Eating Disorders and Romantic Relationships

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This post is from the Eating Disorders, Compulsions and Addictions Service (EDCAS) of the William Alanson White Institute in recognition of Eating Disorders Awareness Week (February 22nd through February 27th).

By Carrie Gottlieb, Ph.D.

Despite the stereotype of the teenager with an eating disorder, many adults struggle with eating issues regardless of their stage of life. And many adults are also in partnered relationships. Researchers have sought to understand how eating disorders impact families, but the bulk of this effort has been focused on the parent/child relationship. Far less has been said about the impact of eating disorders on romantic relationships and spouses.

How do eating disorders impact relationships?

Romantic partners of those struggling with an eating disorder often report feeling diminished emotional intimacy within their relationship. There can be an increased distance--a loss of “couple-hood” or closeness--as their partner slips deeper into their symptoms.

Eating disorders feature intense preoccupation with food, weight, and shape, making it difficult, at times, for individuals to think of much else. This includes their relationships. People with disordered eating may dodge invitations to eat out or share a meal with their partner because they want to ensure control over their food intake and/or avoid being watched while eating.

Sexual intimacy may also suffer. Eating disorders can be associated with Amenorrhea (loss of menstrual cycle caused by low body weight or caloric insufficiency) and other hormonal imbalances, thus creating a decrease in sex drive. In addition, body shame and other body image concerns can become roadblocks to sexual intimacy. This can distance those struggling with eating disorders from their partners even further.

Eating disorders frequently become so central and preoccupying they are often described as taking the place of interpersonal relationships.

How can partners help?

While relationship difficulties are often complex, there is still much a partner can do to help. Partners can play crucial roles in the recovery process. Both recovery from an eating disorder and establishing a healthier relationship are real possibilities. Below is a list of how you as a partner can help.

1. Educate yourself

It is important for partners to learn as much as possible about eating disorders. Eating disorders are complex, multifaceted, and often confusing to partners. A great deal of information is available that can help you learn what an eating disorder really is and clear up common misconceptions and beliefs. It is often useful to attend seminars and hear/read first-hand accounts from recovered patients who can speak about their disorders and their journey through recovery. The National Eating Disorders Association (NEDA) website is often a great resource and starting place for someone looking to learn more. http://www.nationaleatingdisorders.org

2. Support your partner

At times, partners can become overprotective or hovering, inadvertently transforming from romantic partner to parent or even food police. Conversely, there can be times when they withdraw and say nothing, fearful of saying the wrong thing or pushing their loved one even further away or deeper into her disorder. Neither is a good strategy.

What works better is for partners to talk to each other. You should speak up if you notice your significant other is having a hard time--even saying something as simple as, “today seems like a difficult day for you” can be helpful. Ask questions about what your partner might need or what kind of help or support might feel useful. Since eating disorders tend to grow in secrecy and isolation, talking with one another is critical.

3. Support Groups

In addition, many partners need some support for themselves as well. It can be a comfort to speak to others in similar positions.Therapists, treatment centers, and support organizations often run groups for partners and other family members. Such resources can help you feel like you are less alone in your experiences.

Eating Disorders Essential Reads

Can Pregnancy Stall an Eating Disorder?

When an Eating Disorder Isn't Just About Body Image

4. Therapy

Many partners benefit from their own therapy or even couples therapy, typically with an eating disorder specialist who understands the complexities of the issues involved. Therapy can offer a safe place to talk about your concerns and fears, as well as learn new ways of coping with your feelings and ways to support your partner.

Despite the complexities of eating disorders and their potential impact on relationships, it is important to remain hopeful. Help is out there. Recovery is possible. Many couples find that journeying through recovery together can actually help them feel closer to one another and strengthen their relationship.

Carrie Gottlieb, Ph.D., is a clinical psychologist, currently in full time private practice in Manhattan. She specializes in the treatment of adults, adolescents, and couples struggling with eating disorders, addictions, depression, anxiety, and relationship issues. Dr. Gottlieb has received training in cognitive behavioral, interpersonal, relapse prevention, and DBT therapies and adopts an integrative approach with her patient. She currently serves on the steering committee for the Eating Disorders, Compulsions, and Addictions program (EDCAS) of the William Alanson White Institute.