Help with my girlfriends weight

[ConfusedBoyfriend]

I’m coming up on one year with my girlfriend, who is my first love, and there’s something that’s been on my mind for a while now. My girlfriend is 5’3” and about 37kg (81 lbs), and I’m genuinely concerned about her weight. To my knowledge, she doesn’t have any eating disorders, but it’s clear that she’s underweight.

I’ve tried to gently encouraging her to eat enough calories consistently, especially when we’re out together, by suggesting she finish her meals or enjoy desserts and snacks. Unfortunately, this rarely happens, and when I’ve brought it up outside of a food-related context, the response has been the same. This was raised in a gentle and a way that indicated this was from safe space.

Recently, she has asked to stop with my concern. While she appreciates that I care, she insists she knows her body best. What complicates things further is that her ex-boyfriend had similar concerns but expressed them in a very toxic way. Her friends, who are qualified doctors, supported her and assured her that she was fine.

My main concerns are long-term—especially when it comes to pregnancy and adulthood. I don’t think this is a healthy weight to maintain, and while it’s a difficult issue, I believe it’s something that can be addressed.

I’m considering bringing this up in person, as we usually discuss issues over text (which she prefers), but if she doesn't want to change then I'm not sure where to go next.

I dont live with her for reference. Her mum and brother are also quite skinny

I know this is not a typical post but I just need all the advice or input I can get here.

Not for most people, no, obviously not, but it was normal for my mum.
She didn’t have an eating disorder or any other health problems. She was just naturally extremely skinny.

Listen: She does not want to discuss it with you.
There is nothing you can do.
If you bring it up again you will get the same response or she will be irritated or angry. It her body and her business. Stop trying to control her.

Because she has not asked for his help, that's why. She has clearly said she doesn't want to discuss it.

Aren’t women required to be on birth control if taking Accutane?

I can tell everyone commenting on here that skeletons are not attractive.
I am 5'4" and 120, 54.5 kg. I am extremely thin. I can't imagine someone an inch shorter weighting nearly forty pounds less than I do. Weighting too little affects bones, muscle and organs. It can damage the heart beyond repair.

I was told by multiple psychiatric consultants that a BMI of below 14 means you need inpatient treatment. If it's below 13 then you are at serious risk of death. Mine was 12 and I nearly died.
She clearly is underweight.
It's just that pressuring people makes them withdraw. I hope she's not having ED, and is just miraculously really slim. Lots of people with anorexia won't acknowledge it at all.

I’m sorry you are wrong. I was super slim until mid thirties. 3 good meals and plenty of snacks

It's only possible if you don't eat over your maintenance calories for your height and weight with your level of exercise.

So if you're saying you're say 5'4, 7 stone and exercise 3 times a week at age 30. then you can eat around 1500 calories and maintain that weight. That can be 3 meals and snacks and would be 'a lot' depending on how you view food. If you're saying you were eating 2500 calories, then it's simply not possible unless you have done sort of health issue.

She will be on contraception if she is taking Accutane.

And your Medical Degree is from..?

I got major depressive disorder when I was 21. I went from 118lbs down to 88.
I looked a sight. It got so bad that I couldn’t find women’s clothing to fit — I had to buy girl’s sizes.
Is your girlfriend sleeping okay? Is she she raising any flags that might demonstrate that she might be suffering from depression?
Weight loss is a very common indicator.
Just a thought.

The defensive response is a bit concerning. I get comments on my weight and get defensive. But it's because it's out my control and I want to weigh more. I always explain to people I know that I can't help it, I'm trying but my multiple illnesses make it impossible. With no explanation or discussion it feels like there's more to it.

That is very underweight.

I briefly had an eating disorder when I was younger (although it took me a decade to get over it fully, I was only eating disorderly for a few months).

