My friend is sabotaging her health and I am finding it so hard to support her

[LemonTopShop]

I am fully aware that I am going to get flamed for this, but I’ve put my suit on. I am so worried and sad for my friend but anything I, and her healthcare professionals say, is being ignored.

Her doctors have told her she needs a lifestyle overhaul to solve her particular health problem and she won’t listen, and actually is being cheered on by her online friends who claim the doctors are ‘fatphobic’.

I work in health myself and what she is experiencing is 99% down to her morbidly obese BMI and other lifestyle factors.

I know her weight is the result of depression and disordered eating. She’s a wonderful, wonderful person and needs help- but she isn’t engaging with it.

She’s at a private appt today for more scans and blood tests because of the ‘gaslighting’ NHS. The private sector is going to tell her the exact same thing.

She’s my son’s godmother. My lifelong friend. I love her to pieces. But the real world isn’t appealing for her any more and she’s too anxious to play a part in it. She spends her life scrolling body positivity and chronic illness Instagram and TikTok. She has built a large following about her ‘illness’ and this has replaced life.

I’ve tried to come at it from the health angle of encourage her to stop smoking, or reducing the drinking or ‘oh the weather is nice let’s go for a nice walk’. I haven’t spoke weight at all. Our one mutual friend who thinks the same I do has said she needs ‘tough love’ but I feel it’s pointless. We’ll lose her. I just want to help her but I can’t do anything because then I’m no doubt going to be another toxic gaslighter to go NC with.

What is actually wrong with her , being obese and smoking is obviously not going to be helping but sometimes health care professionals don’t necessarily want to look past the obvious .

Honestly I would walk away from anyone who expected me to perform " intimate care" while making jibes at my " heteronormative" life. Life is too short. She sounds an awful friend.

I have many obese friends, but I keep my beak out of their lives because they don't expect the level of help your friend seems to.

I'm sorry but she expects you to do her intimate care? Wtf?!

That's really inappropriate of your friend, I'm disabled and would never in a million years put that on a friend.
I would start refusing "sorry friend I know we are friends but I'm not prepared to be your carer."

Maybe if she was forced into doing these things or paying for a actual carer it would make her see she needs to loose the weight.

Wow why are you doing her personal intimate care? Are you an ex of hers or something? Otherwise you really should not be doing that - she needs to get professional carers not friends to do those tasks.

As someone who has a chronic illness and is fat….

Your position and the GP position might if might not be fair re the weight. You are pretty sure her issues are all down to her weight. I’ve seen plenty if people who have been told that, has fighter, argued, decided to loose the weight and … were proven right because none if their symptoms disappeared.
It’s coming from not understanding the difference between correlation and causation imo….
And yes that includes pain.

And yes too, the pain she is in will make her depressed. And the frustration at the situation will make her pain worse. That’s not new.

But I’m wondering if any of those GPs etc… have ever taken the time to actually listen to her. To take into account what she said - that the pain was there BEFORE the weight gain.
Has she been dismissed with a ‘you need to lose weight’ and then told to just get in with it with no one ever addressing any of the reason for her health issues?

Oh and btw, acupuncture is THE treatment of choice for chronic pain according to the NICE guidelines so your friend is right to go down that route.

It's the only way with addicts, which is what the OPs friend is.

OP, I would treat your friend as an addict - the eating, and the social media, both, are addictive disorders. What is so frustrating is that normally with drug or booze, there are lots of messages from society and loved ones that there is a problem. But your friend is being validated instead.

Personally, I would not take yourself out of her life, or nag, but I would not lie or validate her illusions and I would protect your boundaries. I also would not accept the "heteronormative" bs, she doesn't get to treat you like shit just because she is depressed. What she decides to do with that is up to her, and maybe she will cut you off, but if she ever sees the light she will know you are there for her.

@MangyInseam social media is also the only way people with chronic disabilities can get support (at the very least form each other). Esp when what you can do is extremely limited like it seems to be the case for the OP’s friend.

Its easy to say ‘she is addicted’. She just needs a tough love approach.

It doesn’t mean it’s the only way or the right way.
Tough love approach on its own doesn’t help addicts. Even less so when you are talking about food (that you have to eat anyway) or SM. Very different situation than let’s say alcohol.

I hope you’ll never find yourself in that place tbh.

@LemonTopShop your own distress at how much your friend is suffering is clear.
And I can hear your frustration when the answer seems to be so easy from the outside.

Id say a few things there

• keep your boundaries. If going to help her with intimate care is hard, then stop or reduce the amount of time you are going.
• if hearing about how lucky you are etc… tell her it’s not nice, again put boundaries on what you are happy to accept or not behaviour wise from her.
• trust your friend. Seriously trust her. If she says losing weight doesn’t make any difference, then believe her. If she says acupuncture helps, believe her. What she needs more than anything is someone who truly listens and trusts her.
• and of you still think that losing weight is THE answer, I’d say stop telling her about it. Encourage her to go and see a nutritionist, NOT to lose weight (Even though it might well be the consequence of it) but to eat so she is feeling well in herself - on a MH pov, physically and pain wise.
• encourage her to see a psychotherapist. If she has sufferers that much trauma, she needs support to deal with it both for her MH but also to lose weight and to help with the pain.

(fwiw, trauma is often a trigger for many illnesses, incl those that have no test for such as fibromyalgia)

Google inattentive adhd and see if it applies / disordered and impulse eating a struggle for us

I’m fat - BMI 34 - and have been all my life really. The doctors don’t give a monkeys because at 60 I don’t present with any health issues (touching wood here, obviously!). The fact she is fat and has serious health issues is what the problem is, and being less fat may help to make her have fewer health issues. Is that not how the doctors have characterised it to her?

it sounds like she is in a horrible spiral of denial and anger. I feel sorry for her and sad that body positivism is having such a negative effect on her critical faculties.

