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What do you think?

Posted by Robin Abrahams  December 2, 2008 07:44 AM

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This Sunday I answered a question from a woman whose family criticizes her weight. This is clearly out of line, as I stated. (I also didn't write the headline "Overweight and Out of Patience," for what that's worth.) But here's another question about the appropriateness of talking to someone about their weight.

I told the person who sent this question in that I wouldn't answer it in the column, but would post it on my blog and ask for your perspectives. The original letter-writer will, I think, be able to make up their own mind after reading the different perspectives.

I am a frequent runner around my local reservoir, and as such I've become familiar with some of the regular runners, dog walkers, etc. One woman, whom I've gotten to know just that tiny bit that comes with such minute but recurring interactions, has gotten visibly thinner, alarmingly so, over the past year. She's also upped her mileage; where she used to just walk once around the pond, she now runs two laps.

I am truly worried for her health, and have kept myself awake at night, trying to think of a non-judgmental, non-confrontational way to say something to the effect of, "Are you running to burn calories? Trust me, you needn't, because you seem to be fading away before my eyes...are you okay?"

Honestly, I know I'm not alone in wondering if she is suffering from an eating disorder, but I suspect we are all keeping that wonderment to ourselves. On the one hand, it's none of our business. On the other, if she is truly suffering, maybe a kind word from a friendly source might help.

So, my question: Is it ever appropriate to ask someone how his or her health is, when the reason for asking is concern based on appearances? Does a real concern (and the notion that I might be able to point her toward some professional help) ever trump good manners?

What do you all think? Should bodies and weight be strictly off-limits as topics of discussion for strangers? Should we be willing to take a risk in order to help someone? What if that help backfires?

In 2005 I wrote about what to do when a friend has a risky health habit (in that case, excessive sunbathing). But that was a friend, not a nodding acquaintance, and while I don't disagree with the advice I gave, I think today I'd lean even more strongly toward leaving it alone. I'm inclined to give the same advice to the letter writer above.

But I want to hear what you think.

UPDATE: Fillyjonk kindly posted this at Shapely Prose as well, so welcome Shapelies! There is also a good discussion going on at that site about the issue, as well.

This blog is not written or edited by Boston.com or the Boston Globe.
The author is solely responsible for the content.

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29 comments so far...
  1. I think MC is right on. With weight, you're never telling anyone anything they don't already know about themselves in more agonizing detail than you could ever know. The anorexic knows she's doing something unhealthy. The overweight person knows exactly how overweight they are. In bringing up the subject, you aren't shedding light on anything the subject doesn't already know about, you're just bringing the shame front and and center, which will always backfire. Talk about yourself, ask if life is stressful right now, but don't give unsolicited weight comments to strangers.

    I guess if you were bringing light to something the person wasn't already aware of about health issues ("Hey, did you know high fructose corn syrup is an officially sanctioned instrument of nutritional terror?") , it's probably OK to mention it once or twice, but then you have to let it go or risk revealing your controlling tendencies.

    Posted by verena December 2, 08 08:03 AM
  1. I think it's important that the writer not feel guilty about not confronting this woman. Even if she managed to find a way to express her concern that did not come across as meddling, the chances of her affecting the fellow jogger's actions are, in my opinion, pretty much nil. You really can't save her from herself, so I think I would agree with the advice to just leave it alone.

    Posted by geekgirl99 December 2, 08 08:44 AM
  1. She should keep her concerns to herself. Imagine you're the woman in question being approached by this person and the first thing out of the person's mouth isn't "how are you" but "I think you have an eating disorder". It's presumptuous and inappropriate. I don't think it can be said enough times: you cannot determine someone's level of health simply by looking at them.

    Posted by Jane December 2, 08 08:50 AM
  1. I agree completely with Jane, it's not his place to say. Even if she does have an eating disorder, which she may not, a confrontation is only likely to cause her to feel more self-concious than she already is.
    If the writer is truly concerned about her, they should just continue to talk to her (but not ask if she's all right in a way that insinuates that they think something's wrong) because I'm sure she could use a friend. Ask if you two could plan to always run the laps together, that way at least if she stops showing up or passes out on the run, someone can be there for her.

    Posted by Noel December 2, 08 10:20 AM
  1. "In bringing up the subject, you aren't shedding light on anything the subject doesn't already know about, you're just bringing the shame front and and center, which will always backfire."

    Verena, this is so right on. As is Miss Conduct's advice.


