National Eating Disorders Association

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Doesn't believe in clinical approach

My girlfriend struggles with bulimia nervosa. She was recovered when we first met, and relapsed while dating. She's very open about it with me. The issue I'm facing is she won't seek professional help. In her mind, she went this route for 10+ years before her recovery, and it's a waste of time. She disagrees with the approach.

So she's trying to do it on her own. She's taken the brain over binge program, and is actively trying new approaches. I admire this about her, but objectively she isn't seeing results. Things appear to be getting worse.

I've read a lot about the disorder. I listen intently, support her, and I don't push her recovery. But I'm stuck. Our conversations often go the route of the victim, where she tells me how bad it is, how I don't understand (no-one does), she's going to lose her teeth, etc. It's emotionally exhausting and makes me feel like an enabler.

I feel compassion for her suffering, but I don't know how to best help her on her journey. If I ask her she'll say "you can't" or "if I knew what I needed for help I'd do it myself".

Has anyone been in this spot? Any advice?

Another Approach

Hi benberk. I am sorry you are going through this. The problem is that you cannot help her. I know that sounds a little cold, and probably very emotionally hard, but it is the fact. She is an adult. She is making her choices.

You need to set your boundaries. By this I mean that her problems belong to her and your problems belong to you. You should tend to your problems and let her tend to her problems.

The other thing I would suggest is that you stop talking to ED. ED loves an audience. Whenever Ed pops up trying to talk to you about the eating disorder, weight, food, or anything body-perception oriented, just say you won't talk to ED and change the topic.

Also, try joining Ala-non. It is a program that works for addicts of any stripe, and ED is an addiction as much as it is a mental illness. The very first thing you will learn is that you did not cause this, you cannot control it, and you cannot cure it. Once you take that responsibility off of your shoulders, this relationship will get a lot easier for you.

Finally, a good therapist for yourself is priceless. It is very helpful to have someone who can help us to deal with this.

Sending you best wishes in your struggle.


Some terrific advice from dittoditto above. Getting a grip on what you can and cannot control is a big part of being in your position.

And honestly, your GF has a point about professional help. Not that it can't be of assistance, because sometimes it can be, but more from the standpoint that as long as she believes it's unlikely to help…it's probably not going to help.

So even if she were to get help, she'd still need to be taking responsibility for her recovery. We like to think that therapists or other professionals possess some kind of magic cure, but it simply doesn't work that way. Even if she had the best therapist in the world, how things worked out would still be her responsibility.

At the same time, EDs are really difficult matters. Even with a deep commitment to recovery, the struggle can still be enormous. So the fact that she seems to be trying to self-recover; that really does count for something I think.

"Things appear to be getting worse."

Yep, that can happen. EDs are a lot about control, and if things feel out of control, then a person's symptoms can get worse. If she is pursuing self-recovery with the same sort of iron will that got her into this situation in the first place, and yet not seeing results, well…it's going to feel to her like (you guessed it) she's not in control. A feeling which can prompt symptoms to get worse rather than better.

It's hard to recommend that she take a more casual approach to recovery. But if she can let go of some of her perfectionism, and allow there to be some bumps in the road, and be self-forgiving when there are….rather than trying to clamp down on her behaviors even more severely, maybe that can help loosen up the control-issue thing just a little?

Dare to be imperfect, you know ?

In any case, just a few thoughts.

Keep writing if it seems to help ?


This was great advice, and helped me connect more with the frustration she's feeling. Thank you for this. She's been going through a difficult stretch and I came back to read this.

I'm writing because I had a conversation with her shortly after about 'control' and she had a different perspective that I wanted to share. People may experience this differently, but when she chooses ED she feels a loss of control. This makes logical sense to me given what binging is, it's addictive qualities, and how it must feel when you can't stop. This doesn't change any of the advice, but maybe someone else can connect with this thought and I wanted to share it.

Control - The Paradox

Hey BB,

"...I had a conversation with her shortly after about 'control' and she had a different perspective that I wanted to share. People may experience this differently, but when she chooses ED she feels a loss of control."

Yes, and I'm not surprised. In the beginning, people hope they can restrict and lose weight. This sort of commitment really can feel like a matter of "taking control" of their lives. But it's really hard for most people to successfully restrict in the ways they might hope to. Often they slip up, and in their hunger, they often eat a bunch of food at one setting. But then they can have this big discovery - they can purge and get rid of it. This brings back their feelings of control. Folks will often continue to try and restrict, but since they have this way to get rid of what they eat, they will often plan out times when they will binge and purge. Because heck, they can do all this eating, but then if they purge…there's no damage, and they don't have to worry about that calories. So yay !!

Until it turns into a habit, that is. And they find that it's in control of them, rather than the other way around. Which sounds like the stage that your girlfriend is in. This really is the paradox of EDs. What started out as something that helped a person feel in control turns into the exact opposite of that, once it gets it's hooks into a person. People can sometimes fall into depression when they reach this stage of their ED.

One thing that can be helpful is if they can find ways to shuck off some of the shame that they feel, because people with bulimia often feel shame. Being able to not be so hard on one's self when they find themselves in this position is important I think. Being gentle in one's self-judgments and being open to self-forgiveness…these things are important I think.

Anyhow, just a few more thoughts. It was good to see your note, and I hope you can keep writing when you feel the need to get some of your thoughts out.