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!

Thank you for sharing your experience, I'm glad to hear you recovered. Yes, she is very much loved, I just want to do my best to support her though.

I had an eating disorder when I was young, recovered now.

I’m not saying this to make your worry greater - but your children are exposed to it.

I thought nobody knew and maybe the adults around me genuinely didn’t. But one day I caught my much younger sibling (7 then, to my 15), vomiting his dinner, because “that’s what you do”. It shocked the absolute shit out of me and quite possibly triggered my path to recovery. I cried bitter tears afterwards, I still remember so clearly now almost 20 years later. Children see a lot more than adults realise.

Your wife is unwell, the hold an eating disorder takes over the mind is horrifying. You sound like a wonderful, supportive wife - but you will need to be firm when your inclination is to be gentle. Eating disorders make liars out of the most honest of people.

She must actively continue seeking help, you cannot fix her problems yourself. It is ok that you might feel overwhelmed, need support for yourself separately. I wish you all the best ❤️

@Alldoooomed I even just have traits or elements of ADHD/ASD and even traits can be enough to effect someone's eating behaviours or emotional resilience etc.

I didn’t want to read and run. Just sending you my very best wishes for a terribly stressful situation. I hope your wife finds the help and treatment she needs and makes a good recovery. My thoughts are with you all.

GP should also be doing physical checks eg weight, bloods and blood pressure, on a weekly basis, please see if you can get this to happen OP

Didn't mean to type weekly basis, meant to say frequently

Just to say thank you for the kind wishes. Off to bed now but appreciate all the helpful advice.

I am sorry you are going through this. You could show her articles of the damage she is causing her body because of malnutrition. How are your children they probably notice. I hope your wife gets better.

Hey OP. Im really sorry to hear this. I have first hand experience of ED with a close sibling.
I remember the feeling of being terrified they would die, its all encompassing and you feel helpless.
As many PP have said, your partner will need to want to seek help and in my experience saying they do is often surface level - the real question is do they actually WANT to recover?
I’m no expert but here’s what I learned;

1. Never avoid talking to a sufferer if you feel their fasting or purging has increased. They will feel they are ‘getting away with it’ and the habit will increase
2. A GP can refer for a hospital stay in a clinic. It can be voluntary and it helps to reduce immediate danger
3. Activities like getting massages or spa treatments help sufferers feel positive about their body
4. A good recovery route is to focus on being strong / healthy - my sibling found a sport they loved and so had to eat to be able to participate
5. Meeting other ED sufferers via groups is an eye opening experience as it often feels to the sufferer like a personal disease which no-one understands
6. ED is always almost centred on control - something or a few things created trauma where the sufferer felt a complete lack of control, the ED is a way to counteract it. It doesn't have to be recent. When the trauma is addressed, true recovery can start

Its a long journey ahead, expect many set backs but I promise recovery is totally possible Good luck x

I went through exactly the same thing in my twenties, I was living with my family in what was a very dysfunctional dynamic (they're c-unts) and extremely unhappy, I was internalising all that anger/rage while putting a smiley face to everyone. I had no clue at the time what was happening to me. Once I moved out of that snake pit and "found myself" my eating disorder faded. A few years later I did a magic mushroom trip were I realised all the trauma and how I had been using food to fill in an emotional void that all the cheese burgers in the world could not fill. This trip was a magic bullet. I've been eating disorder free for 30 years and counting. Sounds like your partner is not in a "good place" for some reason, or under a lot of pressure and is using food to cope with it, encourage her to talk, be supportive and get her some therapy. 2 small kids while trying to extract her embryos is a lot to deal with. She sounds very stressed.

OP, sending you love and a hug. Your kindness and desire to support is admirable.

