Loving someone who is battling an eating disorder (ED) can be quite challenging. You may not know what to say, how to act, or in what way your loved one needs your support. While working daily with individuals with EDs, I get asked a variety of questions from family members who are trying to better understand how they can participate in the treatment and recovery process. There isn’t always information readily available for families, more specifically for spouses, on what things are helpful and unhelpful. Inspired by one of my former patients, I created the following list as a general guide particularly for husbands/wives/partners whose significant other is struggling with an eating disorder and is currently undergoing some form of therapy or treatment. Some things on this list may not work for your relationship so I’d always recommend asking your spouse or partner how you can best support him/her and in what ways he/she is willing to let you participate in their treatment.
- First things first, know that at their core, EDs are not about weight. There are many causes for the development of an ED and there are many different reasons why these disorders continue to exist, sometimes for years, before an individual seeks help.
- Once your spouse/partner has informed you that he/she has an ED, take time to educate yourself about these disorders before drawing conclusions. This is critical as you begin to navigate the road ahead of you. The more you can learn, the better prepared you’ll be to participate in this journey and to offer support to the person who needs you most.
- Reduce or eliminate weight or specific appearance-driven comments. While you may be coming at the subject from a place of love, someone battling an ED can misinterpret such comments and the ED can then utilize this to further the disorder. It may be better to comment on other aspects of your spouse/partner that you like or love. Find non-appearance based topics to talk about and remind him/her of the reasons you fell in love.
- Be mindful of the challenges treatment and recovery brings. As if battling the disorder itself wasn’t hard enough, going through this process is daunting, confusing, and anxiety-provoking, among other things. If your spouse/partner is extra irritable in the beginning of treatment, know this may be a result of drudging up many emotional issues that have been buried for years. It may also be a result of stopping the ED behaviors. When the behaviors are ceasing, individuals often don’t know what else to do. They can become easily activated until they learn new skills and new ways of coping with themselves, their lives, and the world.
- Respect their personal boundaries. Because those with EDs are dealing with many body image challenges, whether related to past trauma, bullying or another reason, intimacy can be very overwhelming. In addition, individuals can experience several body changes as they are learning to nourish themselves in a new and healthier way. Give your spouse or partner time and space to develop a new relationship with themselves and their bodies without pushing them into intimate situations that may activate a deep emotional wound or trigger an ineffective response. This is an area your spouse/partner will likely be addressing more actively in their therapy sessions and is one way he/she may be able to use their new skills to share with you what they are or are not comfortable with.
- Treatment is hard and is necessary. Individuals are encouraged to put as much time and energy as they can on their treatment process. Because of the medical complications that can arise when an ED is present, we as clinicians will often recommend that patients prioritize getting better and work on healing the physical aspects of their EDs in order to do deeper emotional work. As patients progress, they can integrate into their lives more fully and more healthfully. This is particularly important when your spouse or partner is in an intensive treatment program such as residential or partial hospitalization.
- Get rid of the scale! Having a scale in your bathroom and readily available can reinforce the urge to step on. We encourage patients to permit their treatment teams to track their weight and to bring their scales to session, destroy it or have someone they trust hide it. If you do hide the scale, it may be tempting to share where it is when your spouse/partner asks. The goal isn’t to exert power, but to assist in limiting the access to a key aspect of the ED, so it is best to refrain from sharing where the scale has been hidden. If you feel you must have a scale for your own purposes, then hiding it may be the best option. Otherwise, I would recommend removing it from the house altogether.
- Your spouse/partner wants you to understand. One of the most common things I hear from my patients is that family members “don’t get it.” Some feel like they are being yelled at or told what to do versus being supported. Others feel like they’re not being heard or like their spouse/partner is not making any effort to understand their struggle. The bottom line is that you may not be able to fully understand because you’re not the one with the ED. However, you can educate yourself and follow some of the other suggestions here to at least build awareness.
- Recovery is possible and it can take a long time. You may assume that because your loved one has been in treatment or therapy for a few months that they “should be” cured. The reality is that full recovery from an ED can take years. There is no “cure” for an ED. Instead, there are various treatment interventions utilized to assist patients in learning new skills to manage their emotions, experiences, reactions, relationships, etc. without turning to unhealthy coping mechanisms. Implementing these new skills then requires practice.
- By being open to providing support, you’re playing a large role in the journey toward freedom from an ED. I’d encourage you to open the lines of communication with your spouse/partner. Ask how they are doing, what challenges they’re having, and most importantly how you can best provide support. Fighting back against an ED on their own makes things much more difficult. If you’re being asked to stay out of the treatment process, I’d recommend asking your spouse or partner in what ways they are willing to let you in. As he/she progresses, you may be invited in more openly.
While the above is not an exhaustive list, these may good starting points. By letting you into the ED world, you’ve been given an immense amount of trust from someone who may have much difficulty trusting people – guard this with all of your might and simply do the best you can. There is no perfection in the journey to recovery.