Concern about appearance is normal; it’s part of being a functioning member of society. But being overly concerned is not. What are the signs that someone you love may have an unhealthy preoccupation with appearance … and, in turn, an unhealthy relationship with food?

And, what—if anything—should you do about it?

“Granted, virtually none of us is ‘at peace’ with food,” says Betsy Cracco ’89. “But very stark rigidity—a long list of absolutely ‘forbidden’ foods, for instance, or eating the same foods every night, laying them out on the plate in a certain way—is one of the things I’ve seen that distinguishes a person with an eating disorder from someone with a less problematic concern with weight.”

“ When girls stop coming to the dining hall, back out of dinner plans, and just take pick-up dinner to go—and it happens repeatedly—that’s the first sign that something might be going on,” says Kristin Tyman ’04. “They don’t come out as often, they sleep more, they go to the gym a lot. They can become irritable and depressed.”

“ People need to trust their instincts,” adds Cracco. “If you look at a person, and you are struck by their extreme thinness, or you feel their habits are rigid or extreme, then these are warning signs.”

According to national experts, possible signs of an eating disorder include:

Anorexia:

• Extreme thinness—15 percent or more below normal body weight—yet the person feels fat
• Obsessive exercise, frequent weight checks, loss of appetite
• Feeling cold—even when others don’t
• Thinning hair
• Preoccupation with cooking and food—yet the person eats very little
• Cessation of menstruation

Bulimia:

• Overeating and/or binge eating as a response to stress
• Frequent purging of calories just consumed
• Frequent weight fluctuation
• Swollen glands
• Obsessive concern with weight—but the person generally fails at dieting
• Menstrual irregularities

What should you do if you recognize these symptoms in another person over a period of time? You may be afraid that, by trying to help, you will lose a friend, or your family member will become angry or resentful—and that may very well happen, according to Cracco and Lipsitz.

But that doesn’t mean you shouldn’t try anyway.

The first step, says Cracco, is to explain the specific situation to a professional, in order to obtain some helpful coaching. In extreme cases, when the person’s life is in danger, immediate medical attention may be necessary. And if a student’s behavior disrupts the dorm community—if she vomits in her bedroom or fails to discard bags of vomit, which Lipsitz says can happen—school officials will step in to handle the problem.

But for less drastic situations, you may be advised to discuss your worries with the person, gently and lovingly.

“ To approach someone with a laundry list of the eating behaviors you’ve been monitoring for the past month obviously puts them on the defensive,” says Cracco. “The main task is communicating concern for the person, not condemnation of the behavior. There is already enough shame.

“ You might note one or two of your most compelling reasons for concern, and offer to assist the person in getting help—perhaps through the Counseling Center,” she continues. “Communicate that you are there for them and will continue to care for them.”

The person may reject your appeal out of hand. And even if the individual does agree to seek help, it may take a while before he or she is truly ready to accept it. So patience is key.

“ You cannot just send someone to the Counseling Center, and they will get better,” says Lipsitz. “They have to be ready. We cannot make people ready. We can try to make people ready, and we can help people who are ready. But if they’re not, they may have to go through several iterations of this process.”

The important thing is to persevere.

“ If you see someone is struggling, don’t say things like, ‘eat this, you look great’; instead, ask them if they are OK,” suggests Caroline Fallon ’03. “Just try and do what my roommate did: keep them in the circle of friends. And tell a parent or adult who can use their authority to help. The sick person is going to hate you. But believe me, we get over it.

“ I thank God for the girl on my high school basketball team who told my coach I was throwing up in the bathroom, and for my roommate who told my parents I wasn't doing well," she adds. "They were angels in disguise. The worst you can do is nothing. And the best you can do is be there."

M.M.

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