Do not ever be confrontational with the person. When you address the problem, let them know that you know they are going through something very difficult, you do not understand (because you don't), and you will do what you can to support them without enabling them. If they are a minor, whether you think it's right or not, leave it up to them to tell their parents. Encourage it, and reassure them, but do not betray their trust unless they are in serious trouble. If you want to help the person, stop trying to help. Be a friend, be as empathetic as you can be, but do not try to force them to stop. Eating disorders are about control, not appearance. It may be a factor, but the root problem is that the person does not feel like they have any control in their life. By leaving the decision to get help up to them, you put the control in their hands, which is what they are looking for. Your job as a friend or loved one is to encourage them to heal, pray for them, and above everything love them. Do not judge them, no matter how hard it is. You would not persecute a person for having the flu, and eating disorders are an illness. If you take a confrontational approach you are creating a wall between you and the person. They will not trust you, and they will not let you in. By humbling yourself to their level, you reassure them that you are a friend, not their enemy. And don't expect them to want to get help. It will take time for them to take that step. You should not get angry if they refuse treatment, but keep on supporting them in their battle. I am saying this as a recovering bulimic, who has been confronted, and forced, and judged. I didn't want to get help until I met my husband, who accepted me as I am and left the choice up to me. He didn't enable me, he would give me ultimatums, like no kisses if...never anything truly threatening to me. By giving me the control over that choice, he built trust between us, whether he meant to or not. The most important thing to remember is that this is not about you. If you make it about you, ultimately you will damage the person more. Make sure they know that you are on THEIR team. You are fighting for THEM. I think that this is the only successful way to get through to someone who is being dominated with any mental illness, and especially eating disorders.