Body Image and Eating Disorders: My friend says she doesn’t have an eating disorder, but I think she does

A few mornings ago it happened again.  While staring at the TV in my “I desperately need more coffee” stupor, another ultra thin, bony movie star denied that she has an eating disorder.  I almost flipped channels on her because I am very tired of all the denial in Eatingdisorderville.  I don’t keep up on celebrity tidbits, but my morning wake-up show interviewed this woman.

This is not an uncommon denial.  I know several people who deny that their thinness is the result of an eating disorder.  Yet I sense they are extremely uncomfortable around food and are hyper-critical of their bodies.  On the other hand, I have a beautiful friend in her fifties who is thin yet does not have an eating disorder.  People have been quick to accuse her, yet I have been with her on several long trips and could not help but notice her relationship with food.  She definitely does not have an eating disorder.

Don’t get me wrong. I don’t sit around and observe what people are eating and not eating.  Yet at the same time, due to my training and experience, I have noticed how many thin women meet the criteria for anorexia yet deny having an eating disorder.

From Behavenet:

“Early signs may include withdrawal from family and friends, increased sensitivity to criticism, sudden increased interest in physical activity, anxiety or depressive symptoms.

  1. Refusal to maintain body weight at or above a minimally normal weight for age and height (e.g., weight loss leading to maintenance of body weight less than 85% of that expected; or failure to make expected weight gain during period of growth, leading to body weight less than 85% of that expected).
  2. Intense fear of gaining weight or becoming fat, even though underweight.
  3. Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.
  4. In postmenarcheal females, amenorrhea, i.e., the absence of at least three consecutive menstrual cycles. (A woman is considered to have amenorrhea if her periods occur only following hormone, e.g., estrogen, administration.)

Specify if:

  • Restricting Type: during the current episode of Anorexia Nervosa, the person has not regularly engaged in binge-eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas)
  • Binge-Eating/Purging Type: during the current episode of Anorexia Nervosa, the person has regularly engaged in binge-eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas)”

If you think a friend or relative may have an eating disorder and is denying it, research the subject carefully and proceed with love.  In my experience, the majority of women who are excessively thin do have eating disorders.  Obviously this is a tough call because sometimes it is difficult to know.  Yet if you sense an extreme fear of fat, and/or a magnified fear of food, you may be on to something.  At that point, it is best to educate yourself and to proceed carefully in loving her and calling her (or him) to glory.  Normally the first place to start is to learn all you can about the eating disorder.  And then tread lightly, remembering that to engage her in a power struggle about her denial is generally not a good idea.  Sometimes interventions work well, but before you proceed, study the subject from good sources.  I recommend  Then you can begin the process of calling your friend or relative to glory.  After all, that’s what friends and family are for.   Because if you don’t, she may end up robbing herself in terms of life expectancy.  The prognosis for untreated eating disorders are dark, yet  the glimmer of hope abounds with experienced eating disorder specialists.


  • 5-10% of anorexics die within 10 years after contracting the disease and 18-20% of anorexics will be dead after 20 years.
  • Anorexia nervosa has the highest death rate of any psychiatric illness (including major depression).
  • The mortality rate associated with anorexia nervosa is 12 times higher than the death rate of ALL causes of death for females 15-24 years old.
  • Without treatment, up to 20% of people with serious eating disorders die. With treatment, the mortality rate falls to 2-3%

2 Comments Add yours

    1. Sorry it took me so long to respond. For some reason, your comment ended up in my “spam” box. 😦 Thank you for the trackback. Take care, Cherrie


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