how to deal with my girlfriend's anorexia

October 26, 2008 3:26 PM

How do I deal with, what I believe is, my girlfriend's growing issues with anorexia

I have been dating my girlfriend for about two and a half months and during that time, we have discussed her extensive past struggles with anorexia and bullemia, culminating in a period of professional institutionalized rehab. Ever since we have begun dating, in a period of chaos in her life, it appears that she is reverting back to her anorexic habit. This may be due to the tumult of the circumstance that led to our dating (I was openly choosing between her and another girl, which may have forced her to feel the need to “improve” her image). I judge this not only based upon my own observations of her eating habits, but those of her closest friends who have a more accurate understanding of her body.
I have spoken to her several times about her need to either engage in normal eating habits, or if unable, to seek therapy to deal with the apparent underlying psychological reasons behind her image issues. She is fully aware of these factors and is well versed in the nutritional and psychological problems with eating disorders. It makes it even harder to speak sense to her, because she reiterates the plethora of professional help she’s had and my lack of experience in the matter. Furthermore, the control issues that are associated with anorexia are a distinct part of her personality: she feels the need to be in control.
Last night after a night where she engaged in heavy drinking, while we were laying in bed, she was having near violent physical convulsions and serious headaches which scared me tremendously. Although I’m no expert, I attributed this to her body’s vitamin and nutrition deficiencies (she admitted to having eaten nearly nothing the entire weekend, culminating in a weekend of heavy drinking).
I need advice as to how I need to tackle this issue. She has spoken about her willingness to see an expert and talk, but I feel in my heart that she is reluctant to give up her ways. I have often told her that I cannot be in a relationship with someone who is engaging in a path of self-destruction. When she fears my reproach, she will begin lightly eating for a marginal period of time, but will revert back to her ways when I am not around or when she feels that my suspicions are alleviated. I have thought about breaking up with her on the condition that she gets healthy before there is a chance that we get back together, but I honestly fear for her health, as the emotional damage might take her down the wrong path even further. I cannot, in good conscience, let her resume down this path. But, I am scared that if I am too harsh, it will only exacerbate the problem. I am 23 years old, she is 21 years old.
You can reach me with personal information/inquiries on this at [e-mail] . Thank you for your help.

posted by anonymous to human relations (13 comments total)

Alcohol and convulsions is never good. Convulsions alone are not good. She needs to get to a doctor ASAP!

Alcohol will rob your body of nutrients and electrolytes, further making her health unstable.

Again, she needs to see a doctor, really!
posted by 6:1 at 3:35 PM on October 26, 2008

"She has spoken about her willingness to see an expert and talk" That's good. You've got to get her to a professional. You can't handle this on your own. Sometimes the most obvious answer is still the right one. Why not try contacting an eating disorder specialist on your own and see what they recommend vis-a-vis getting her professional care?
posted by bananafish at 3:36 PM on October 26, 2008

I was anorexic during a period of my teenage years and although I was never hospitalized, my disorder caused frequent fainting spells, hair loss, and is the likely cause of a heart condition that developed during that time. My friends, parents, and high school gym teacher all expressed concern but the thing that got me started eating again was the idea that I was making myself uglier and uglier the skinnier that I got. A few friends commented that I "looked sick" but in my head it was easy to warp that sentiment into jealousy ("they're just saying that because they wish that they were as thin as I am"). Then a not-so-friendly acquaintance bluntly said "You could be pretty but you're so skinny that it's gross. Just look at yourself. It's disgusting." I don't know that an expression like that would benefit anyone else who is anorexic, but it really turned me around. Perhaps if you stressed to your girlfriend how attractive her figure was, and could be, if only she looked healthier, and that NOTHING is more attractive than a woman who has confidence in her body regardless of body type.
posted by mezzanayne at 3:47 PM on October 26, 2008

Do not talk about her body. Do not try to do this yourself. She needs professional attention. ASAP. I'm not sure how more strongly to say these 3 things.
posted by Sophie1 at 4:01 PM on October 26, 2008 [7 favorites]

I hate to say this, but from what you've said here, it doesn't sound like this relationship is super healthy for either of you. It sounds like drama central, frankly. How serious are you about it? If you do break up with her, I would do it no strings attached. Don't play some control game about how you can get back together if she gets healthy. Getting healthy is going to be a long-term project, and you will probably have moved on before she's anything like well. Just realize that, unfortunately, you didn't meet her at the right time in either of your lives. Cut your losses and look for someone who does not have serious emotional problems right now.

