The question: My boss is incredibly skinny – I think she has an eating disorder (she only has one or two bites at any lunch that I've seen). Is it wildly inappropriate for me to ask her about that? I'm worried about her.
The answer: Lower than average body weight (less than 85 per cent of one's expected body weight based on their sex and height) and significant restriction of food intake are two hallmarks of anorexia nervosa, a rare but serious eating disorder. In addition, individuals have an intense fear of weight gain. They may excessively exercise and may misuse laxatives, diuretics or enemas. There may occasionally be elements of binge-eating or purging.
Food restriction can also be associated with bulimia nervosa, which has the hallmark features of recurrent binge-eating behaviours (i.e., eating a markedly high quantity of food during discrete periods of time, with an associated lack of control during the binge) as well as purging behaviours to prevent weight gain (self-induced vomiting, excessive exercise or use of diuretics, laxatives or enemas may occur).
Keep in mind that being skinny and eating small quantities of food for lunch may or may not indicate that your boss has an eating disorder. She may have a small build, have health issues that explain her low weight or be eating larger quantities of food at other times.
That being said, you may still feel concerned. Your question then of how – if at all – to approach this with your boss is a difficult one. The fact that she is your boss makes this much more complicated than if she were a friend or a family member.
You need to remain mindful of a number of issues. What type of relationship do the two of you have? Your concern makes me think that you may have some level of friendship or closeness with her that is beyond a formal employer/employee relationship. What is your guess about how she might react to you bringing this up? Would you be placing your position in jeopardy if you were to overstep what in some situations may be very clear workplace boundaries?
Given your worries, you may want to consider very gently and respectfully expressing them to her. Keep in mind that she may feel not at all comfortable having this discussion with you because you are her employee, which is perfectly understandable and acceptable.
If you do decide to approach her, make sure that you have some dedicated time to speak, that you are in a private location away from other employees and that it is not at the beginning or in the middle of a busy work day.
Be very honest. State that you have felt nervous or unsure about how to approach this conversation and that you respect her privacy, but that you care about her and are concerned. Be specific, but qualify this by acknowledging that you may be way off base. Indicate that you notice she has lost weight (if this is accurate) and that she eats very small quantities of food. Ask her if there is anything you can do that could be of assistance, and if so what would be helpful. If she does not want to have this conversation, respect her wish and apologize for overstepping any boundaries.
Send psychologist Joti Samra your questions at psychologist@globeandmail.com. She will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.
Read more Q&As from Dr. Samra.
Click here to see Q&As from all of our health experts.
The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.