I have a friend - a young teenage girl in Hong Kong. She has, I strongly suspect, Bulimia. She has no support at home, she gets berated for eating too much. We know she vomits shortly after eating but she is not seen as having any kind of eating disorder. There is no kind of support here in Hong Kong for such things. What can I do --- as a westerner who is somewhat of an outsider --- to help her? The local Chinese here do not believe in therapy --- they consider it a weakness and 'psychosis', if you will, of the Westerner. So I have a thin line to tread. Can you advise? I don't want her to end up in hospital or worse. Thank You, Stuart

Thank you for your genuine and heartfelt note. If all people had supportive and intuitive friends like you, I think fewer people would ever have to deal with problems like bulimia. Before I offer my few words of wisdom, I just want to remind you that I am in no way an expert. My only credentials are that I was once bulimic--mostly the result of not wanting to gain weight and wanting to eat a pint of ice cream, french fries and the like. And of course, because I wanted to be thin and look like I was the next Glamour cover model. The one thing that is different, between then (approximately 10 years ago) and now--is that we are at least identifying it as a problem by naming it--bulimia. When I was making myself throw-up, so were all of my friends--so we just thought it was natural. Now, with our raised consciousness, we know that it is a common problem and one that needs to be corrected.

As you know, bulimia is a "mental health" disorder not a physical one. So I think the best thing you can offer to your friend is 1.) support and 2.) belief in herself. Maybe identify the things that are beautiful about her body...those areas that don't revolve around actual pounds like eyes or hair, so she has some features to focus on. I don't think it's realistic to say that "it doesn't matter," because to her it obviously does. So your role can be to make it matter "less" and in comparison to her and not to others. Obviously, there are features she has--looks and personality and intelligence--that others don't. Let her know about these--and how she stands out on her own. You might also want to do a search for "Bulimia" or "Eating Disorders" on the search engines to find other sites on the Internet for other ideas and insights.

Sorry I can't be of more assistance. Good luck to you and your friend. Sometimes it's just helpful knowing that you're not alone. If you think that will help your friend, you can either share my note with her or at least my e-mail address

—Amy