National Eating Disorders Association

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Rose1022
A developing problem for my boyfriend

Hello everyone. Firstly let me say that I’m so glad I found this forum because at the moment I just have no idea what to do. My boyfriend and I are both 24 and have been together for almost four years now. We have had our fair share of hardships as my boyfriend has several mental health disorders including bipolar, anxiety, and depression. He is a self conscious person, but up until now he’s had no history of any obvious eating disorders. His sister had a very serious ed when he was a child and it affected him significantly.

About 9 or so months ago he developed a stomach ulcer and was getting sick consistently every morning because of it for several weeks. He went to the doctor and got it treated, but never stopped getting sick. He has a therapist and they toyed with the idea of him being so used to getting sick at this point that it is in his head. I believe this is very likely but lately it has taken a more sinister turn. I no longer believe this is a reflexive issue, I think it has turned into an intentional act.

My boyfriend is a relatively compliant patient when it comes to treating his mental health, but his attitude with this new problem is unlike I’ve ever seen him. The first time I brought it up, I approached it very gently, like I always do when handling these kinds of issues, but he turned very defensive and agitated. He very adamantly insistent “It’s not a problem” over and over while attempting to justify his actions. I pressed it slightly, but dropped it for the night. I brought it up again recently and he was just as cold and unyielding. Despite seeing a therapist and a psychiatrist I feel confident enough in saying that this is something he has not told either of them.

His relationship with food is a tricky one as it has changed a few times throughout our relationship. Before his ulcer he had a tendency to over eat, but he would sometimes say that he hates the concept of having to eat. During his ulcer he lost a lot of weight and expressed often how much he hated food and hated getting sick. Now, he says nothing negative about food. Sometimes he will over eat and other times he will not. But he does, and always has, snacked a lot at night after dinner. He gets sick just about every morning. He is so non compliant with this I just don’t know what to do. He has an addictive personality and I know I really need to do something about this before it spirals into something even worse.

Thank you for taking the time to read. I could really use a bit of guidance.

BobJ48
Rose

Dear Rose,

Yes, it's hard to know what the story really is with this. Is it an eating disorder, or what ? It might be, I suppose, particularly if he's mentioned issues with his weight in the past.

It's also possible that this stomach issue is emotionally unsettling for him. It would be for me, I know. So his throwing up might be one of those " OK, let's get this out of the way" sorts of things ? Where he throws up on purpose, rather than waiting until things get so bad that he dosen't have a choice but to do it ? Which might be a thing that makes him feel as though he has some bits of control over the issue ?

Who knows what the situation with his meds might be, because I suspect that the doctors may have prescribed some antibiotics for his ulcer ? Sometimes those can make a person feel nauseous too ?

My sense is that you may have to give this situation a little more time, before you really know what the story is, because if he is legitimately in pain, and really is still nauseous with some regularity, I can see where it might still be hard to pin down exactly what's going on.

PaulShipmanSmith
Reply

The therapists may have been a little too blunt by saying that the sickness is just 'in his head' and could have worded it more sensitively. However. It is not unusual for many of us to experience this fear after a bout of illness, especially when it involves being sick or having diarrhoea.
Your boyfriend does appear to be at risk of developing an eating disorder but it's finding out all the facts without him feeling pressured.
Although you fear that he is developing an eating disorder, try using the ulcer as a starting point in your investigation.
Approaching the subject with him about the ulcer may be a little less confrontational than discussing his possible eating disorder. That you can move on to later.
For a start. Your boyfriend has already been treated for this ulcer. However. He could still be experiencing some trouble with it. He may need to go back to the doctor and have it checked out.
People often don't want to talk about health problems and admit to being in pain. Your boyfriend could be trying to hide this from you.
He may not be discussing issues with the therapists for various reasons. One reason could be that he feels uncomfortable talking with them about his physical problems.
The counsellor/client relationship does not always work. Sometimes, two people 'get on' straight away. Other times they don't and communication can be less effective.
You could sit with him for a start and gently approach the conversation about his sickness and try to encourage him to see the doctor. He could be experiencing a deep impact from the ulcer - which can sometimes follow on with the patient becoming over-preoccupied with their health.
On the subject of his eating and general health, it might be worth investigating his diet. What your boyfriend ate before, during and after the ulcer episode could actually have played a part in his illness.
You mention that he 'snacked' a lot and still does. Yes. As hard as it may be to accept. Snacking can cause poorly tummies. A change may be needed in that area.
Many people find it difficult to accept and deal with the fact that what they are consuming is making them ill.
In fairness. Many people are unaware that what they are eating is making them ill.
Your boyfriend may be suffering an allergic reaction to certain foods and is unaware of this. He could be aware that certain foods - the stuff he likes most - may be making him ill yet he is unwilling to face and accept this.
Due to your boyfriend's various issues with mental health, his eating habits will have - and still be - affected by his situation. It is not unusual for people with mental health issues to experience difficulties with regard to their diet or eating habits.
Some people will be very 'picky' eaters. Some will only eat at a certain time, from a particular style of plate or want the food in a certain order or position. Then there are those who will only eat if the food is prepared in a certain way.
Some people will eat 'out of character' when experiencing the emotional highs and lows of their mental health journey. When depressed - for example - some people will overeat or 'comfort eat' . However. Some people will not eat all day.
There are those that will not eat amongst other people, so will avoid food until they are alone.
Then you get those that will criticise when others are enjoying their food, in the hope of causing a 'guilt trip'. The list can go on........
Guilt can be associated with eating and meal times, especially if someone is experiencing the anxiety, depression and negative feelings involved in struggling with their psychological well-being.
These are areas worth exploring.
You could explain that you are worried about his health and you may both benefit by seeing the doctor as a couple.
You may also want to look into couples counselling in order help encourage him to explore the possibility of a developing eating disorder. Should this be the case, you'll be more informed and prepared to deal with this together.