As for you OP, I suggest you step back from being her carer/punchbag and just be her supportive, but self-respecting, friend.

I totally understand you OP. My mum is in the same position as you, watching so many of her friends suffer huge health problems which could be avoided with a healthier lifestyle, better diet choices and more exercise. MN famously takes the whole 'it's her body her choice stance' but I get where you are coming from. Poor lifestyle makes you a burden to the health service (yes, it's true whether you like it or not) and it is hard to see a friend suffer when she could have a better life by being healthier.

We’re not talking GP here- we’re talking very senior level consultants. She has had various diagnostics, scans and appointments. She will always have the condition but apparently the symptoms that keep her in pain and reduce her quality of life can be radically lessened with losing 10% of her body fat as a starting point.

Her pain is being taken VERY seriously.

her disordered eating is being taken seriously and she has been offered so much support inc therapy.

She is not getting fobbed off. I don’t know why posters are leaping to this.

I imagine her TikTok followers are making similar jumps.

@BaddogGooddoggy if my experience is anything to go by, the OP’s friend won’t have been told that losing weight MAY help with her pain.
she will have been told there is nothing they can do and to go and lose weight with maybe a signpost to weight watchers.

More importantly, they will have said that there is no need to do any tests etc beyond what they have done and it will look like to her that they’ve stopped bothering.

Telling a morbidly obese person, "Your problem is that you are too fat" is akin to telling a severely emaciated person, "Your problem is that you are too thin". It utterly misses the point.

We are extremely bad at treating the underlying causes of obesity, so what exactly would you be advising her to do?

I imagine emotional support is what your friend needs most from you right now and not problem solving or practical support.

Read the bloody thread yawn

Xpost @LemonTopShop

Sorry but the fact she is followed by senior consultants etc… wasn’t clear at all in your posts.

It’s great that she is taken seriously.
And it sounds like she is getting treatment fir her pain but it’s not working well?? (If she still need to get dressed/showered etc….)

How is/did the therapy go for her ED? Was it offered as away fir her o lose weight or as an issue on its own that needs to be seriously looked at!

You are right. And it's also incredibly difficult for a morbidly obese person to lose weight.

However, being morbidly obese has huge health implications, and will limit significantly how chronic health can be treated / managed. That is the reality.

There is without doubt discrimination in the health service around obesity.

At the same time there is a huge amount of denial from people who are obese about the reality of the impact of that on their health.

The OP is describing someone who is in utter denial that her weight is impacting on her health and is something that she needs to try and tackle (with the right support). This is sadly backed up by her online followers who just feed her echo chamber. Body positivity it great but not when it's putting your like at risk.

I don't know the answer, OP. But I would be backing away from providing personal care to a 27yo who refused to accept their obesity is one of the main reasons that they need that help. So I guess I'm advocating tough love.

So the issue here isn't that she hasn't had expert opinions, and it isn't that she hasn't got support or therapy for her ED, she's had plenty of both and is also seeking a second opinion. She has all the information, she's not ignorant and she's been advised about weight in particular and how this impacts her condition.

So there's no information you need to give her. The issue is how frustrated you feel when she goes on about her Tiktok friends and body positivity, and also the care you are offering her. I think it's entirely reasonable to set boundaries around both those things, so if she starts on about the body positive stuff just say 'well, what did the second doctor say to you?' and defer to the experts, if she goes on just keep with 'I guess it's up to you'. Push the choices back onto her, don't agree with her, at some point she either will or won't chose weight loss and nothing you say will make any difference. As for the personal care, that sounds inappropriate and I wouldn't do it, so it's up to you to decide what's ok within those boundaries as friends and only do that. I've cared for someone terminally ill in that way, but not a friend. No friend has ever asked me to, or helped my relative so that's not a common thing IMO.

Just get a few phrases like 'well, it's up to you, I guess' or 'we'll have to agree to disagree' and change the topic. There are videos and guides on how to help people with ED, often for those with anorexia, but also with binge-eating disorder and these type of neutral statements, where you don't argue over their size, treatment, or anything are very useful and stop you getting into negative spiral conversations.

I've read it. You're snarky, and that's nothing to be proud of.

Your posts indicate that you are frustrated with your friend's failure to recognize how obesity exacerbates the symptoms of her health condition. You appear to resent the emotional support she gets elsewhere because you feel it undermines obesity's contribution.

I'm asking you: Why does this particular aspect of her situation bother you so much? Is it because you think she should be more ashamed, guilty or self-flagellating?

Would it be better if she repeated, "This is all my fault because I'm fat"? How would it change anything?

can you encourage her to get help for her disordered eating and depression?

As a fellow binge eating disordered person who is finally in recovery:

She will not change unless she is ready to, or until she hits rock bottom and listens to what her body is saying.

She will not enter recovery if she is unable to see the wood from the trees when it comes to TikTok, which is a horrifically toxic platform for fat people who are in danger of death from being fat.

There is nothing you can do or say to stop her. I'm aware it's horrible to watch. She already knows, in her own way. Either she'll get it together and make the changes or this will be her life.

I am so sorry.

Have to say I find your snippy responses pretty shit tbh. Is that how you respond to your friend?

Is there any DBT therapy available in your area?

There is presumably some trauma history, ED and addiction issues.

I spent the last five years working with geriatric ED patients. Much worse than teenage EDs because they have an extra half a decade of experience and organ failure becomes an issue. The dietician and I managed to persuade the local health group that DBT might be our best bet.

You can't help someone who does not want to be helped. You have to have boundaries because she will eat into them without noticing (just part of the illness).

Good luck