My roommate obsessively tracks her calories and I think she has an eating disorder. How can I confront her without sabotaging our friendship?

Refresh Mental Health

One of my roommates and close friends eats a very restrictive diet. I see her document her calories in a journal and punish herself for “bad” days when she goes over a certain amount of calories. It’s been going on for almost a year.

I know everyone should be empowered to follow a way of eating that works for them, and I want to respect that, but her calorie-counting seems extreme to me and it’s hard to ignore. It may be a sign of an eating disorder, but I don’t want to assume anything.

I care about her and don’t want her to do something that’s harmful to her health in the long-term. Should I talk to her about it? If so, how should I go about it? Or, is it not my place to intervene?

– New York

Dear New York,

You love someone who’s going through something that could seriously negatively impact her physical and mental health, so it’s absolutely your place to intervene. It’s just about finding the right way to do so.

Before you ask your friend to sit down for a difficult talk, you should make certain her habits align with those of an eating disorder. Andrew Walen, the founder and executive director of the Baltimore-based Body Image Therapy Center, suggested reading online resources like the National Eating Disorder Association’s website to bolster your knowledge of eating disorders before you get into the details with your friend.

If her behaviors seem to align with what you learn, you’ll have to tell your friend that you want to have a serious chat with her. Choose a place and time that’s private since the matter you’ll be discussing is sensitive and there is a chance she won’t have the most positive reaction to your awkward, albeit necessary, confrontation.

When you initially bring up your concerns, Walen recommended using what he calls the four-step DESC model. Here’s how it works:

1. Describe what you see.

Start by telling your friend about the alarming behaviors you’ve witnessed. Walen said it’s important to focus on only the facts, not your opinion, so you could say something like, “I’ve noticed that for about a year now you’ve been documenting your calories in a journal.”

2. Express how you feel.

Next, explain how you feel about what you’re witnessing, such as fear or concern that your friend is harming her health.

3. Specify what you hope she does about the situation.

Walen said it’s important you suggest an actionable way your friend can improve her health and heal from her disordered eating. It can be as simple as “I hope you and I can read some online resources together about the risks associated with eating disorders” or “I hope you seek out help from a therapist.”

4. Create consequences.

Perhaps the most difficult part of your conversation will be telling your friend that if she doesn’t address her potentially dangerous behaviors, there will be consequences. That doesn’t mean a punishment, though. Simply saying, “If you do this you’ll be so much happier and healthier” could work, Walen said. You could also frame the consequences in terms of what could happen to your friend’s health if she continues down this path.

This emotionally-charged conversation won’t be easy to get through, and Walen said you should “expect a strong reaction” from your friend, whether she becomes angry or tells you she’s relieved someone finally called her out on her unhealthy actions.

If your friend has a visceral reaction to your confrontation, remind her you brought this topic up because you care and stay calm. “Don’t argue,” Walen said. “Go back to statements like, ‘I hear what you’re saying, but I hope you hear what I’m saying, which is I love you and am concerned about you. Would you at least consider that what I’m seeing is frightening?'”

Following this tough conversation, you may have the urge to keep trying to persuade your friend to get help even if she seemed resistant at first. In this case, Walen said you have to put yourself first, as hard as that can be. For you, that may mean moving out of your shared apartment if she continues to exhibit unhealthy behaviors despite your support.

“If you force them, they won’t get very far. They’ve got to be ready to accept help to some degree,” Walen said.

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