National Eating Disorders Association

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FSW91
What am I supposed to do/say?

My wife went through treatment for an eating disorder and on most days is doing well. She follows the recommended meal plan that was taught to her in treatment, but of course has better/worse days with it. I'm struggling to find information on the best thing to do in certain situations. For example, on bad days when she asks if I think she's gained weight, I've opted to gently refuse to answer the question. I usually say it's not helpful or important, and that I love her and am attracted to her. I have no idea if it's helpful that I refuse to answer- I just figure it's wrong to entertain her preoccupation with it and justify it by answering as if it's okay to be concerned about it (for most people of course it is okay to notice/get concerned but for her/others it's a slippery slope). Another situation is when she's having a bad day with it and she's saying she's anxious about good- I have no idea what to say or do. Do I lovingly push her to eat normally? How hard do I push it? If she wants to go for a run before an anticipated big meal, is that okay because it's not completely outside the norm of what people might generally do, or is that heading down that slippery slope? I guess I'm struggling with which coping mechanisms to support or let go, and which to fight. Any advice is appreciated.

BobJ48
Helpful Comments.

Hey FSW,

To be honest, I think that your on the right track with your comments. As you have noticed, old ED concerns and ways of thinking die hard, and will try and intrude themselves while people are working at recovery. While I think it's only being realistic to acknowledge this, it's good to not allow yourself to get sucked into going along with it. But to do that in a caring and sensitive way.

As you've seen, left over ED thinking will try and lure you into making appearance-type comments. Depending on the mood of the moment, you can take a more or less light-hearted approach to your answers. Which sounds like what you are doing, so good for you !

When it comes to anxiety about food, it's probably OK to commiserate with her about that. Because frankly, it's not unrealistic that she's going to be anxious. It's going to feel risky to her to take chances with eating sometimes, and I think it's OK to let her know that you understand those feelings, and how recovery is going to involve taking risks with food. Because recovery really is like that - Daring to take both food and emotionally related steps that ED is going to be telling them that they should not take. There really are risks that she'll need to be taking, and my sense is that it's OK to be open about that in a caring way.

When it comes to coping mechanisms , one of the things about EDs is that people often respond with actions ( like going for a run, or out and out restriction or purging) when it would be better for their recovery if they were responding with words and emotions instead. As you may have noticed, exercise is not necessarily a bad thing for any of us. Sometimes it can be a healthy way to deal with stress. But if the person finds themselves using it as a response to fears about weight-gain, when they probably should be experimenting with trying to talk those fears out instead.

As you are noticing, recovery presents the person with a lot of challenges. They are constantly asking themselves to do things which are a direct challenge to their old ways of thinking. Taking chances which really can feel wrong to them. This sort of anxiety and ambivalence is pretty normal I think, and if you show that you understand that, it really can feel supportive I think.

( I saw that it seems to have taken a few days for your post to show up here. Not sure why that was, but I hope you won't let that discourage you from continuing to write )

Bob J.

Doingmybest
Adding on with my own questions

Hi, sorry to hijack this thread but I'm having a hard time posting my own for some reason and my concerns are very similar.

I've been with my 24 year old boyfriend for about 2 years and last year he opened up to me that he had been severely bullied in middle school for his weight which resulted in him developming serious bulimia. At that time he missed several months of school and his doctors and parents still don't know that it was because of bulimia-- they thought he was just... sick. I understand that many people unfortunately didn't and still don't understand that these struggles effect both genders.

He's an incredible person and I just want to help him more than anything, and finally was able to convince him to see a therapist for the first time in his life. I know it has been heloing him a lot (she's an ED specialist) and it has definitely been a great relief for us both. However, he definitely still struggles and sometimes he just shuts down and acts really down on himself. When I ask him why he just shuts down. Sometimes he tells me its because he thinks he's "fat" or because he's gained weight. I don't know what to do or say when he says this. If I say "I really don't think you have! You are so handsome" I worry I'm encouraging his thoughts about his appearance, but if I say something like "I don't care about your weight, I love you for who you are" I feel like he might think I'm conceding that I think he looks like he's gained weight or something. I usually just say some jumbled mix of the two, and it feels like I've done nothing to help. I honestly don't care how much he weighs, I just want him to be happy, and I want to say the right thing. I love him.

