Eating Disorders: How to Have the Hard Talk

If you suspect someone you suspect may be engaging in dangerous weight-control behaviors, it may be difficult to approach them with your concerns—but could also be life saving. Here’s how.

Are you concerned that a friend, family member, or student might be engaging in 
dangerous weight-control behaviors such as dieting, purging, or overexercising? Having a conversation may be difficult, but could also be life saving. To learn how, we spoke with Melody Moore, a Dallas-based clinical psychologist who uses yoga in her work with eating-disorder patients, Dianne Neumark-Sztainer, Ph.D., who researches body image and eating disorders at the University of Minnesota School of Public Health, and Bo Forbes, a yoga teacher and clinical psychologist who specializes in the application of yoga for psychological disorders.

1. Speak in private. Invite the person you’re concerned about to speak with you in a confidential space—perhaps after yoga, over tea, or during a walk. If others are around to overhear, your friend might shut down out of shame or fear.

2. Ask permission to speak openly. Doing this gives them a sense of control. If they don’t want to talk, or won’t admit they’re ill, don’t force it. Let them know you’re there for them if they want to talk later.

3. Give observations without judgment. Use statements like, “I’ve noticed you’re taking multiple classes a day,” or, “I’ve seen you’ve lost weight.” Don’t make assumptions or accusations: Saying, “You look so anorexic!” is the fastest way to send them running. Have them share what they are feeling by following up with open-ended questions, such as, “How are you doing? Are you OK?”

4. Offer resources and support. Decide what kind of support you can offer and set boundaries if needed. Can you share a meal with them bimonthly? A weekly cup of tea after class? And encourage them to get professional help: Come prepared with a list of eating-disorder resources in your community like therapists, nutritionists, treatment centers, and support groups.

5. For teachers: If you’re concerned a student could be physically compromised, set a firm but compassionate boundary. For example, “I’m worried I can’t keep you safe in my level 2 class. Until you’ve gotten medical clearance, here are some gentle, restorative, or yin classes I recommend for you.”