Dear Dr. Andrea,
My partner has a history of eating disorders and was very open about it when we met. She was very active in therapy and a support group, and she was motivated and committed to a healthy lifestyle, mentally and physically. Fast forward three years, the past year of course very strange with both of us working from home all the time and stressed like everyone else. Our usual routines were thrown out the window, and it bothered her that she couldn’t have the active life she usually did. At some point, she started to get pretty regimented about jogging each morning, which I thought was reasonable and healthy — getting fresh air and cardio, and adding structure to her day. (Honestly, I wish I had the motivation to do it myself.) She added a pretty strict lunch for herself, which also sort of made sense, because she could make a bunch in advance and not be bogged down with food prep during work.
But I’m a little worried that maybe I am blind that this is her eating disorder taking over again. She never has dessert, she jogs extra if she thinks she’s eaten too much the day before, she weighs herself multiple times per day. She now never eats what I cook, and does Zooms with friends where they’re having dinner, dessert or a drink and she’s always the only one without. I do think she’s lost a little bit of weight, though not a lot. But I’m with her so much it’s hard to tell. I keep trying to convince myself it’s all just a way of getting control during a time that feels uncontrollable, but I’m not sure.
— Just want her healthy
I’d bet what you’re witnessing is her trying to gain some control over a situation that feels uncontrollable, like for so many millions of us. But that doesn’t mean all is well. Ask anyone in recovery from an eating disorder, in fact, and they’ll tell you that trying to control what feels uncontrollable is often at the origin of the eating disorder itself.
I’m not saying this is an emergency. But disordered eating is a spectrum — which looks very much like a slippery slope. I don’t subscribe to the idea that behaviors need a diagnosis to be a problem, especially when there’s history. This is just like how getting tipsy at a wedding may not be a big deal for someone with zero past alcohol abuse, but might be a warning sign the size of a Las Vegas billboard for someone who struggles with addiction: The context of history matters immensely when looking at behavior.
And that behavior does seem to be moving in a concerning direction: toward more rigidity rather than less. Flexibility and balance are the very foundation of recovery from eating disorders, so the all-or-none mind-set of jogging extra because she ate “too much” and the constricting standards that make her want to see her weight multiple times per day are definitely worth paying attention to.
But let’s not treat her like a lab specimen: She’s your partner, and it’s obviously her thoughts and feelings that matter most here. You don’t need a referendum or a clinical opinion to start a “How are things really going?” conversation with her. Plus, she’s been so open and committed in her recovery: This should be far from a taboo topic. I see this as an opportunity for an open-minded, loving and supportive conversation — not an intervention.
The crucial mistake that a lot of loved ones make is to focus too much on the behaviors themselves or the weight (or its loss), which at best creates an accusatory “gotcha” vibe, putting the person on the defensive. At worst, it can make them feel like the only thing that matters about them is their body or size — part of the very mind-set that contributes to eating disorders in the first place.
So, open instead with how she’s feeling. About everything — big (life) and small (lunch). Make it clear that you love her and that you want to know how such a crazy year has fit in to her recovery (or hasn’t). Let her know that you sometimes wonder if you are supporting her in the right way. Is she still in touch with anyone from recovery? Does she miss her group? Has she ever wanted to check in with her old therapist? How are other people handling such a mess of a year? Is there any way you can help, or anything she wants you to know?
Listen more than talk, especially at first. She’s an adult who’s well-versed in what recovery entails. Whether this is a temporary blip to find solace in uncertain times or the precursor to a full-blown return to past challenges, being a team, together, can help her most.