If you’ve been thinking this whole time that eating disorders are a “teenager problem,” it’s okay–you’re not alone. Little media attention is given to the exploding number of women (and men!) aged 20+ who struggle with eating disorders, but practitioners and researchers alike are realizing that people outside the “typical” age range of eating disorders are seeking treatment in greater numbers than ever before.

Why are we seeing more adults with eating disorders in treatment? A few hypotheses:

  • These adults may have had eating disordered behaviors as teens that were either never treated at all, not fully treated, or are simply resurfacing because of stress, trauma, low self-esteem, depression, anxiety, etc.
  • These adults may have had the eating disorder behaviors all along, but were unable or unwilling to seek treatment previously, for various reasons.
  • For men, eating disorders were once considered something that only women were “supposed” to have. While it’s true that women still comprise the vast majority of patients in treatment for EDs, men are presenting for services in increasing numbers as well.
  • While the role of the media is controversial among those who treat EDs, the fact of the matter is that female models are thinner than ever, and male models have impossible-to-obtain muscularity. Yes, airbrushing has a lot to do with it, but many people take what they see on tv, online, and in magazines as the truth of what “beauty” is, and it’s an impossible standard.

There’s lots to know about eating disorders, especially if your partner is struggling with one. This post will just skim the surface with a few basics that you as the healthy partner should know, and I will come back to this topic from time to time.

The top five things you need to know as the partner of someone with an eating disorder:

  1. Eating disorders do not appear overnight, and they do not disappear overnight.
  2. It’s not about the food.
  3. Recovery from an eating disorder is an “all hands on deck” process. Everyone in the person’s life needs to be part of the team and supportive of the person’s recovery.
  4. Your partner has to want recovery for themselves. No one else can be the reason they choose to get better, and medication alone will not solve the problem.
  5. Recovery from an eating disorder is hard work, and it is often not a linear process. There will be two steps forward, three steps back at times. This is normal…as long as the process does keep moving forward.

Now a brief explanation of the above:

  1. No one wakes up one day with an eating disorder. One of the toughest parts for everyone involved in eating disorder recovery is the length of time it takes to recover. The average recovery time is two to seven years. Yes, years. Some people can do it faster, some will never fully recover. And that’s with full-blown treatment that includes at least weekly psychotherapy, medication, and active participation on the client’s part to change behaviors. For people who are more severely ill, inpatient or residential treatment may be required.
  2. For someone who does not have an eating disorder, the recovery process seems pretty simple: eat more, if the client is anorexic; stop bingeing and/or purging if the client is bulimic or has binge eating disorder. In theory, that sounds great, but that’s actually not the problem. Food is a tool that is being used to manage the client’s distress. For people with anorexia, not eating produces a “high” that can distract from unbearable emotional pain. For bulimics and binge eaters, bingeing can be a way to “stuff down” feelings. Purging can provide a relief, a way to release tension and anxiety. So, food is not the enemy; it’s the feelings your partner is struggling to control that are the problem.
  3. Your partner will need a lot of support through the recovery process. As you’ll learn, people with eating disorders struggle with accurate perceptions. A well-meaning comment of, “You look great!” to a person with anorexia who has regained five pounds translates into “You are so fat!” Patience, encouragement, discussing your partner’s feelings, being willing to support your partner when they are trying “scary” things, like eating out, and communicating with their treatment team are all vital for recovery.
  4. Having said that, no one can make someone with an eating disorder recover. Sadly, eating disorders have the highest rate of death among the psychiatric illnesses, at 10%. Even hospitalizing someone and sticking a tube in their stomach or down their throat cannot make them survive if they don’t want to. The person can have the greatest therapist ever, an appropriate amount and type of medication, and lots of love and support from family and friends, but the bottom line is that the person has to make the right choices for themselves.
  5. Finally, even with making good choices, and having all of the above as support, recovery from an eating disorder is a process. Your partner might be doing really well for a while, and then suddenly backslide into old habits and behaviors. This is where communication is extra important, both with your partner and with their treatment team. Your partner may be reluctant to share their slips with their team, but it’s really important that the team know what’s going on. For example, some medications only work appropriately if taken with food. If your partner is restricting or purging, the medication they are prescribed may not work, which could increase the velocity of the downward spiral.

As I said, this is just the tip of the iceberg on having a partner with an eating disorder. I encourage you to check out the following links for more information:

All About Eating Disorders

Weightless, a blog on body image here on PsychCentral

Eating Disorder Hope

Something Fishy

EDReferral.com, a site for finding treatment

National Eating Disorders Association