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!

Agree with the previous poster who says the idea of another child may be the trigger.

Hard as it is to accept, she's not telling you something she's feeling.

Although you think it's all 'excellent' her behaviour and illness now is based on something which needs to be talked about and maybe you aren't the right person if it includes you and your relationship.

Please think that this is possible, along with other possible reasons.

This is what my DD had, it's anorexia nervosa binge/purge type - this is what this sounds like anyway.
The restricting makes people really hungry so then they binge because they are basically in starvation, then they feel terrible & throw it all up. It self perpetuates & this type of ED is particularly hard to deal with.

A good GP will refer your wife to the adult ED team urgently.
She needs to speak to her GP asap. She could write down what's going on and take you for support.
She should get an initial assessment by the ED team pretty quickly.
You may pm me if you like.

Yes that is exactly bulimia. The differentiation between anorexia bing-purge type and bulimia is generally the latter maintains a normal body weight.

I believe eating disorders are a cry for help & often the person suffering doesn't know why. I'd open a conversation with asking her to tell you everything in her life that upsets her even if its just a comment or type of behavior. It can take ages for the person to finally understand the reasons then to process it. This plus hand holding and strong cuddles after every meal. I'm in no way suggesting this will work as professional help is paramount. I'm just saying instinctively its what I'd do in your situation OP as a supplement to professional help.

It's not wise to force people to eat period. It can be extremely traumatic for people who are struggling with AN or AN binge/purge type.

Yes, I understand this but we have really good communication and our relationship is not the issue. Like I said she has always had issues with food, obsessing over losing weight and so on. She has an excellent job in finance and is not a stay at home parent, nor am I. All home and childcare tasks are shared, we are a solid team. She certainly wants this baby, more than anything. We do have other life stressors- her parents have split and it is very difficult, our DD has autism / ADHD and is struggling etc. Obviously she will be able to discuss her feelings with the health care professionals and I will support her through it.

Presumably she spoke to the GP to get referred for CBT unless she’s doing it privately.

Is the CBT within a specialist Eating Disorders service?

It’s not likely to be a lot of use if it’s the generic 6 sessions of IAPT/CBT that your GP refers you for as a “one size fits all” for any mental health problem that you might turn up with. She needs the GP to refer her to a specialist service. If you happen to be anywhere near Nottinghamshire/Derbyshire/Worksop area I can recommend a service that she can self refer to who are commissioned to provide NHS ED services. I’ve used them personally and it has changed my life completely.

If her bloods were all normal (and I assume they’ll have checked her U&E’s) then her bradycardia is likely due to cardiovascular fitness rather than an electrolyte problem, so I wouldn’t worry too much about that for now.

Contact Beat.
You are fantastic support and she will get through this with help from professional services.

We had same situation with a close friend.
She made a full recovery and is currently retraining to be a paramedic.

Believe. I will 🙏 for her.

I feel like I’m always recommending this to people and don’t want to keep banging on about it but it might help - a book called Brain over binge by Kathryn Hansen - it’s basically a non-therapeutic approach to stopping binge eating/purging. Written badly but it worked for me. And it’s only a tenner and a few hours for her to read it and it might be all she needs to do. If you try it please let me know whether it worked!

Thanks so much everyone, I'm taking on board all the advice and suggestions.

Normally CBT would be part of the whole ED service, not stand alone i.e. alongside physical checks.
If someone is physically unwell CBT will likely be counter productive. It's emotionally very hard work.

Yes, she spoke to the gp, explained the issue and they referred her to ED CBT, which she has started, but it's only once a week and 1 hour long. So she is going to go back and explain how bad things are and see what they can offer (via her private healthcare).

I had these exact symptoms (making myself throw up after eating normal amounts of food) and eventually got a diagnosis of atypical bulimia just because they felt they should do something in case I wasn't keeping down my bipolar meds. I had a diagnosis of non-specific ED before that- none of these diagnoses I managed to get until my late 30s. It was very hard to get it taken seriously.

They wouldn'tve diagnosed me as anorexia binge/purge subtype because I wasn't thin enough. Thankfully I only get it in this acute form very occassionally, the rest of the time I mainly just obsess about food and stuff.

I think they use the same CBT treatment for all eating disorders where I am, because people tend to cycle through different eating disorder symptoms over the course of their life (I definitely managed to restrict more in my teens/early 20s.)

I have bulimia, I haven't purged for over a year but its always in the back of my mind.
It's hard because it's not as apparent as anorexia, I kept it hidden for years as I was just a normal weight.
It's amazing you want to support her, sadly it took me years before I was willing to let anyone into my secret life. It was my coping mechanism and I struggled to give it up. I was referred to a consultant then cbt and group therapy. My husband saved me and that's so true. We talked about it and he was so supportive and so interested and learned as much as he could.
There's no magic cure, I'm.in my 40s now and still struggle after 25 years. You are doing am amazing thing supporting her. I hope she gets the help she needs xx

There’s some really awful advice on this thread from people who don’t understand the differentiation between each type of ED.

OP says that her wife restricts everything and purges, she doesn’t refer to binges AT ALL.

Thank you, it is helpful to hear experiences. And yes, I have explained, she does not binge. She restricts and every time she eats she vomits. She definitely isn't binging and purging.

You know her best & your DD's condition might be taking a toll. I'm hoping she'll be able to get some perspective on what's going on.

I agree with this, when I had ED treatment I worked with an integrative psychotherapist so she was able to pull from multiple different approaches and modalities, not solely from CBT.

There was also a dietician to work on nutrition and an holistic therapist to help me with relaxation/self care and learning to connect with my body in a positive way.

Not sure if the GP has registered how unwell she is.

I’m sorry for what you are both going through. It’s really tough. I had ED CBT years ago and it was very successful and allowed me to be well enough to have my first born. It does take quite a while to improve (the CBT was weekly for months) and you have to put the work in between sessions (targets, food diary etc) but your partner can get better. Challenging the ED is really uncomfortable, your support will make all the difference

I think also she has got worse quite quickly. And now the exercising I.e. joining the gym and doing high intensity classes at the crack of dawn without eating etc.

I found CBT-E very unhelpful, but I am autistic. NHS ED services seem to offer it to every outpatient, whether it's appropriate or not. I was threatened with discharge half way through my third session for not engaging in treatment well enough. I'm now too ill to have any ED outpatient therapy.
If there is a chance she can access private care, then definitely go for it.

Have you tried these for info and help?

https://www.nhs.uk/mental-health/feelings-symptoms-behaviours/behaviours/eating-disorders/overview/

https://www.beateatingdisorders.org.uk/

Sorry, haven't read full thread. Try and learn what you can and encourage your dw to explore other resources. Get support for yourself as well. Any idea what the trigger was? Figuring that out is a start. Good luck. 🩷