My wife has an eating disorder, world is falling apart

[Alldoooomed]

Not really an AIBU but just need some support I guess. My wife (same sex couple) has developed an eating disorder and is very unwell. She is restricting all food and vomiting after every single thing she eats, up to 10 times a days. She is also exercising obsessively. I just don't know what to do or how to support her. We have 2 primary aged children and were about to do our frozen embryo transfer, which obviously we can't do now. I'm so scared she is going to end up dead. She has started cbt but it is one session a week. She ended up in a and e with chest pains last week and although bloods were normal, her low heart rate was concerning. I dont think she sees how serious this is. What should I do? How can I help? Thank you!

Support thread 10 for parents of young people with an eating disorder www.mumsnet.com/Talk/eating_disorders/4901861-support-thread-10-for-parents-of-young-people-with-an-eating-disorder

There is a group for eating disorders. I'm sorry you find yourself here, we're going through this with my son and it's the hardest, scariest thing. Similar to you it came from nowhere. GP urgent appointment tomorrow you need a referral to eating disorder clinic. She needs to start 3 meals and 3 snacks everyday - keep a food diary. She'll struggle and will need someone to sit with her and help her through each meal. No visit to the toilet up to an hour after, she'll feel horrific guilt distract her, watch a film or play a game, draw anything to keep her mind off the fact that she wants to purge

Is she under a specialist eating disorder service? Or is the CBT with a more general talking therapy service for anxiety and depression. There is a big difference and it does sound like she needs a specialist ED service. Good that she is going to the GP. Go with her if she is ok with that.

I completely agree with that. I'm currently battling eating disorder services for support and it's been five awful months since I referred myself.
I'm waiting to find out if an in-patient bed will be agreed. Was told there was a day patient space, until I didn't get it.
It's been incredibly distressing. I would have never have believed support was this bad until I found myself very unwell. And I've been through CAMHS with Ds, our local ED service make even CAMHS look good and that's not an easy thing to do.

I'm sorry you find yourself in this position OP, definitely try the GP. Mine has been excellent and has been trying to advocate for me, in what is a broken system.

It sounds like your wife has binge eating disorder rather than anorexia and you are right, she is very unwell and can do herself significant damage.

I suggest the main thing is that she wants help: that is important. GP is a gateway to more specialist services so a good place for your partner to start. B-eat, as suggested, have some good resources for both you and her: if you are to be on the position of carer, you will need support too.

Sorry I just read someone posting that you need to force her to eat. But that was advice given to someone anorexic. Please don’t do this to someone who is bulimic!

I’m sorry, no advice but wanted to say she is so lucky to have you & your support x

If the plan was for her to receive the embryo that seems like a potential trigger

She really needs to be under a whole team who specialises in eating disorders

She needs a dietician and therapy

Ideally a stay in a unit to help her at the beginning and then community care

Thank you for all the advice. The cbt is called CBT ED so is supposed to be for eating disorders. She isn't under any service. To the poster who asked - no, not going to receive the embryo. I underwent IVF and I was to have the transfer. I also underwent ivf before and conceived our other children, not my wife. Just to be clear, it's not anorexia and not binge eating disorder. She restricts food and then purges after she has eaten anything at all, multiple times a day. Thank you everyone.

Is she underweight at the moment?

Not massively underweight- 60kg.

If she has private health insurance then call them as some of them will treat this.
I had a member of staff go into the priory for about 3 months with another 12 months of out patient care. This was BUPA but every policy will be different. Some policies you can self refer with GP referral.

Got to be worth a call tomorrow to investigate.

Hopefully the gp / her private health insurance can suggest something. There is no way she will go in to an in patient unit though.

The NHS over-eggs and over-emphasizes CBT to the exclusion of other approaches. It may be that another therapy would be more beneficial.

Where do you live? There is a place in Leeds that my friend travelled to with her daughter called Insight Eating, they offer private therapy. Her DD is on the road to recovery but unfortunately not cheap

Thank you. We are in the South East but would consider anywhere/ anything for therapy. I agree re cbt, it seems to be the only thing suggested.

The sooner you get some help the better and it'll also help you. My son has possibly always had arfid/picky eating and he started trying to eat new foods but smaller amounts this caused him to lose weight and his brain chemistry changed and he's tipped into anorexia. It happens so quickly and she won't be able to control it, it's important to support her through meals as it's very frightening for the suffer (family too feeling helpless)

Is there any chance she is not as happy in your relationship as she appears?

The fact this breakdown has coincided with embryo transfer rings alarm bells for me.

Might she be unsure?

Are the children you have between you from previous relationships or are they biologically yours/hers?

Can you see any connection between her behaviour now and the next step you were about to take together?