If you decide to stay with her, I guess my advice would be to try to stay as far away from her food issues as possible. I doubt that will be very far: for one thing, food issues are very often related to issues about sexuality. Her anorexia is going to intrude on your relationship one way or another. But you do not want to get caught up in constant control games around food. You can't make her get better, and trying will only make you the villain in her imaginary epic battle. Let her know that you are concerned about her, be supportive of non-food and weight related aspects of her life and identity, and then change the subject whenever she brings up food or weight. Call 911 when she has convulsions.

I don't know if that advice is any good, but that's my take on the situation. I've been anorexic, and I don't think that anything anyone ever said to me made the slightest bit of difference or convinced me to get better. What made me get better was realizing that I hated the horrible, self-indulgent, self-obsessed brat that I had made myself into and that I wanted to be something more than my diet. That had to come from me. Other people could have told me that until they were blue in the face, and I don't think I would have been able to hear them.
posted by craichead at 4:01 PM on October 26, 2008 [1 favorite]

I cannot, in good conscience, let her resume down this path.

Here's the news -- you cannot stop her from this path. It's way bigger than you are, likely way bigger than her. Anorexia is different from compulsive over-eating, wherein the problem lies in being out of control; anorexia is all about being in control.

One of the things she's in control of right now is your emotions.

She's running a game.

You can come to understand what she's got going on but you can't stop it. Regardless you quit dating her, you might want to remain her friend -- you wouldn't want a friend to bail out on you in rough times. Losing the love relationship might be the jolt she needs to get the help she needs.

Eating disorders are horrific, every bit as devastating as alcoholism, and as confusing.

Good luck.
posted by dancestoblue at 4:03 PM on October 26, 2008

This sounds like an intense situation, and not the kind of thing you should have to help someone through in the first couple months of a relationship. Help her get the kinds of help mentioned in the answers above, and if you're met with refusal, evasion, or manipulation, then you need to throw on the breaks and really consider where this is headed.

A year from now, you could wind up being exactly in the situation you are now -- a nearly bearable stalemate. Except by then, you'll feel far too invested to walk away. If you're going to fight for this, you'd better be honest about whether it's a battle that someone in your position can afford to fight, and whether it's even possible to win.
posted by [NOT HERMITOSIS-IST] at 4:12 PM on October 26, 2008

The current research on anorexia suggests that the disease is neurobiological in nature, and that susceptibility to eating disorders is up to 50% heritable. This isn't about food or about control issues or about her relationships with you or anyone else in her life. It's her brain not working right, and the manifestation of that is that she doesn't see her body and food the same way that other people do.

She needs treatment by competent physicians and mental health professionals. You can't fix this by talking with her or by monitoring her eating habits. Talking about her body, positive or negative, is likely only to make things worse if you don't know what to say. Call a doctor who specializes in eating disorders and ask for advice. You can't force her to get treatment unless she is a danger to herself (which may become the case at some point), but you can get assistance from trained professionals about the best way to make her more receptive to treatment, which she clearly needs.
posted by decathecting at 4:24 PM on October 26, 2008 [3 favorites]

Nthing what everyones said so far. You can't control this or her disordered habits. She needs serious help.

It might give you some perspective to read about what other people have been through. I've had several friends with disordered eating, and always found Bobby Burgess's journal, where he discusses her relationship with a girl with bulimia, to be incredibly honest. If anything, it might help you realize the scope of it all--how utterly out of your hands the whole thing is.
posted by PhoBWanKenobi at 4:35 PM on October 26, 2008 [1 favorite]

nthing what others have said, and also to add: you have no way of knowing what you say or do in the guise of being helpful is going to be a trigger for her. She can't even probably tell you what is a trigger for her. I know you think you are being helpful but unless you are a qualified, licensed therapeutic professional, this is beyond the scope of a layperson, and you put her in danger by trying to "help" her.
posted by micawber at 5:19 PM on October 26, 2008 [1 favorite]

yeah, the other thing to keep in mind is that anorexia is one of the hardest mental health disorders to treat and one of the deadliest--partly because it is so poorly understood, and partly because an anorexic's brain is literally wired to self-destruct. i recently read about a study that shows that when anorexics deny themselves food, it has the same effect on them as, say, indulging in something totally decadent and wonderful might have on us. it feels WONDERFUL. it's the best high in the world. and the reverse is true--while we might love indulging in a yummy ice cream treat or steak, eating for them is painful and repellent.

getting an anorexic learn to eat is a lot like conditioning yourself to light your hair on fire on a daily basis.

