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!

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

Yep that's what I have. I hardly binge at all, especially when I'm in one of those phases of throwing up everything I eat. That's why I have a diagnosis of atypical bulimia. If someone carried on they would get a diagnosis of AN binge/purge subtype.

@Alldoooomed It's great that they've seen her so quickly (if they have- I had to wait 9 months or something and so do a lot of people.) So it sounds like they have taken it seriously and prioritised it. Have you phoned ED services again and impressed on them how concerned you still are? For sure keep ringing them, and it's great she has potential access to private help too.

I think it may get to that because the body just cannot cope with being in starvation. Maybe not at this stage but I'm expecting this will unfold. It's very early days hopefully someone will be able to stop the cycle before it becomes too established

Messyhair321 sorry if I wasn’t clear. I wasn’t agreeing that forcing someone to eat was a good idea. Just that someone else was saying to the OP that this was the advice given to her to help treat her anorexic DD. That may well be the case. But as someone who is in recovery from bulimia I would not under any circumstances advise this approach for a bulimic!

Yes, even a lot of people with anorexia end up binging sometimes, because the whole of their system is nagging them to eat- insulin, ghrelin etc.

Being sick after every meal is is v v dangerous as electrolytes easily go out of sync.

My dd is slowly recovering from an ED, the advice for bulimia is teens is 3 meals and 3 snacks a day (prepared by the parent/carer) and then literally following them around coaxing them not to vomit. In teens you would use lots of distractions after food, whatever works for the individual, sometimes going for a car drive or short walk helps. In some cases taking the door off the bathroom so they can't vomit in private is needed.

The exercise compulsion is closely linked to the brain struggling with a lack of food as the primal part of our brain goes into overdrive thinking we need to move to find more food.

Tabitha Farrah has written a few books on EDs and I think is v good for adults who want to get better.

Actually my DD started doing this too, right at the start of the ED. I'm really hopeful that your partner will be able to get the right help at this stage in the illness

A word of....not so much caution but managing expectations.....BEAT are great but very overwhelmed. I developed anorexia at 46 as a result of trauma and struggled to get help. They are really good but a middle aged woman who is not at deaths door is less of a priority than a skeletal 12 year old, as it should be, but it means that accessing help has been hard.

As I have a large frame, my BMI is actually classed as normal (despite my BFI being well below normal) so my GP wasnt interested, just congratulated me on my weight loss! I look terrible, my skin is bad and I spend every moment I am not at work either tired or asleep.

I cant afford private help, but as you have that cover I would be going down that route as you are more likely get specialist help that way than via the NHS. Like al the services in the NHS there are more people who need treatment than they can provide help for.

For me the lightbulb moment was when I collapsed as my blood sugar was so low. I smashed my face up and ended up in hospital with "malnutrition" on my notes. As a single mother with kids at home who needs to drive for work, I realised that it wasnt just my life I was risking. Now I still have the ED but knowing that I have to keep my blood sugar stable, means that I do eat more than I did. I dont eat anywhere near as much as most people or as often, but it is just about manageable at that level.

I vomitted after food a lot at the beginning. It wasnt something I did deliberately. I am the opposite of a comfort eater, when I am stressed or unhappy my appetite disappears and when I eat my stomach basically rejects it and I throw up. I rarely throw up these days unless I am going through something (recently my mother collapsed and was rushed in with a suspected stroke and I physically couldnt keep food down for three days), so it may not be her deciding to make herself sick. Might be worth bearing in mind.

I agree too

Cbt did absolutely nothing to help me

An incredible dietician who specialised in eating disorders worked wonders with me though

Is she genetically related to your daughter? It's just that people with ASD are more likely to develop eating disorders. Is it possible that she too has ASD?

She does have some ASD traits but no, she is not genetically related to our daughter as I carried her, my own egg, donor sperm. She is obviously her mother, on the birth certificate etc but not genetically related.

@porridgeisbae

Yep that's what I have. I hardly binge at all, especially when I'm in one of those phases of throwing up everything I eat. That's why I have a diagnosis of atypical bulimia. If someone carried on they would get a diagnosis of AN binge/purge subtype

Yes - that’s what I was thinking - atypical bulimia. She’s eating 10 times a day then vomiting. Anorexics try to avoid eating altogether. It can be a struggle to get them to eat even 2 or 3 times.

