Dear Ms. Demeanor,
My neighbor's 10-year-old daughter comes over occasionally to hang out with my kids (4 and 2) after school when I am making dinner. She is sweet and very cute with the little ones and is counting the days until she can babysit (as am I). The other day she stayed for dinner and afterwards I heard her vomiting in the bathroom. She came out acting like nothing was wrong so I am fairly certain she was making herself throw up. I am not friendly with her parents at all. Do I tell them or just let it go and figure they know what's going on?
That is a very upsetting story. There are other possible reasons for the behavior, but an eating disorder is definitely the most common and most worrisome. Eating disorders are very serious and are affecting children, primarily girls, at an ever younger age.
Your closeness with the parents is immaterial at this point and the child is too young, and possibly too fragile, to confront directly. I think it behooves you to speak with one or both of her parents face-to-face and tell them precisely what you observed, no more and no less. I cannot predict what there reaction will be but hopefully they will be appreciative that you are looking out for the safety of their child.
If they ask for your advice, I would refer them to their pediatrician, school guidance counselor, and the National Eating Disorders Association. Your involvement beyond this is really up to you, but I would advise not having her over for meals for the time being. There may be medical and/or behavioral issues that need to be monitored closely by her family and, until food is (hopefully) a neutral topic in this child's life, it is best to keep her issues close to those who are managing them.
With best wishes,
Ms. Demeanor is channeled by a longtime Manhattan vertical dweller and real-estate voyeur who writes under the pen name Jamie Lauren Sutton. She is here to commiserate, calm and correct. Please email your quandaries to email@example.com and put "Dear Ms. Demeanor" in the subject line.