I've been in and out of eating disorder services (also south east) for 14 years. Yeah... it's been a lot. So hopefully this helps:

1 - Go to your GP. Get the referral to your local eating disorder services. The wait can be LONG so best do it sooner rather than later. The GP may also be able to implement health checks during this time - blood test, ECG, blood pressure, just to keep an eye on things.
2 - Don't be deflated by GP response. They're just the stepping stone to ED services, so keep this in mind if they say the wrong thing or don't see the extent of the issue.
3 - Keep at it with CBT.
4 - Be open to the eating disorder service options. There'll be counselling and therapies, day patient services (Mon-Fri, 8-6 typically), and outpatient which you can do voluntarily - though appreciate you said partner wouldn't want the latter. They often allow you to do day patient for a short term period to get you over an initial hump to be safe back in community support, to make it less daunting.
5 - There are charity support groups for loved ones and often your local eating disorder service will offer this too.
6 - Listen and be patient with partner, as it sounds you are. But make sure you both educate yourselves on the extent of illness, and how damaging this can be both short and long-term to her health, and the mental health of your children.
6b - Emphasis on education and electrolyte imbalance damage from excess vomiting and restriction, its bloody terrifying and causes irreversible damage.
7 - If she has heart pains, do not be afraid to get down to A&E and lay it down straight as to why. I've been to A&E a few times for symptoms triggered by eating issues, and each time have been offered more care and support than received in the past year in community in a single night.
8 - Wherever possible, discuss her urges with vomiting, approach the uncomfortable, but keep things 'calm' so as not to create a fear factor around food. She will know deep down why, even if only a small hint, but perhaps isn't consciously acknowledging it yet.

Hope you slept well. Best of luck to you both x

Can you afford a private dietitian/counselor who specializes in eating disorders? That way you can have more sessions per week now and tail off as she gets better. She’ll have to attend but likely she can get sessions after work/ at the weekend etc. so it’s not an inconvenience.

that period of intensive support may cost as much as a holiday but worth it.

It can be very difficult to recover even when a person wants to because that feeling of being full is scary and triggering. Any weight gain tends to go straight to the middle as well, which is triggering. It takes a lot of attempts and therapy to get through that part of recovery. Has she tried sipping on protein shakes or other nutritional drinks? So she can get the vitamins, etc without the fullness that triggers the vomiting. Obviously that's not the answer but it might help her from getting worse physically while she's seeking treatment.

I know you need to focus on your wife here but please also get support for your children. There is no way primary school aged kids will not notice their mum has started vomiting up to 10 times a day. They may just be too scared to talk about it.

OP, I can really relate to your post. My son (22) has bulimia nervosa, and his behaviours are almost identical to your wife's behaviours: bingeing, vomiting (multiple times a day) , over-exercising and so on. I should imagine, your wife will have other related behaviours too.

My son sees a therapist once a fortnight for an hour. I think it is helpful insomuch as he has someone else to talk to, but I live with his behaviours 24 hours a day. There are days when he has eaten everything in the house, and the vomiting has caused weakness in the left side of his heart, and resulted in hyperthyroidism (mild at the moment). Again, because he is not dangerously underweight, there is no emergency intervention.

BEAT have been helpful for me. They offered my son the opportunity of accessing a support group for young men with bulimia, but he is very asocial, and this was a bit too much for him. However, I had six sessions of counselling from BEAT, which I found helpful in that I had a reference point for guiding my son.

One of the problems was that the main book upon which the counselling was based, 'Skills-based Caring for a Loved One with an Eating Disorder: The New Maudsley Method' was pitched primarily, although not exclusively at parents of young people with EDs, and this was not entirely appropriate in our situation, where our household comprises me and my adult son.

However, my son's openness about his disorder, how frequently he vomits and so on, is really helpful for me because we can talk about possible triggers or contexts for an episode, and I have my phone ready in case he has a heart attack (because I also fear for his life).

I could go on for pages about this situation, but needless to say, it is so difficult to live with someone with a profound ED. I will add that I had the same ED as a teen and young woman and it nearly killed me, so I do not underestimate the seriousness of the condition.

