Friend Afraid of Therapist Breaking Confidentiality--> Will They?

This hypothetical person started cataloging when and where she was having certain thoughts and some problematic behaviors. Her results were a little more extreme than she had thought they were going to be. She realized that she is spending the majority of her time thinking about her own death, and ruminating about being doomed and at the end of her life. She has been justifying skipping meals and smoking cigarettes as essentially a form of self harm ('my life is over anyway', 'it will make things easier down the line'). She's already super skinny and has apparently gotten light headed several times (people at her work have noticed she is not doing well). But her outside life looks generally fine, and she's admitted that she doesn't actually feel distressed about it, and doesn't want her therapist to escalate it by breaking confidentiality and getting her help that she doesn't want. But it also seems like that actively doing unhealthy shit to degrade your health is something that she should talk to someone about?

Involuntary hospitalization does not hypothetically exist in this hypothetical scenario. She has had confidentiality broken before due to physical safety concerns and, hypothetically, seems pretty angry about that experience.