Amy

DEAR AMY >> “Charlotte,” my dear lady friend of many years, looks more like a string bean than a human being, because she has been purging. Charlotte has recently overcome addictions to smoking and alcohol, concurrently. She has a distorted image of her figure and exercises to extreme in order to maintain that appearance. I realize that she needs to convince herself to turn the tide and take action in order to tackle this latest problem, and I’ve let her know that she’s at a great risk of increased illness, if she stays so thin. She has yet to seek professional advice. I’m wondering if it would work if I got some trusted family members and close friends together in order to confront her and speak some wisdom to her?

— Concerned Chap

DEAR CONCERNED >> According to a paper published by the National Institute on Alcohol Abuse and Alcoholism (niaaa.nih. gov), many studies show that alcoholism and eating disorders frequently “cooccur,” but as yet, no definitive link between the two addictive disorders has been identified. All of this is to say that your friend’s other addictions are likely related to her current bulimia, that this is complicated and that she needs professional help to deal with her underlying issues before she can get healthy. Interventions — by family and friends — seem easy. You just get together and go around the table and tell the affected party that you are worried about her and that you want her to get help. And then the subject of the intervention rages, or cries or sits sullenly, or tells you all to go to hell, leaves the table and stops communicating with you because, even though your intentions were great and you were all gentle and loving, she feels attacked and misunderstood. If this happens, then “Charlotte” will be without the thing she needs the most, which is contact with loyal and loving friends. This is why interventions are best led by professionals. A therapist or other specialist can deliver constructive and concrete ideas, as well as the inspiration and incentive to begin treatment. By all means, share your concerns with your friend: “You’ve been through so much lately. I’m worried because you’ve gotten so thin. Are you seeing a therapist?” Offer to help her find one. And also continue to accept her as she is. She has a serious illness.The National Eating Disorders Association offers a “find treatment” tool (nationaleatingdisorders. org), as well as a helpline that she (or you) could call: (800) 931-2237.

DEAR AMY >> I wonder if other readers were shocked by the question from “Still Shocked,” whose mother had carried on a longtime affair with the family’s high school foreign exchange student. I don’t know if I could recover from that knowledge.

— Also Shocked

DEAR ALSO >> I agree. Mom wanted to sweep this affair under the rug, but I agree that it was obviously wrong in so many ways, and she should answer for it.