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I have a friend 22 years old. She has lost weight dramatically over the past 6 months. Last time I saw her she was approximately 42 kilos and she is 1.56 cm. I saw her again this christmas and she has lost more weight. Her eating habbits indicate an eating disorder as she only eats salads and little white meat such as chicken or turkey.

She has always been concerned with her weight, she has also problems with her family from a young age. Her attitude has changed dramatically, from an outgoing person full of life she has become very quiet and has withdrawn from her old friends. She spends a lot of time at home and rarely goes out. She says that she wants to gain weight but yet still diets. I have tried speaking to her mother and her sister but it seems that they are in denial. I have spoken to her other friends but they are in the same situation as me; they do not know what to do.

She is currently in Greece at the moment but will be moving to new york in a few days. What would you advise me to do ?

Answered by: Michael Devlin

Thanks for writing in with this question. Having a friend who appears to have a serious problem but who is not interested in treatment is one of the most difficult situations a friend can be in. Your friend is definitely in a low weight range - her body mass index is something less than 17.3 kg/m2 (which is what it was when she weighed 42 kg at a height of 1.56 m), and this is well below the cutoff for adequate nutrition. It is impossible to make a diagnosis just from a brief description, but your friend seems to have a constellation of symptoms that includes components of an eating disorder and other components that may or may not have stemmed from the eating disorder.

As far as what you can do, usually the best thing is for you (and the other friends) to let your friend know that you are concerned and that you'd like to help her to get help. The other very important piece is to find out about treatment resources so that, if she does become willing even just to go for a consultation, you can be ready with information about where to go.

It can sometimes take a very long time for people to become willing to seek help, but having a good friend like you always means a lot to people suffering from illnesses like this, even if they are unable to tell you so.