    Posted by Kate Harding December 2, 08 10:29 AM
  1. I am not sure what I would do for the runner. However I did have a co worker (Jane) approach me about another co worker (Sally). I am close with Sally and Jane approached me off to the side and asked about Sally, who had been working to lose weight and was successful. But Jane didn't want to comment on it in case Sally lost the weight due to illness as that could be uncomfortable, so she asked me if the weight loss was intentional and if it would be ok to compliment Sally. I thought that was a nice was of going about it.

    Posted by Amy December 2, 08 10:31 AM
  1. The woman may not actually have an eating disorder - maybe she had gastric bypass surgery, which might explain her drastic weight loss. It actually may be okay. Unless she looks frail/gaunt/extremely unhealthy, then don't necessarily assume this is anorexia. But I have to take exception to verena above - a person with anorexia suffers from a psychological disorder, not an intentionally unhealthy lifestyle. That person does need help and sometimes you need to point it out if you are a caring friend.

    Posted by LF December 2, 08 10:41 AM
  1. It is, in theory, kind of your author to be concerned. But the author's concern is based solely on appearances, not on any knowledge of her as a person with a full life outside of her running habits. In my opinion, this is no different than the "well-meaning" and "concerned" strangers that feel the need to tell a fat woman she is fat. This woman is likely well aware that she is skinny, and comments from a relative stranger... well, what will that accomplish?

    I think that comments on the bodily appearance of someone you do not have a reasonably close relationship with should be generally forbidden. And comments on the bodily appearance of your nearest and dearest should be carefully weighed and considered, and most often discarded without being spoken.

    If the author is concerned that this woman may need a friendly hand -- and if we're honest, most of us admit that there has been a point where someone reaching out to us would have been helpful -- the author should take some time to talk to this woman -- just not about her weight. Be a friend, not a critic. Not even a "helpful" critic.

    Posted by MK December 2, 08 10:41 AM
  1. Visibly thinner by how much? 160lbs to 130lbs? To an unhealthy weight? Upping mileage to running twice around a reservoir (if it's the one I'm thinking of) doesn't seem like that big of a deal, and maybe this visibly thinner is actually a healthy weight loss. However, I am sure it would be rude, since she doesn't know this person to say anything, because presumably she has closer friends who can express concern.

    Posted by amii December 2, 08 10:48 AM
  1. Following up on Verena's comment: It seems likely that many women with eating disorders already know their eating habits are unhealthy and thus expressing concern can be seen as reminding them of something shameful.

    But not every thin women has (or yet has) an eating disorder. Can any readers shed light on how inquiries about health and appearance are received and interpreted by women who want to stay thin and may have become very thin? Do some women who are very thin sometimes react, "People have been noticing that I'm thin -- I guess I really am so I maybe it is time to stay healthy and ease off on my diet and exercise."

    Might a very thin women sometimes think, "No one has even said anything about how thin I am!" -- with the inference: no one cares, I'm invisible.

    Posted by Traveling Psychologist December 2, 08 10:52 AM
  1. I think it is best to mind your own business, especially since the person is not someone you know well. Perhaps she is training for a marathon or something that requires a lot of training. Maybe she is ill with Cancer or some other disease and running has become a sort of therapy for her. There are many private and personal reasons that someone may be losing weight.

    Just give a friendly wave when you see her and leave it at that.

    Posted by Lisa December 2, 08 10:58 AM
  1. Unless you are a medical professional, it is never appropriate to comment on, compliment or criticize another person's body. (OK, if you're in the throes of intimacy... compliment away!). ;)

    Posted by kmacjp December 2, 08 10:59 AM
  1. If it's a chatty acquaintanceship, it might be possible to say something like "I get so stressed over the holidays, running here at the Res really helps me relax! How about you?" It's not a probing question into her physical or mental well-being, but it opens the door and lets her come through with anything she may want to volunteer - if anything. Perhaps she *is* miserable and just aching for someone to reach out with a little human concern, although the likelihood of that is probably low. First it may be helpful to consider what your goal is in having the conversation at all. You are unlikely to be able to fix eating disorders or wasting diseases just by letting her know you've noticed, sad but generally true.

    Posted by Harriet Warmer December 2, 08 11:04 AM
  1. Its totally none of the writer's business. She has no right whatsoever to mention this woman's weight to her. She doesn't even know the person. If the person has anorexia and you say 'you're getting too thin' that's just adding fuel to the fire. You're telling them exactly what they basically want to hear. If a person is truly anorexic YOU KNOW. There's no 'is she or isn't she'. If you've been around anorexics, you can spot the various signs immediately. Body size is always off limits in my book. Even if people lose weight I do not say anything. And if prompted by the person to comment about their weight loss, I'll usually end with 'but I think you've always looked great.' I refuse to play into people's body hatred-skinny or fat.