My advice, which is only based on my experience as someone who had such a disorder, and as the carer for someone with the disorder is this:

-Remain non-judgmental and supportive. Low self esteem may be a very deep part of this condition, and bulimia reduces your self esteem to nothing.

• Encourage your wife to visit the GP for regular check ups. The dentist can also offer helpful advice about how to protect the teeth (they are a lot more understanding now than when I had the disorder).
• This condition isolates the victim and the carer. Try to build time to do other activities (not food or exercise related if possible).
• As others have said, the children need to be protected from the worst of this disorder. There may come a time when they will need to know about EDs so they do not feel that excessive exercise or an intense focus on weight is 'normal'. They may be too young for this discussion at the moment.
• Look for ways of distracting your wife, if you feel she is going to binge/vomit.
• Tell your wife that you cannot answer questions about her weight body shape. These questions become incessant, and arise from the fact that the person with the ED cannot see themselves as others see them.
• Your wife's emotions may manifest themselves as feelings of being 'fat' or 'heavy'. She may misinterpret everyday sayings such as 'You look well today' as meaning 'You have put on weight'. It can seem like you are walking on eggshells, but remember, this is a mental illness, and you are not responsible for your wife's behaviour.
• Consider a carer's assessment. I went for one. I did not expect any help for myself, but i wanted agencies to know that my son needed help and that I was performing a caring role.

I will stop there because I have written too much already.

@effylump OP, I can really relate to your post. My son (22) has bulimia nervosa, and his behaviours are almost identical to your wife's behaviours: bingeing, vomiting (multiple times a day)

OP has stated clearly that her wife is not bingeing.

I hope your son starts on the road to recovery soon.

Just want to write and offer support. I was bulimic from the age of 16 and had issues with body dysmorphia. It was hard to get past but doable with private therapy once a week. I was also diagnosed with ADHD at 31 so this explained a bit more of my behaviour. I manage it now by trying to moderate everything I do: if I’m going to the gym, I try to go not too much that I’ll get obsessed but not too little that I’ll feel sad. I get bad again if I’ve eaten too much take away food. It’s a struggle but she can totally get by this. But the first step is really understanding what’s happening and why. Good luck OP. Thinking of you all.

Alldoooomed

Hi there I am the mother of a 19 year old who has had Anorexia for 3 years. She has ADHD and ASC. Many with anorexia/ EDs do.

My daughter is now doing much better since transferring to the adult ED team and starting MANTRA. It has really helped in a way other methods just didn’t.

I think I’d get the neurodiversity investigated so she can identify personality traits. I’d go to the GP and push for an urgent referral to the adult ED team and failing that look into a private course of MANTRA if it was felt to be applicable. Forcing and cajoling imvho is not useful when there is neurodiversity in the mix or with adults. My dd needed to be in full control. The love she clearly has from you will be a huge strength.

Try not to panic. You can get through this.💞

Do you have private healthcare?
Can you ask your GP for urgent referral for assessment to a private clinic in the absence of NHS being able to meet her health needs this could be funded by the local authority? Or at least investigate these ideas.
Ideally, she needs to be in residential treatment dealing with the issues.

Residential isn’t always the preferred way of treatment particularly if there is neurodiversity in the mix.

What leads you suggest residential care is needed?

Residential is not always needed and not always covered or referred for by private or NHS. It has to meet criteria.

Please don’t diagnose/assume peoples treatment without knowing their circumstances.

Thinking about it OP, your wife has a stressful job, her parents going through a divorce, and you share a child with ASD/ADHD who is struggling.

This is a lot of work and stress.

I'm sure on one level she's worried about the increased stress of having another child, especially as that child will have a potentially higher than average risk of also having developmental issues, making for potentially even more stress and work.

She might not even be aware of the extent of her worries but her body/subconscious mind are.

It covers a range of ED. Not just bingeing.