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What Shoud I Do? What to Say? The Role of the Educator
Nutrition DO's and DON'Ts? How to Survive an Eating Disorder What Helped Me get Better


Talking To Someone You Care About When Their Eating
Seems To Be Causing Problems, Or Perhaps Has Become One Itself


Adapated from Rahn Fleming, Substance Abuse Counselor/Education Specialist, Dartmouth College
MOTIVATION: I CARE
The most legitimate reason to address what may or may not be an eating disorder in someone you know is in response to your own gut feeling. That is, if/when you feel the need to say something, it is okay, even important, to do so. Reasons: avoiding the issue almost invariably leads to additional anxiety with each succeeding problematic eating/dieting episode; your own sense of emotional integrity, your own need, to speak to the issue, and to communicate to individuals that you have noticed and you care about them. These reasons are unto themselves necessary and sufficient.
You do not need to wait until she/he has a full-blown "eating disorder." It is easier, and just as powerful, to address those problems in the individual's life that seem to you to be directly related to his/her bingeing-purging-dieting. Again, making clear that the reason you are doing so at all is not to label them, but because you have noticed and you care.

MESSAGE: I SEE, I FEEL
Be simple, specific, and concrete. Identify two or three instances, specific incidents, that clearly demonstrate the problem(s) that have you concerned.
Say what you saw: what was said, what was done, where it occurred, when it occurred, who else was there (ask this person to join you, if they are willing). Make it clear how, in your judgment, weight or food played a role in the events cited.
Say how you felt (angry, frustrated, hurt, embarrassed, scared, etc.). Do this in such a way as to be referring back to those emotions, not talking from them. For purposes of this conversation, the focus needs to stay on the person being confronted, and the tone needs-as much as possible-to stay calm and caring.
Do not try to be a diagnostician. It is a role that can back you into a corner and cost you the connection you have with the individual you are confronting. When speaking to him/her, keep your observations to a level of XXXX seems to be associated with these problems" rather than "your eating is a problem." If a person denies that their eating is causing them any problems, cite "the things you do when you eat/do not eat" or "the things that you avoid when you get so wrapped up with food are becoming a problem for (name the people involved). We are concerned that ...." "

GOAL: I EXPECT,I HOPE
To confront a problem without offering some means of a response is okay, but not as effective it could possibly be. For purposes of a Peer-intervention, it is most helpful to suggest some manner of remedy for the person you are talking to: most often an appointment with a counselor.
'I may be right or I may be way out in left field on this. It is not important that I am right or wrong. I think it is important that you fmd out what is true for you. I am willing to be wrong. But I am not willing to leave this unsaid. Because right or wrong, I am worried and I care."
In-house expectations can be established too within the realm of the shared living quarters, the relationship, or the situation. Do not set any bottom lines you cannot or will not uphold. In the long run, these only teach the person that it is okay to continue to abuse food, even if it upsets you a little-nothing is ever really going to change.

SUCCESS; I LET GO

For the purposes of peer-intervention, a successful confrontation is one that has happened. Unless there is a formal intervention with clinical guidance, a clearly defined bottom line, and treatment expectations, your peer-inteNention will be a success because you have the courage to make it happen. Hold true to whatever expectations and bottom-lines you have established, and you have done all that you can.
It is possible, perhaps even likely, that the person you are talking to will become angry. Expect it, and you will not be as disappointed. If this is the case, know that "anger" is the natural next step when "denial" is broken through. If the individual becomes vem, angry, this is in and of itself important information. Respect the anger and, to the best of you ability, try not to personalize it. Let them know that you are not turning your back on them, nor are you attempting to instruct then on how to live their lives. You simply saw a situation that-as a friend who cares you needed to address. You will be available to them if they want to talk about it further.
If that still does not feel like enough, seek out the help of a counselor to determine what next step to take. Again, your need to do so is reason enough.
Reprinted with permission from Dr. Marcia Herrin. For more information contact: Dartmouth College Nutrition Education Program (603) 650-/4/4 or: Earing Disorders Awareness arid Prevention, /nc., 603 Stewart Street, Suite 803. Seattle, WA 98101. (206) 382-3587.