Many women secretly believe that being thin is the solution to finding and maintaining a good relationship. But when the obsession to lose weight is taken to an extreme, real intimacy becomes impossible. The need to stay thin takes over every aspect of their lives. In extreme cases bulimia sufferers can spend up to £500 a month on food for bingeing, and can vomit up to three times a day, sometimes more. They become so single-minded about food and their body size that they don’t have room in their minds for anything else. David was to discover this with his wife Kate, as he found himself out of his depth trying to survive the stress and madness of living with someone with an eating disorder.
“I was bingeing and vomiting every evening, always on savoury food, never on sweets,” says Kate. “I wouldn’t eat during the day and would cook meals for us all but then I would go up to the bathroom. David knew what I was doing. He spent a lot of evenings away because it was such a horrible situation.” The couple are in their thirties, living in North London with their two young children. They met 11 years ago. “The attraction was physical and mental,” David recalls. “Kate was intoxicating; intelligent, strong, fiery. However, from the beginning, I knew that something was wrong around food.” He was right. Kate had turned to food for comfort in her teens when her family failed to give her the emotional nourishment she craved. “I would come home from school at the end of the day and had to eat with my family. I started throwing up then to get rid of the food and it became a daily occurrence for 20 years,” she says.
David says that her bulimia made him feel lonely, shut out and unloved. “Everything about our life was affected; our social life, my relationship with my family and, worst of all, our life as a couple. Every time we had an invitation, it filled me with dread knowing I had to make up excuses not to go. Kate was like a teenager; I couldn’t trust her. The way I dealt with it was by thinking it’s not her, it’s because she’s ill. I was always making excuses for her in my mind.” Giving up bingeing was too frightening Kate also knew that her eating disorder was affecting the marriage. “We weren’t functioning as a couple. But I also knew that to improve our relationship I’d have to give up bingeing, and I was too frightened to do That. “I never felt safe outside the home because I didn’t feel safe around food. We couldn’t go anywhere there was food because I felt that if I ate, I couldn’t control it, and that I would end up bingeing and vomiting.”
There are 6.6 cases of bulimia and 4.7 cases of anorexia per 100,000 population, according to the Eating Disorders Association, now known as Beat. And women are 12 times more likely to suffer than men. Beat says, too, that the age at which eating disorders can start is rising gradually. Many sufferers leave the illness untreated for years, so more are now married or living with partners. These couples typically have low levels of emotional and sexual intimacy and poor communication. Research and statistical findings also suggest that married women with eating disorders experience more severe symptoms and have a less favourable prognosis than single women. How then does the condition contribute to problems in relationships, and how might partners unknowingly contribute to the illness?
Sufferers attempt to satisfy their needs and soothe their feelings through their obsessions surrounding food, which allows them to avoid the difficulties and complications of relationships. They master one relationship only: with food. With this single-minded attitude, they begin to treat their partners in the same manner as they relate to food. Women with anorexia, for example, deny that they have any needs, physical or emotional. They will interpret all the nurturing and care other people have to offer as dangerous intrusions that must be repelled. In the case of one couple I treated, the wife interpreted her husband’s attempts to encourage her to eat as aggressive. Yet she could not recognise the dangers of a cabbage and vinegar diet that left her hovering around 5st (31.7kg). Through their vomiting, bulimics not only get rid of food, but also the bad feelings that they cannot digest; they are rejecting the nourishing aspects of a relationship. They often attempt to mask their needy and demanding sides by trying to convince their partners of their self-sufficiency. As they push their husbands away, they hide their need for closeness, all the time becoming more vulnerable and less approachable.
This can be terribly confusing for men who feel as if they can do nothing right. They cannot ignore the distress of their wives and yet they are pushed away, often aggressively. As with food, these men can be left feeling spat out, as if their words have not been properly digested. David describes it this way: “I thought the way to fix it was to make Kate happy. She wasn’t able to accept it. I could buy her ten things, but it wasn’t good enough because it wasn’t eleven… like a cup you couldn’t fill up. I felt like a child trying to gain love and approval from his parents, but at every stage being told ‘you’re a disappointment’. “Kate reflects on the impossibility of his attempts to help. “You cannot have a relationship if you have an eating disorder. It will want to destroy any relationship you have because it threatens your relationship with Food.” After several years of watching their lives and relationship deteriorate, David says that eventually he had to do whatever it took to get help for Kate. She began individual therapy, followed by couples’ therapy five months later. It was here that Kate says she finally saw how damaging the disorder was to their marriage. “Even in individual therapy you can fool yourself and your therapist. David would bring the reality into the room and I had to face it. Going through the experience together was essential for my recovery.” David also had to recognise his unconscious contribution in maintaining the symptoms. For example, by projecting his own insecurities on to Kate – seeing her as the only one with problems – he could rid himself of negative feelings. Kate has noticed many changes in David during the course of therapy. “He’s more assertive. Before, he never wanted to upset me, which gave me an enormous amount of power. Now, he’ll challenge me. Therapy has strengthened him and given him a voice. That was difficult for me at first because I heard his challenges as attacks on me. And I knew that I couldn’t hide, so it threatened my eating disorder.”
“The illness had permeated my life” She also had to learn to use her mind and voice, both suppressed by her bulimia. “I’m learning how to communicate. I had to recognise that I couldn’t trust my thoughts, and that I needed to listen… that was the hardest part. The biggest shock to me was that it wasn’t just about food. “The illness had permeated every aspect of my life. I thought that once I dealt with the food, everything would be all right, but it was just the beginning of a long process.” Kate is now free from bulimic symptoms, although she continues to struggle with her difficulty in dealing with intimacy and acknowledging her needs. But David is optimistic about their progress. “Our life is completely different. It’s so much more normal. We’re more of a couple, our life is much more social. There are fewer barriers between us. It’s like a huge burden has been lifted from the both of us.” David and Kate are not their real names.
Advice for men: ‘Don’t think you can cure it on your own’
- Learn what you can about eating disorders. If you think there’s a problem, do something about it. And be patient; it won’t go away overnight.
- Don’t have challenging conversations around meal times, that’s when feelings are most intense.
- Look after yourself; don’t give up the things you enjoy.
- Say what you think. People with eating disorders need a dose of reality.
- Avoid arguments. People with eating disorders are sensitive to criticism, so be aware of your words and tone.
- Don’t think that you can cure it on your own.
- If your wife says no to treatment, seek professional help on your own. This can provide support and perhaps make your wife curious enough to join in.
- Find someone who knows about eating disorders.
And for women: ‘Let your partner help. Don’t shut him out’
- Don’t think you can recover on your own, get professional help.
- Talk about the illness with your partner or other people; it will lessen the fear.
- Be honest about how the eating disorder is affecting your life and those close to you.
- Get the facts. Know that this illness is progressive. The longer you leave it, the more difficult it is to treat.
- If you find it difficult seeking therapy, let your partner help. Don’t shut him out.