    Posted by Valerie December 2, 08 11:39 AM
  1. I think that the best way, as a stranger, to create positive change in this situation is to either stop being a stranger (ask her about her new route, start up an acquaintanceship, then ask 'how are you feeling' at some point in the future when she seems down), or start wearing body positive t-shirts or something similar. It's not neccessarily going to change the world, but it sends a message to love yourself without barging in on someone's personal space, or making their body your business. Besides, both of those approaches would create good in the world regardless of what's going on - visibly getting thinner or heavier doesn't always mean that the change is unhealthy.

    Posted by Alice December 2, 08 11:43 AM
  1. "Do some women who are very thin sometimes react, "People have been noticing that I'm thin -- I guess I really am so I maybe it is time to stay healthy and ease off on my diet and exercise."

    Not in these corn-fed United States. "Thin" is equated with way more than "healthy", there's no incentive to stop because of good health.

    Posted by verena December 2, 08 12:10 PM
  1. Its totally none of the writer's business. She has no right whatsoever to mention this woman's weight to her. She doesn't even know the person. If the person has anorexia and you say 'you're getting too thin' that's just adding fuel to the fire. You're telling them exactly what they basically want to hear. If a person is truly anorexic YOU KNOW. There's no 'is she or isn't she'. If you've been around anorexics, you can spot the various signs immediately. Body size is always off limits in my book. Even if people lose weight I do not say anything. And if prompted by the person to comment about their weight loss, I'll usually end with 'but I think you've always looked great.' I refuse to play into people's body hatred-skinny or fat.

    Posted by Valerie December 2, 08 12:12 PM
  1. I see a lot of strangers doing things that seem to me like they might be unhealthy. Some of them are people I see frequently (say, the cluster of folks who gather outside a nearby office building to smoke several times each day). Some of them are people with whom I have a nodding or greeting acquaintance.
    It would never occur to me in a million years that I should make an amateur intervention based on my eyeball diagnosis. Never. These people all have friends and family members, and probably doctors and therapists, with whom to discuss this stuff should they be so inclined. It would be narcissistic of me to think that my magic words could somehow save them. The letter-writer needs to let it go: her fellow runner's body is her own business.

    Posted by Julia December 2, 08 12:29 PM
  1. Also, if this is the reservoir in Cambridge, the letter-writer may well be referring to a friend of mine. She is training for a marathon and managing a very serious case of celiac disease. I imagine a lot of people look at her and think "Unhealthy!" when the exact opposite is true--she's very focused on improving her health and achieving her goals despite the celiac.

    Posted by Julia December 2, 08 12:39 PM
  1. I think the letter-writer is a very kind and compassionate person for worrying about someone she barely knows. That being said, I agree that he/she should not say a word.

    I had to consider it for a while, but one of the other posts got me thinking. She isn't going to listen to a stranger. If she does have a problem, she will need to hear it from someone close to her or a medical professional - so don't feel guilty about not saying anything! I truly don't think it would help, despite good intentions.

    Also, I have a friend who is about 5'3" and weighs under 100 lbs. People are constantly commenting (to me) about a possible eating disorder. Well people, I have known her for almost 10 years and she is and always has been naturally skinny. I wouldn't exactly say she tries to pack on the pounds, but she eats and doesn't even exercise. It happens.

    Posted by RT December 2, 08 01:59 PM
  1. This is a difficult question, but the writer should certainly not approach this woman. I think the only person that has license to comment on my body is my husband--if he should notice that I am suddenly losing or gaining significant amount of weight, he has every right to be concerned and to let me know that. Anyone else, even my best friend or my sister, should consider my body size off limits.

    I am a thin woman. By some standards, I'm underweight. However, I am an athlete. I look at myself and think I am muscled and fit, while some others don't recognize my body as that of a distance runner, and perceive me as frail and sickly. My body is naturally lean and I am a happy, successful runner. I get plenty to eat and I don't worry about my weight. However, other people, especially people who don't know me, have taken it upon themselves to comment on my weight throughout my life. It has always been inappropriate and offensive. I can only assume that they think I look unattractive, which is of course not a nice thing to hear. We often associate what we perceive as unattractive with being unhealthy, but this is a dangerous association.

