Your story reminds me of a friend of mine. She told me that she had developed anorexia while away at college and her roommate at the time became concerned and spoke to her own mother about it (who happened to be a nurse) and she then spoke to my friend’s parents. An intervention was put in place and my friend returned home from college, enrolling in the local university and beginning therapy. Yes, she was hurt and embarrassed about it all back then, but now as an adult, she speaks of the situation with gratitude, realizing that her friends’ concern most likely saved her life.
Based on what you have observed and shared here, I believe that your friend most likely does have a fairly severe eating disorder and she needs help. The skin picking and nail biting are also signs of psychological distress and can be treated. Your friend needs help but she may likely resist it and deny the problem. You can first try approaching her yourself and just lovingly share your concerns and ask if she would please make an appointment at the university counseling center. I don’t think you necessarily need to let her know what you saw in her phone, but you can share that you have observed her weight loss and behavior changes around eating. If this seems too intimidating to do alone, can you ask some other peers to join you? Otherwise, it may be time to speak to her parents or the nurse.
Even though I feel that you should take action to help your friend, you must be aware that she may reject your ideas and it could strain your friendship, but hopefully she will be able to see how much you care and ultimately come around. Doing the right thing is rarely the easy thing.
All the best,
Dr. Holly Counts