protect and hide, keep, their disease. It is their only means of controll. They will Lie, and Lie to protect their disease.... period.

Now, mom not interveining is neglect, regardless of the intent, lack of insight, is neglect. for >5 foot the normal body weight is >80 lbs. NO MD would state this, mom is lying. period.

You are faced with, if you intend to intervene, and live with yourself if you don't.....approaching mom and kid seperately, helping mom understand the needed therapy and treatment... calling child protective services, if mom doesn't get treatment see if there is a "hidden disease" and they don't want to share it.

If you speak to the child, just be upfront, are you making yourself vomit? have you noticed your weak, what did you eat yesterday, did you keep it down, are you stressed and having a hard time dealing with it... are you very sick and the family has decided to keep it a secret?

you are left with very few options; ignoring it, getting involved with a huge mess in which the standpoint from a friend will limit your involvement, or making a VERY difficult, possibly lifesaving call to CPS

I'm surprised you haven't received more advise, most hands off, which is the easiest path, but I don't suspect it to be the right one.

Mind you, I'm writing as a parent of a child with bulemia, so my vision, and advise may be well of the mark. I can tell you I saw the same things in my daughter, and it took my oldest daughter telling me "I think .... is throwing up after each meal"... to knock my butt from denial into action as well as a best friend who was trusted by my daughter to approach her and she admitted to her actions.

again, I may be off my rocker (frequently am), but your message is screaming someone take action to me and quick. This is a tough one.... thinking about you. let us know

pm me if you think it'll help

heart queen

206 Posts

try it's a support group for those with eating DO.

Somehow it sounds the parent in the situation may be either in denial, or in support of the daughter's weight loss. Some parents push their children to perfection, to a point the child has no control, but to control their eating. And that may result in the eating issuse; of course there are hundred factors that can play into the psychology of an eating disorder.

Unfortunately eating disorders, much like substance abuse can only be helped when the person suffering is ready to help themselves. I struggled with anorexia for a year, then took on bulimia for about two years. I was terrified when Iwas confronted by my family physician at 17 years old. He seemed "onto me."

I cannot think of anything you can do, perhaps notify the school psychologist? I do not know if that would be overly intrusive. I am certain her teaches have concerns, and may have voiced them already. One of the best approaches would be if a classmate approached a school counselor or nurse.

As another poster noted a hands-off approach seems the easiest. Altho, I tend to agree with her, that someone needs to le tthis girl know they see what is happening. Anorexia/Bulimia (in my experience) is a "secret" disease, a lot of time; once the person with the illness is confronted that is enough to scare her into seeking help. Obviously as a minor she will need her family's assistance.

The MD claiming the 80pound thing is a bunch of @$#%. The mother is clearly lying about this, I just cnanot imagine this being said to her by a md. Perhaps the daughter told the mother this?

Or like I said, this is a parent who demands perfection of her child. And the child is responding this way.

More that i think about it, I lean torwards notifying the guidance department of your concerns, or the school psychologist. I am certain teachers have raised concerns already.

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