Creighton University

Confronting

When confronting a person with an eating disorder, it's important to have a plan.  A confrontation can be difficult because those suffering from eating disorders are often in denial and the topic is very sensitive.  Even if a person does deny the problem, the initial seed has been planted. Hopefully at some point in the future, the problem will be recognized and admitted. Your assistance in confronting a person with an eating disorder may make a big difference in helping them make the decision to seek help and begin the process to recovery:

The Plan: "CONFRONT"

C- Concern.  The reason you are doing the confronting is because you care about the mental, physical, and nutritional needs of the person.
O- Organize.  Decide in advance who will be involved, where to confront the person, why the concern, how to talk him/her, and when is a convenient time.
N- Needs.  What will be needed after the confrontation?  Professional help and/or support groups are options to consider.
F- Face the actual confrontation.  Be empathetic but direct.  Do not back down if the problem is initially denied. 
R- Respond by listening carefully.
O- Offer help and suggestions.  You may want to encourage the person to contact you when there is the need to talk to someone.
N- Negotiate another time to talk and a time frame in which to seek professional help.
T- Time.  Remember to stress that recovery takes time and patience.  However, there is a lot to gain by the process and a lot to lose if the choice is made to continue existing habits.

Some things to do:

• Talk to the person when you are calm, not frustrated or emotional. Be kind. The person is probably ashamed and fears criticism and rejection.
• Mention evidence you have heard or seen that suggests disordered eating. Don't dwell on appearance or weight. Instead talk about health, relationships (withdrawal?), and mood.
• Realize that the person will not change until s/he wants to.
• Provide information.
• Be supportive and caring. Be a good listener and don't give advice unless you are asked to do so. Even then, be prepared to have it ignored.
• Continue to suggest professional help. Don't pester. Don't give up either.
• Ask: "Is doing what you are doing really working to get you what you want?"
• Talk about the advantages of recovery and a normal life.
• Agree that recovery is hard, but emphasize that many people have done it.
• If s/he is frightened to see a counselor, offer to go with her the first time.
• Realize that recovery is the person's responsibility, not yours.
• Resist guilt. Do the best you can and then be gentle with yourself.

Some things NOT to do:

• Never nag, plead, beg, bribe, threaten, or manipulate. These things don't work.
• Avoid power struggles. You will lose.
• Never criticize or shame. These tactics are cruel, and the person will withdraw.
• Don't pry. Respect privacy.
• Don't be a food monitor. You will create resentment and distance in the relationship.
• Don't try to control. The person will withdraw and ultimately outwit you.
• Don't waste time trying to reassure your friend that s/he is not fat. S/he will not be convinced.
• Don't get involved in endless conversations about weight, food, and calories. They make matters worse.
• Don't give advice unless asked.
• Don't expect the person to follow your advice even if s/he asked for it.
• Don't say, "You are too thin." S/he will secretly celebrate.
• Don't say, "It's good you have gained weight." S/he will lose it.
• Don't let the person always decide when, what and where you will eat.
• She should not control everything, every time.
• Don't ignore stolen food and evidence of purging. Insist on responsibility.
• Don't overestimate what you can accomplish. 

Source: Anorexia Nervosa and Associated Disorders www.anad.org