Another thing I worry about is how to respond to his exercise habits. Before I knew him, he was overweight and went through a really bad time with drugs and depression. About a year before I met him he stopped using drugs, got an awesome job, moved out of his parents' house, and lost a lot of weight. I think a big part of how happy he became during that time had to do with his self-confidence surrounding his weight, and I don't think (although I guess who can say for sure) bulimia was the cause of this weight loss. I think it was going to the gym. It makes him feel really good and confident to go to the gym and eat healthy. Should I encourage those behaviors for those reasons? It's normal and healthy to regularly go to the gym and to eat healthy foods, but I don't want to encourage behavior that might make him obsess over his weight. The problem is, when he doesn't go to eh gym and eat healthy he gets really depressed. Sometimes, he'll even say "Okay, I'm really going to get back on the gym grind, don't let me miss tomorrow because then I'll spiral." It's true... he does spiral when he loses that healthy eating and exercising routine. Should I help him stay on it as a normal healthy habit to encourage, or is that wrong? It is so hard to know.

Anyway, so sorry FSW91 for adding to your thread, and sorry this was so long. It has been building up for along time. I really appreciate it if any of you have read this far.

-Kate L

MMTF98
Hi FSW,

Hi FSW,

I am sorry you are dealing with this. Since April of this year, I have also been trying to help my wife recover from anorexia. It has been terrible, frustrating, and sad. It has also been a big learning and growing experience for me. I am slowly learning that the best help isn't the direct help, problem-solving, or the planning and worrying that I did. The best help for my wife is indirect – listening with compassion when she opens up, detaching with love, and living my values in what I say and do in the present moment.

I recently read "Don't Feed the Monkey Mind" (about Anxiety) and "The 8 Keys to Recovery" (about ED) and both books have been helpful in understanding what is going on with my wife and what I am doing that isn't helping her or me. I am currently reading "Codependent No More," which is largely written for loved ones of alcoholics or addicts, but also applies to ED. I am not done the book yet, but the concept of "detach with love" makes a lot of sense as it is beneficial for me while also empowering my wife to make her own choices for health. I have seen a therapist with experience in treating ED for several months now and I find that helpful too.

As you and Bob suggested, I think you are doing the right thing by not taking to your wife about weight or looks. She already values these concepts too much as part of her identity. I would also recommend you make sure her friends and extended family also don't talk about looks to her because even something seemingly benign like "Oh you look great" can be misinterpreted by the ED as "that means I got fat". And again "Oh you look great" reemphasizes the importance of looks over the substance of who your wife really is. The run stuff is also concerning for anyone with ED as it is a safety strategy that only serves to reinforce the importance of looks, weight or being skinny (i.e. – I am anxious about eating so go for a run [to burn calories] and then I won't feel as bad about eating. This simply reinforces the idea that keeping net calories down is the important thing). Like Bob said, you hope your wife won’t avoid the anxiety (with the run or other safety strategy) but talk about the underlying emotions and thoughts to process them and eat anyway. This is what she did in treatment, and what she has to continue to do to keep moving towards recovery.

From someone who is currently right in the thick of these struggles, I understand how sad, frustrating, and confusing it can be. Recovery isn't linear, motivations change, and life can and will throw you plenty of curveballs. With that said, I think there is wisdom in what Carolyn Costin says in The 8 Keys ". . .the only people who don't recover are the ones who stop trying." As along as your wife is trying, recognize that as a positive and try to find ways to empower her to make small changes that set her up for accomplishment and a sense of control apart from the ED.

Best,
MMTF98

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