Taking good care of our health and physical fitness is important for all of us, but some people can take it too far, which can lead to an eating disorder. In fact, an estimated 24 million Americans (teens, adults, men and women) meet the criteria for an eating disorder.

Signs of Eating Disorders

So how do you know if a friend has an eating disorder? After all, someone who has lost a lot of weight may have another type of health condition or might have been overweight and deliberately tried to eat better and exercise more.

But certain signs can indicate a problem. It might be time for concern if someone:

  • Exercises all the time, even when sick or exhausted, and might talk about compensating for eating too much by exercising or burning off calories
  • Avoids meals with others or in public or arranges food around on the plate without eating
  • Wears big or baggy clothes as a way to hide his or her body and shape
  • Goes on extreme diets (for example, eating only clear soup or only raw vegetables)
  • Seems to compete with others about, or be proud of, how little he or she eats
  • Goes to the bathroom a lot right after meals, or vomits after eating
  • Obsessively criticizes his or her own weight or specific body parts
  • Appears to be gaining a lot of weight even though you never see him or her eat much
  • Is very defensive or sensitive about his or her weight loss or eating habits
  • Buys or takes stimulants, diet pills, laxatives, herbs or other medicines to lose weight
  • Has a tendency to faint, bruise or become easily cold

How to Help

Eating disorders can be caused by -- and lead to -- complicated physical and psychological illnesses. Many people with an eating disorder also have problems with anxiety and depression. When you're trying to help someone with an eating disorder, remember it isn't just about food.

  • Start by talking to your friend privately about what you've noticed. Explain that you're worried. Be as gentle as possible, and try to really listen to and be supportive.
  • It can be hard trying to help someone who isn't ready or doesn't think help is needed. If your friend tells you it's none of your business or there is no problem, trust your instincts and be the best friend you can be, even if that means telling your parents or another trusted adult about your concerns.
  • If your friend opens up about what's going on, ask how you can help. Tell your friend you want to help him or her get healthy again. Simply ask, "How can I help?"
  • Try not to be too watchful of your friend's eating habits, food amounts and choices. It can be tempting to try to get a friend to eat more if they are struggling to eat, but it may push your friend away if he or she thinks you're judging, lecturing or just pushing weight gain.
  • Focus on inner qualities. Try not to talk about food, weight, diets or body shape (yours, your friend's or even a celebrity's). Focus instead on your friend's strengths -- like how someone is a good friend, has a fun personality or has talents in something like math or art.
  • Remind your friend that you're there no matter what. Listen and be supportive. Sometimes the best thing you can do is ask, "What would make you feel better?"

People with eating disorders often have trouble admitting that they have a problem -- even to themselves. They may feel guarded and private and worry that people will try to make them eat or gain weight. It might be difficult for you both, but helping them get the help they need to heal can save their lives.