When Joanna Kay and her now-husband were dating, her thin body and bird-like eating habits weren’t terribly alarming to him. After all, that’s how he’d always known her. But as things progressed from dating to wedding planning, with all its stresses and expectations, the anorexia she’d been hiding reached a breaking point.
Her sudden entry into inpatient therapy shocked her fiancé. As a medical student, he had spent a single day looking at a PowerPoint presentation on eating disorders. Kay says he was shocked and even felt a bit betrayed, and his learning curve on how to support her was steep. Suddenly, their relaxed weekend brunches after sleeping in were replaced with strict meal plans on regimented schedules.
When your significant other is among the 30 million Americans who has an eating disorder, date options like dinner and a movie or cocktails and appetizers can seem fraught. But while long walks and museums are great, eventually you need to eat, which means the issue is going to come up.
“Eating disorders are complicated and counterintuitive,” says Ilene Fishman, a licensed social worker who co-founded the National Eating Disorders Association. Fishman, who has private practices in New York and New Jersey, has specialized in treating people with eating disorders for more than 30 years. “One day the rule could be they can’t go out to eat in a restaurant. Another day, maybe they can. You need to keep an open mind and talk to them regularly about what they're feeling and what they need."
Sometimes, a relationship can actually be the catalyst for a sick person to get treatment. Anorexia first showed up for Kay, 29, when she was about 14. But it wasn’t until roughly a decade later—when she was 25 and planning her wedding—that things became unbearable and she finally sought help.
For her husband, a fourth-year medical student at the time, the temptation to try and manage her eating plan was strong. At the beginning of treatment, Kay's diet was highly regimented so that she could gain to a healthy weight and get used to eating regular meals again. “We had to find that balance between him being helpful," Kay says, "and not being the food police."
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Jamie Dannenberg, 30, serves as the primary caregiver for her partner, OJ. While Dannenberg works as a dietician outside Boston, her training didn’t prepare her to care for her anorexic partner. She found herself going into caregiver mode, whether it was welcome or not.
“Asking OJ to take one more bite of food—that’s more of a parent role than a partner role,” Dannenberg says. “It caused a lot of tension in our relationship. We knew it wasn’t going to help recovery. It wasn’t making things any better, so I just slowly tapered off.”
Being in a relationship with someone who has an eating disorder can also mean indulging certain quirks more often than you’d like, especially as they’re taking baby steps toward a more healthy relationship with food early in recovery. For instance, Fishman explains, your date may need to scrutinize a menu online before agreeing to eat at a given restaurant. They might also need to make a million substitutions to their entrée—but that should be the server's problem, not yours, Fishman says. Commenting won’t help.
She also cautions against any impulse you might have toward managing their food intake. “That’s a losing proposition, always,” Fishman says, adding that you'll likely just breed resentment. “Boundaries are really important,” she says. “They're a huge issue for someone with an eating disorder. It’s important to respect them."
Kay, four years into recovery, says that the beginning stages are more regimented and difficult, both for the recovering person and their partner. With time, things get simpler—so brunch may be in your future again.
Another potential trap to watch out for: Any question that involves commenting on your partner's weight or appearance. “No matter what you say, it can be misinterpreted,” Fishman says. “It’s best to say, ‘I think you’re beautiful,’ or even, ‘I’m not going to comment on your appearance.’”
It's also reasonable to expect that, if your partner is in recovery, they're probably in therapy—or may be eventually. Fishman says family, friends and partners have a role to play there, and she highly recommends their involvement in therapy.
“I love when people bring in partners and family members and siblings” to therapy, she says. It allows the person in a supportive role—friend, family or partner—to get firsthand, personalized information about their loved one’s struggles and recovery.
Kay takes that a step further, also recommending couples’ therapy. She explains that it's been helpful in negotiating and communicating the needs she has as a recovering person with her husband. Recovery also brings change, Kay says, and that can be a bumpy road in any relationship.
"One person can’t undergo a transformational change like going through recovery without the other person changing as well,” she says. It’s also important for you to find a support network of your own—even if it's an online community.
“It’s stressful to watch your loved one struggle and wonder, ‘Why are they doing this? Why can’t they just eat?’” Kay says. “It’s critical [for partners] to have a support network without putting that on the person in recovery.” As a partner, you might feel a little out of place, since many support groups are geared toward parents, Dannenberg says, and that's okay. Take what you can from the experience.
“There are definitely similarities, but there are [also] differences," Dannenberg says. "Those gaps for adult caregivers are one of the reasons we started our blog, to be able to reach out to other partners and friends who are primary caregivers.” Even if a Facebook group seems to be made up of mostly parents, don't hesitate to join anyway. A community of people who get what you’re going through is crucial.
Finally, if the person you’re in a relationship with seems to be struggling but doesn’t have a diagnosis, bringing it up may feel horribly awkward but it could be the lifeline they need, Fishman says. “I encourage people to say something and be direct and honest and clear. If it quacks like a duck, it’s a duck. I think it’s a mistake to try to avoid it. The person suffering needs a person to notice.”
For more information, visit the National Eating Disorders Foundation.
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