That sounds like a really difficult situation!

Do you have any family/extended family or friends around, that you can reach out to for some support?

I’m surprised her GP simply referred her to ED CBT without referring her to a consultant psychiatrist specialising in EDs given she’s vomitting that much.

If she has health insurance that means she can get referred asap to exactly without a wait list. If you’re near a Priory they have good ED provision and she can look online to see which psychiatrist she’d prefer.

You may find that health insurance in-patient cover is more generous than their outpatient cover so bear that in mind.

Well I think there's some good advice on here. My DD has an Eating disorder & is currently in recovery - it never really goes away a bit like alcoholism. It went on for 15 years & in my view she's lucky to have survived. She spent many years in inpatient treatment (no exaggeration) but I'm sorry to say it didn't really help.
What did help was a private dietician, private counselling from an nationwide organisation called SWEDA & day & night care from family for a few months.
In my experience even the people who are supposed to know what to do, don't really.

I suspect that your partner had issues as a teen with food however fleeting, usually it rears it's head again at stressful times. Something has re triggered it & I'd say try to look at this time as an opportunity to help her look at what she's struggling with underneath her eating issues.
It's people who are prone to obsessional compulsive disorder, depression & anxiety. I think everyone I've met who has developed an eating disorder has a combination of these, and it needs to be picked apart to try to work out how to deal with it.

Find out what she wants to do, what she'd like to work on, and how she wants to be helped & try to get that as matched as possible to what support you can get for her. I say this because all too often it's like they push people down a route that isn't helpful because it's not really what the unwell person wants & will never really work, perpetuating the illness. And then they become "revolving door" patients, in & out of hospital & inpatient facilities. This is how my DD was for years & it didn't help. It just made her angry because she wanted them to do something different, care, some individual help & support, she wanted to be seen & this was sorely lacking.

At the time she didn't know how to say this, just kept saying she wanted to die, but she can say now that she didn't really want to die, she just wanted people around her to do something different.

So I'd say really listen to her, be mindful of being sucked into "treatment" because unless she's given space & support to understand what she's doing, why & what she really wants, treatment has much less chance of helping.

She restricts food and then purges after she has eaten anything at all, multiple times a day

Bulimia?

I don't think anyone here can diagnose, but refusing food and purging is like anorexia.

Thank you. Will ask about much more specialist provision / priory etc.

Re our relationship - it is excellent. We've been together 17 years, since school. Our 2 children are ours not from any previous relationship. We have both been very excited and on board throughout. It is me who has had no to the frozen transfer now because she is so unwell, if it was her decision we would still go ahead.

Hi OP, I spent 12 years as a bulimic. Vomiting multiple times a day. At times very underweight. Weight was my goal. I wanted to be stick thin. But I was also very angry with my weight-obsessed alcoholic mother. There was a LOT going on. I had no life and was constantly in pain. It is utterly obsessive.

Control was a big thing. Avoidance was another (I come from a very high achieving family and sometimes felt I couldn’t live up to things, so I’d “check out” instead).

In your wife’s case, based on how I was, my strong suspicion is that she can’t cope with the idea of another child. She might think or even say she wants another BUT she is sabotaging it, by being ill. Alternatively she might desperately want another child, but her brain is telling her she can’t do it (perhaps she found the previous pregnancies hard, or perhaps you did and she worries about that). Whatever the case, she’s sabotaging the whole thing.

In terms of getting better. Sadly I never told anyone. And I had no support. But at age 32 I landed a job I loved, and I decided enough was enough. But even now, age 51 I still obsess about my weight. I think the very nicest thing a partner could do would be to be utterly accepting and loving. But don’t wrest control from her. This bloody condition is (or was in my case) all about control.

One final thought, is she a stay at home mum? I was studying for much of my illness (post grad) and having all that time alone, without structure, was very dangerous. Binging was sort of fun too. Especially since I was so hungry from dieting. I realise how perverse that sounds, but ask her if she can tell you what the advantages are for her of what she’s doing. That may go some way also to analysing things and maybe solving this hideous illness. What’s missing from her life, or what’s she tying to do or achieve by this illness?

Do you think it might've been triggered by a fear of pregnancy or the weight gain associated with pregnancy, as you were about to do the egg transfer? So she has developed this now because she has some doubts about pregnancy/having a new baby?

Either way, I've had eating disorder CBT (through Eating Disorders services- as far as I know it's all they do apart from inpatient) and I can't say it's very intensive. Therapy of any kind would probably help of course though. Has she seen her GP? Maybe they could try some meds to help stabilise her. That would help her engage with therapy, too. She should see a GP/consultant if she hasn't for them to decide what to do to help.