At 60kg she’s a relatively normal bodyweight unless she’s super tall, anorexia becomes relevant if her body weight drops really low. Which it may do with all this purging and exercise.

Yes. You need to make the GP aware how dangerous the situation is and that she needs more than weekly CBT. She needs an urgent psych referral.

Thank you. I have said to her to ask for a psychiatrist referral at her appointment and she says she will do this.

It might be worth talking to the people running the classes at the gym, as she really shouldn't be doing them on effectively no food intake at all.

What jumped out just now is your dd has autism/adhd. Could your partner be neurodiverse and things are starting to unravel? Iv only recognised my own traits as my dc have received diagnosis and grown

This must have something to do with the IVF, surely? Have you had a long chat about that as a loss root cause?

That's good. I hope she gets better soon. These things are a coping mechanism for stress sometimes but then can become a thing in their own right. Please keep us updated OP. x

I can hear that you believe that your children are not aware.

You are wrong.

They may not witness the vomiting, but they will absolutely know that there is something very wrong.

Your wife is unlikely to be fully emotionally available for your children. They WILL be aware of tension, subdued conversations, changes in behaviour of both you and your wife.

My mother had eating disorders from when I was 7 until I was 45 years old.

I'm sure she thought I wasn't aware either.

It has totally affected me, since I was 7 years old.

It has affected my relationship with food.
It has affected my relationship with friends.
It has affected my relationship with my family.
It has affected my self esteem.

Please protect your children by talking honestly to them, in an age appropriate way about the fact that their mother is very ill.

If necessary, protect them by moving away from your wife, temporarily.

@Passepartoute Eating disorders are so endemic, there's even a trend where people think 'fasted cardio' has extra benefits.

If they’re both working and she’s in finance which is high pressure and they’ve got a ND kid - it may be just step too much for her.

I personally always recommend this charity:
https://www.talk-ed.org.uk/about/meet-team-talk

(rather than BEAT although they can be helpful too). This is because they offer 1:1 free bookable appointments with an experienced adviser, and also run a family and carer support group in the evenings. When you ring up they aren't reading from a script either. I think you'll find this enlightening and a great source of support for you and DW.

Fwiw one of my best friends had anorexia in her 20s which then resurged in her 40s with overeating. I’m not sure if there was a particular trigger but she was doing IVF.

Could your wife also be Autistic/ADHD? It’s a common occurrence to also have an ED. I mention it because it can be helpful to get the right treatments. Hope she gets the right help and that you can both get back on track where you want to be.

I'm really sorry to hear about what your wife has been going through, and you yourself also. I was bulimic for 7 years, I've since recovered and what I reflect on the most now is how it seemed to stem from a lack of control. I am not sure why I felt that way though, I didn't have a life full of responsibilities, I just couldn't suddenly handle life as it was. My ED was a compulsion, without it I didn't understand who I was supposed to be. It was like I was punishing myself but also rewarding myself at the same time. My mindset was warped if I am being honest. I had CBT therapy once a week for ED for a few months and it helped me to understand parts of myself and how I thought better, but it wasn't until years later after I stopped the therapy that I really let the disorder go.

My now husband was really patient with me, met me in the thick of it and had no idea what to do. I think what helped was that he didn't give up on me, he didn't judge me, but he also didn't just do nothing. He didn't monitor me but he would listen to me, he didn't understand but he did try and he loved me.

What made me stop was the realisation that I wanted to have children and was going down a path that would ruin that. I knew I could not sustain this way of life and I wanted to let it all go. Ultimately it did have to come from me, I wish I had not wasted so much of my life though.

I'm not sure that any of this information helps, but it's honestly something I wouldn't wish upon anyone, or any relationship. The hard part is we are all different, and sometimes it's hard to pinpoint exactly what is causing our actions, to voice what we are feeling, as a lot of the time it doesn't make sense at all. Especially living in a time now where we are consuming so much information daily without knowing how to process it all. Having an eating disorder is truly running a race that you cannot possibly win. But it is also really hard to get yourself out of it.

Your wife sounds loved, and I hope this love gets you both through this.

If going private is an option for you and you’re somewhere not too far away (although I have a feeling they have online treatment sessions), then Orri could be a good option. Check out their website and videos. We haven’t used them but we’re bordering on it last year but our DS improved slightly.

So sorry your wife is going through this. I can only imagine the worry for you both.