Is my friend too thin at 95 pounds?

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I’m so glad I found your site on the Internet! Eating disorders are hardly acknowledged in Asia and I’m starting to get really worried about my best friend.

My friend has been on this crazy diet for 6 months since we started freshman year at law school and she’s lost 17 kilograms (37.4 pounds)! She used to be nicely rounded at 60 kilograms (132 pounds) and 166 centimeters (5 feet 5 inches), but now she weighs 43.5 kilograms (96 pounds) Is this too thin?

Her work has always been excellent and she was always popular, but now she’s really changed. Sure she has a boyfriend and has even been offered a modeling job, but I got really scared when she overdosed on laxatives today and called me sick in a panic from a fast food restaurant. I was really shocked when I drove her home and put her to bed. She had bruises on her hips and ribs and she said sleeping on them was painful!

When I tried to get her to drink some soup, she cried and cried and said it would make her fat! I’ve only ever seen her drink coffee in the last 5 months. She never eats with us in the cafeteria anymore and would always brightly excuse herself to work in the library.

We’re all envious of her wonderful figure now, but she’s really thin and I’m worried. She said if I tell her parents, she’ll kill me. She swears she’ll stop dieting once she loses the last kilogram, but that’s what she said at 50 kilograms! I don’t want to lose her friendship, but I don’t want her to lose even more! Could she die? Is this anorexia? Do write back soon or she’ll be less than 95 pounds!

Your friend’s weight is unhealthy for her height as she should weigh between 111 and 149 pounds. Also, she has lost 28% of her usual body weight. Considering her weight loss, refusal to nourish herself, not eating in front of others and abuse of laxatives, I would say that she has anorexia.

You mentioned that she called you from a fast food restaurant. Most people with anorexia do not eat out at restaurants especially with friends. Remember what you said about her excusing herself when friends ate together? Do you think that your friend is vomiting after eating? If so, she could be in real trouble with anorexia-bulimia because her sodium and potassium levels could drop below normal levels. Depending on how many laxatives she took today, her potassium could be dangerously low. You should take her to the nearest hospital if she continues to vomit. Yes, she needs help.

The bruises on her hips and ribs may be from being too thin, but she may be bruising easily from a lack of vitamin C in her body. It would be wise for her doctor to find the cause of the bruises. Body fat does help pad the bones and internal organs and at 43.5 kilograms your friend certainly doesn’t have much body fat.

I would suggest that you tell your friend that she looks unhealthy and needs to talk to someone. Offer to accompany her to see a psychologist who specializes in eating disorders. Perhaps there is a counseling office in your law school that she could go. People with anorexia are not realistic in their perceptions about their weight. Your friend will continue to lower what is her “perfect” weight goal.

If she is an adult (over 18) then legally (in the U.S.) you don’t have to notify her parents. You will have to make the choice of whether or not to tell her parents, but haven’t they noticed that she is very thin for a person of her height? If her family hasn’t seen her for a while, they may not know about her low body weight. You will have to make the choice to contact her family or not given your knowledge of her relationship with her family. What you have to lose is her trust, but people with anorexia aren’t thinking clearly when they are thin and she will probably thank you after she starts gaining weight back and getting healthier.