    Posted by Kelly Dagger December 2, 08 02:20 PM
  1. This is a delicate issue. As someone who also struggled with anorexia and bulimia, the only kinds of comments I ever received about my condition were weight-loss compliments that only served to encourage my disorder. In retrospect, I sometimes wish that someone -- anyone -- had expressed actual concern about my dwindling appearance. It probably wouldn't have been a major wake-up call for me -- I knew I was disordered and that I needed help and recovery is usually only effective when you choose to embrace it -- but it would have at least let me know that others cared about me and were concerned. Keep in mind, the number one cause of death amongst people with anorexia isn't starvation – it’s suicide. That being said, even if someone had come up to me during my disorder and asked me if I had an eating disorder, my first reaction would most likely be to feel defensive and self-conscious. Eating disorders fester in isolation; they thrive in secrecy. The crux of the whole eating disorder world rests largely on the construction and maintenance of normality. Once that façade is broken, you will do almost anything to rebuild it.

    I agree with others here that it is inappropriate to assume or even imply someone might have an eating disorder on the basis of appearance alone. Eating disorders do not discriminate by gender, age, ethnicity, class or even size and those whom you least suspect might have one and vice versa. Let’s assume that this woman does have an eating disorder. I agree that the best way for the letter-writer to support her is by becoming her friend, one she feels comfortable confiding in and who cares about her and her health. Part of the reason pro-ana sites are so popular isn’t just because those who seek them out want to learn how to become better anorexics; it’s because members perceived them as a place of nonjudgmental support. My advice for the letter-writer is this: Be a friend and be a healthy role model. Eating disorders are a form of control; sufferers are often reluctant to let go of them precisely because they are afraid that they cannot live without them. By her very example, the letter-writer can show this woman what a life without an eating disorder can look like..

    I think it is absolutely appropriate for close friends and family members to express concern over what they feel are dangerous and unhealthy behaviors, though. I’m not advocating for a tough love kind of approach, at least not initially, but it benefits no one to silently watch a loved one self-destruct. The three most important things you can do for a loved one with an eating disorder are:

    - Express concern without blame. Use “I” not “you” language, i.e. don’t say “Don’t you know you’re killing yourself?” but rather “I love/care for you and am afraid I will lose you.”

    - Seek professional help. You can’t force someone to embrace treatment, but it’s helpful to have a professional on-hand if treatment becomes necessary or your loved one decides to seek it out. Plus, a professional will be able to better tell you how to approach the situation given your own unique circumstances.

    - Most important of all, show unconditional love and support. Nagging, criticizing and threatening will only push someone with an eating disorder further away.

    Posted by Rachel December 2, 08 02:38 PM
  1. Rachel, thank you for the brave and courageous response -- both in this posting and in your own life. I have a cousin who struggles with anorexia and bulimia. Something you said range true with me when thinking of her: "Eating disorders are a form of control; sufferers are often reluctant to let go of them precisely because they are afraid that they cannot live without them."

    My cousin definitely fits this. All major (and minor) decisions have always been made for her (but she had to suffer the consequences of bad decisions herself). She is in co-dependent relationships with everyone in her circle. From my limited perspective, her eating habits are her only control over her own life.

    What would you recommend I do to support her? She’s been in and out of treatment programs for the last year and knows (and acknowledges) that she has a problem. But she clings to the “control.”

    Posted by Lynette December 2, 08 03:51 PM
  1. — cross posting this on Miss Conduct & Shapely Prose —

    I think the appropriate response really depends on the relationship. If my mom, brother, or close friend was looking ill and thin, I would be blunt - “It looks like you’re not eating enough. Are you okay?” And if the response was “I’m fine,” I’d keep pushing.

    If a non-close friend or classmate who I’m on good terms with looked ill and/or too thin, I might say, “Hey, you’re looking a little drawn/tired - are you doing okay these days?” If the response was “I’m fine,” I might just leave it at that, or I might say, “okay. I’m always around to talk if you want” - and then not bring it up again.

    If it was a casual acquaintance, I wouldn’t say anything unless I was quite worried. And, my first response would be to check in with a mutual friend if possible - like, “Hey, I know you’re friends with Jane - do you know if she’s doing okay?” If there wasn’t a mutual friend, I might go to Jane and say something along the lines of, “hey, I know we’re not close, but you look like you’re having a hard time these days. [I might add something about my own ED, if appropriate]. If you ever want to talk about it or anything, I’m around. ” And then I wouldn’t bring it up again.
    and if I didn’t know the person at all -

    And if I didn’t know the person at ALL - we’d never spoken - I wouldn’t say anything. There used to be a woman at the gym I went to who looked dangerously, painfully thin. I’m 100% she wasn’t healthy, though of course I don’t know if it was anorexia, chemo, or something else. But, I saw her with various trainers regularly, and while I was surprised that they let her exercise at all - she was SEVERELY underweight/emaciated - the gym staff saw her. It might have been their place to comment, but it certainly wasn’t mine.