so, there. you have to let go of this. you can't make her better. you can't even make her take the first step to getting better. she is quite ill, and all you can do is support the decisions she makes to get better and make sure she gets help when she is in bad enough shape to require immediate care. you can't make her eat, and you can't make her see a therapist. and you can't reason her out of it.

now, this girl may have a lot to offer and you may love her, in which case god bless and good luck to you both, because you have a hard road ahead of you, but if you are minimally attached and not particularly invested in dating an active anorexic--which she will surely be for the rest of her life--then i wouid make the break now and move on.
posted by thinkingwoman at 6:40 PM on October 26, 2008 [1 favorite]

A family member is a psychologist who specializes in eating disorders. She is very effective and a wonderful psychologist, but HATES working with anorexics. We were talking about it at brunch today and she revealed that in 22 years of practice, she has never seen someone suffering from anorexia who came into treatment of her on volition.

All of them were coerced or forced into treatment by husbands, boyfriends, or parents.

Moreover, while patients who suffer from bulemia seem to recover under her care, anorexics do not. Like your girlfriend, they are well-informed and have very concrete goals: they enjoy the ability to control their environment tightly in terms of regulating their food input and have a real goal (e.g. 'All I need to do is get down to 75 lbs and I'll start eating').

They are not interested in recovering because, speaking bluntly, they're not unhappy. When my psychologist friend has hospitalized patients, she has to work with the people to work there to make sure the patients can't game the system: searching for hidden food after meals (in pockets and cuffs of pants, once in an oversized bra) and ensuring that they aren't allowed to wear clothes (to hide weights in) or drink water prior to getting weighed.

Any changes you may be able to convince her to make will likely be temporary.
posted by arnicae at 7:25 PM on October 26, 2008 [4 favorites]

This is a very, very tricky situation and I wish you the best of luck. And you are likely to get a bit of conflicting or not-applicable advice precisely because it is so very very difficult to help someone suffering from an eating disorder - even if you are a professional.

Read up at Something Fishy to get some information on how you can help.

I've never been in your position, Anonymous, and I don't know if I'd be any good at helping a loved one with an eating disorder. I have, however, had an eating disorder myself (not anorexia nervosa but ED-NOS) and the more confrontational people were about my eating, the more evasive I would get, and the more I would pull away. It's common for ED sufferers to withdraw from others in order to keep their eating patterns from being threatened; no matter how much they cherish and value their personal relationships, if the relationship is in conflict with their ED it's very likely that the ED will win. Eating disorders are similar in nature to addictions.

What helped/helps me (though of course everyone is different and this may not help her) is Just Being There. Making a fuss about food or size or weight might cause her to perceive you as a threat to her disorder, but creating a calm, non-judging environment could make her feel more secure around you and more likely to open up.

On the other hand, if she is in shaky physical condition, you might not have time to let her come around to you. The good news is that a health scare might cause her to be more open to seeking treatment (I had to get an EKG for scary heart palpitations, and although I didn't tell the doctor about my "diet" or my ephedra use, it got me eating somewhat normally again) but on the other hand, it might not. Many anorectics consider themselves somewhat invulnerable - if you can survive on 300 calories a day and burn 700 in the same day, it could very well lead you to think you're pretty strong, and maybe other people might die from heart attacks and electrolyte imbalances, but not you, right?

What I would do if I were you, Anonymous, would be to tell her something along the lines of, "You don't seem happy and you were so ill last night that I was very worried about you. I want you alive and I want you happy, and I want to help with that in any way that I can. But ultimately this is not something that I am equipped to do. Will you agree to see a therapist ASAP?" And, from there, the two of you sit down and do not stand back up until she has a confirmed appointment with a therapist, preferably one who has extensive experience with eating disorders (you can frame this as "I would prefer you talk to someone who is knowledgeable with EDs because they will understand where you're coming from" rather than "I want you to get help for your ED"). Try to make it as not about food/weight/body as you possibly can, to minimize the risk of inadvertently triggering her.

However. Even if you two have a fantastic, perfectly functional relationship, even if she is 100% willing to go into treatment, and even if she gets therapy and appears to make a complete recovery, in the long run the odds are still stacked in the ED's favor. Complete recovery is rare, and it is very likely she will revert to her old attitudes and behaviors under periods of stress. Even decades from now. You may need to fight this for as long as you are in any sort of relationship with her.

My heart goes out to you both and I hope you find something that works.
posted by Metroid Baby at 8:24 AM on October 27, 2008