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[Helmaroc]

removed

[LordBucket]

what can I do in my capacity as a friend to help?

I suggest not forming an expectation for her, not attempting to impose upon her your idea of what she should be like, and not being judgemental.

Accept her. If that means accepting that she doesn't want to eat, so be it. If you tell her she has a disorder, that reaffirms in her mind that something is wrong with her. If you tell her she needs to ear because she's not eating enough, that reaffirms in her mind that something is wrong with her. If you cringe every time you see her ribcage, that reaffirms in her mind that something is wrong with her.

Don't be constantly telling her there's something wrong with her.

My advise is to give her acceptance. Have faith that more than enough people will give her the "you need to eat" message. It's not like she doesn't know, and it's not like nobody else is telling her and she needs you to be the one guy to say it. Instead be the guy she feels comfortable with being who she is. Not yet another guy telling her she's not ok and needs to change.

[Orange Wizard]

Not yet another guy telling her she's not ok and needs to change.

I'm probably not giving good advice, but this is a sentiment that I can't appreciate.

In the event that this person is dangerously underweight, is lying to them really the best thing to do?

[Darkmere]

Lying and/or dismissing the issue isn't the point. The difference is between "who I am now is broken" vs "who I am now is great but could be better." She's less likely to want to change if she fells unworthy if change. Pushing against defenses usually only strengthens them.

More OT: I don't have much experience with eating disorders directly, but as a guess... Ask her if she feels "trapped" somehow. Maybe there's a lot of pressure in other areas of her life for her to perform a certain way or "be a certain person." I've known a few people who used self destructive behavior as an empowerment tool (Example: ridiculous scholastic self-expectations led one friend to under-eat and overwork to exhaustion. Another in similar circumstances chose cutting as something easy to control that only they could choose to do to themselves). If that's the case... and I hate to sound like a buzzwordy pop-psych douche... but making an empowered life decision in some form might be the first step to removing that emotional crutch. Decide to change daily routines to give time for yourself, or devote more time for a personal hobby that's been neglected. Meditation. Reading. Drawing. Some kind of creative outlet?

[Nuttycompa]

As a medical student who have 1 month, psychology training.
I will say, as a friend what you can do is support her emotion while the doctor do their work.
Be the one who willing to listen and accept her, not one of many who always say she has a problem

The most important thing in the patient like this is their co operative.
Most patient with psychotic disease never accept/realize that they are sick.
If you confront them with the reality they will start denying it, thinking that they have a problem because everybody think they are sick. Which often lead to refusing to see a doctor.

So, yea Sometime the truth is not really an answer.

If your friend are seeing psychiatrist like now that is a good sign, the last thing we want to see is she droping the therapy because too many people telling her that she has a problem.

[Vector]

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[Orange Wizard]

It doesn't really make any sense to me, but I'll take your word for it.