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Confronting Someone with Signs of Anorexia


Professional counselors use a process when confronting someone with anorexia or bulimia. The end goal is to get the patient to agree to, and participate in, treatment to get better. But it’s sometimes difficult to get an anorexic to see a medical professional in the first place. This means the goal of confronting someone is to get them to the next step -- seeing a professional.

Why a Professional?

Anorexia can be a fatal condition. It isn’t just something that goes away on its own. In this sense, it is no different than diabetes or obesity. If the person shows signs of anorexia, they need to be evaluated and they need help. Anorexia treatment works, but like other medical conditions, expertise is required.

With that in mind, before you broach the subject, have some resources in mind. You should be able to offer these as a next step if the person you are confronting agrees they need help. It doesn’t have to be set in stone, but you should have a concrete plan and real options to offer. This might mean checking out specialists in your area or seeing what medical insurance will cover.

Broaching the Subject

If you have some physical condition you ignore, you already know what the likely reaction will be. In the US, it’s easy to find people who are obese or who smoke. Bringing up these problems immediately engages a defensive mechanism. From their perspective, it feels like you are judging them as having a flawed character. Denial and avoidance are the quick defenses. But that’s why it’s called confrontation.

To broach the subject, start with the facts. Come at it from a place of concern for their health but without being overbearing about it. The facts are your ally here. Whatever you have noticed, they have noticed as well. Stay away from conclusions, but don’t shy away from telling them your are concerned about weight loss, the fact that they’ve been purchasing clothes which conceal their shape or any of a number of anorexia symptoms.

Don’t Back Down

It’s very easy to react in kind when someone you’ve confronted strikes back in anger. Just realize this is a normal reaction to what we feel as an attack or harsh criticism. Don’t buy into that. It’s up to you to keep a level head.

When the conversation is uncomfortable, it’s very easy to shy away from the subject and lose sight of your goal. Resist this. They need help. Putting off further confrontation just means that help is delayed and the danger for them increases. If getting treatment means they will do it just to, “get you off my back,” well, so be it.

Look for an Opening

Most people who suffer with a behavioral condition will admit some small part of it when confronted. They might something like, “Well, I am getting more tired than normal.” When that happens, use it. You’ll have to listen in an understanding fashion, but later in the conversation, you will repeat their own words back. So, in our example, when they reject seeing someone, you might say, “But you did mention you don’t have the same energy level. Let’s see what a doctor has to say.”

Confronting is part of healing. It opens the door to progress. But it’s also a learned skill. Here’s a model that counselors find useful, using the acronym CONFRONT.

Overall, remember that you may be the only life line they get. You can’t give up or stop trying. Ultimately, the decision to get well is up to them, but every time you bring it up, that’s another chance for them to make the right choice.