    Posted by emi December 2, 08 06:07 PM
  1. What about the question "Hey, you look like you could use a friend, sometimes. How's everything going?"

    If nothing's wrong, she'll probably just be confused. If something is wrong, but she doesn't want to talk about it, well, the writer tried, and at least she knows someone noticed and was concerned. If she's willing to talk, great!

    In short, I agree with Emi's "casual acquaintance" suggestion. I think a vague, non-accusatory inquiry and an offer of friendship/open ears would be the best way to go. Hopefully she wouldn't feel attacked because, heck, haven't we all had a hard time/needed a friend sometimes?

    Posted by Kate December 2, 08 09:11 PM
  1. Maybe she's training for a marathon....I don't know. But I am one of those women "blessed" with a speedy metabolism, I prefer to think of it as a curse. I'm 24, about 5'6" or 5'7" and I weigh around 115. The most I've ever weighed is probably 120. I can eat junk food and drink all the beer I want, and never ever ever gain a single pound (it just redistributes as I get "older"). If I were to start running, I'd probably lose even more weight. I get irritated when people I know assume I don't eat or that I'm an anorexic in training, I'd probably be even more offended if some passing acquaintance mentioned something. While I don't have to exercise now, I know I should or else I'll be very unhealthy in my 40s when my metabolism slows. The irony of being thin is that men think they want twig women, until they realize we have smallish breasts and not that much of a butt.

    Posted by veronica December 2, 08 11:11 PM
  1. Miss C. --

    Here's my take: what if the person asks the woman "How are you?" and the woman says "Fine." Does she then say "You look so thin, I'm concerned"? What does she say if the woman says, "Oh, thank you, I've been trying so hard to lose a little weight"?

    In other words, what does the person envision herself doing, should she become engaged in a very personal conversation with this relative stranger? Does she believe she's the only person who's noticed the change in the woman's appearance? Does she believe she has a magic answer to whatever the woman's problem may be, that no one else is likely to have offered her?

    I'm not trying to be snotty. Just suggesting that, if this woman is indeed anorexic, she is probably surrounded by people who know it and have made comments to her about it. How about the next time your writer sees the woman, she says "Hi, I'm (name), I've seen you around. Want to have lunch sometime?" Maybe after getting to know the woman a little better, she'll either get more insight into what's going on with her health (if anything), or be on a more personal footing and feel comfortable bringing up the subject of her weight loss.

    Hera

    Posted by hera December 3, 08 04:02 AM
  1. Veronica, You're too funny - I wish I could see you - the two of us are apparently shaped exactly the same (although I'm older and married and my husband reassures me that he likes a skinny gal) ;) I've definitely heard from people, after they've gotten to know me, that they had initially worried that I might be anorexic (this misapprehension is rapidly cleared up after they see me eat). It hasn't really bothered me, so I guess it just depends on the person. Which makes me think that there's really no way to know how the thin-looking runner would react to words of concern. I do agree it's important for the worried person to closely examine her motivations for saying anything. If she does so and comes to the conclusion that she's not acting from some kind of narcissistic impulse, I think it's really not the end of the world if she decides to chance a kind word of concern after she's chatted with the woman a few times and solidly established herself as a friendly presence. You never know how things could go...

    Posted by Linda December 3, 08 12:11 PM
  1. I would not make a comment to the individual, because if she does in fact have an eating disorder perhaps her friends and family should be supporting her in finding help. I'm not sure what the runner could say that would even prove helpful??

    Also, I enjoyed reading Miss Manner's response with regard to the weight issue- I am also someone who was constantly asked highly personal issues regarding my fertility (not my weight). Some of the remarks were rather offensive. I think that personal issues (i.e. weight and fertilty) are off-the-table for discussion, even by well-meaning (or sometimes just plain nosey) relatives and friends.

    Posted by JD/Swampscott December 9, 08 12:39 PM
 
About Miss Conduct
Welcome to Miss Conduct’s blog, a place where the popular Boston Globe Magazine columnist Robin Abrahams and her readers share etiquette tips, unravel social conundrums, and gossip about social behavior in pop culture and the news. Have a question of your own? Ask Robin using this form or by emailing her at missconduct@globe.com.
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Robin Abrahamswrites the weekly "Miss Conduct" column for The Boston Globe Magazine and is the author of Miss Conduct's Mind over Manners. Robin has a PhD in psychology from Boston University and also works as a research associate at Harvard Business School. Her column is informed by her experience as a theater publicist, organizational-change communications manager, editor, stand-up comedian, and professor of psychology and English. She lives in Cambridge with her husband Marc Abrahams, the founder of the Ig Nobel Prizes, and their socially challenged but charismatic dog, Milo.

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