I looked pretty bony at my worst. Like my shoulders had extra bones jutting out of them. I was clearly unwell. I got tired a lot. I subsisted on gin and soup. I think at my lowest weight I was 42 or 43kg (and 5ft3.5)

To be that height and only 38kg, she would probably:
Look alarmingly bony with sucked in cheeks and eye sockets
Run out of breath going up stairs
Be tired and listless a lot of the time
Have scanty, but long drawn out rusty periods
Complain about feeling cold often
Have red-tinted fingertips, knees, nose

Do any/all of these apply to her? If not, I wonder if she's exaggerated how low her weight is (for reasons unknown)

Edit to add: I'm right as rain now and 54kg. It took willpower but I got better. Its like an addiction though, you can't make her better, she's got to want it

Yeah she's not at all well and you're in over your head.

You can't fix this.

@Uptheflagpole I remember that suggestion from VIZ. it was a TopTip; 'replace your Girlfriend's SlimFast with protein weight gain powder'. I did snigger but obviously would never condone and hopefully anyone who thought funny and adulterated another person's food was dumped with contents dumped over his head after being combined with any handy body fluids.

Please don't do this!

I think it sounds like an eating disorder, I've had one on & off since my teens, unfortunately there' not a lot you can do or say if she's determined that nothing is wrong & she's FINE! The defensiveness is another marker

ED are so hard not just on the person with it but for their loved ones & really difficult to address, I have no advice sadly for you, only you can decide your bottom line but I just wanted to reply in recognition with what you (&she) are going through, I wish you all the best going forward

I think you’re perfectly entitled to be worried. And I’ll disagree with PP who seem to think that “having periods” means you’re not infertile, as being able to get pregnant is not the same as being able to sustain a pregnancy.

I think you need to have a proper conversation. As a minimum, if she’s confident nothing’s wrong, a GP appt would surely be wise? Being that thin could be linked to a number of different health issues e.g thyroid. Surely it’d be prudent to rule those kinda of things out? Ultimately though if she won’t discuss it, you’ve got an extremely hard decision to make.

No he does not "need to have a proper conversation".
She has made her position clear:

The OP: "Recently, she has asked to stop with my concern. While she appreciates that I care, she insists she knows her body best."

Whether she is ill or not he needs to leave it. He cannot change her, he cannot help if she does not want him to. If she even needs help. Why is that so difficult to understand?

I think it's unlikely that any doctors have told her that a bmi of 14 is healthy.
What, if anything, you do about the situation is a different question. People with eating disorders need specialist help. I'd also take her comments about the ex-bf "making toxic remarks" with a pinch of salt.

@NonsuchCastle i guess I took from that, that maybe if you’re going to walk away because of this (as multiple people have suggested) she deserves to have some warning? But yes maybe I don’t get having these kind of conversations over text so I probably have misunderstood.

She sends you photos? Why?

Also, wrt the doctors who told her she was fine, did you hear this directly from them or is this something she told you they said?

Frankly, I think you're right to be very concerned here. I wouldn't get too invested in the relationship. You can't fix this.

If she does have an ED, it will always be hanging over your heads regardless of treatment. But from what you say, she's a long way from accepting the need for treatment.

I agree with posters who are saying deception is a big part of the picture with eating disorders.

The primary relationship of the person with an ED is with the disorder, not other people.

How did you meet? Were you friends who graduated to relationship status? I'm asking because you must have found her attractive and perhaps she thinks she has to stay the same. I feel that you're in a no win situation; she'll feel you're monitoring every mouthful if you comment. Perhaps suggest trying new cuisines e.g Korean BBQ or Dim Sum with other friends? These are interactive foods and she may feel 'safe' to either eat or hide not eating. I had a friend who, in restaurants, would eat slowly but methodically everything on the table - she would have eaten the tableware. It took hours. Then she would purge - which would take another hour. When I finally voiced my concerns she came up with various medical conditions which meant she needed the loo for so long before ghosting me! She now works in the food industry. Strangely enough, another person I knew with an eating disorder (anorexic) worked in the industry too; I think it was a bit of masochism. Her husband (my friend) was oblivious and thought it was funny on the rare occasions she went doolally and inhaled chocolate followed by vomiting it all up. She acknowledged it to me but wouldn't get help. Both have died.

It would appear that there is a link between taking the drug your gf takes (isotretinoin) and anorexia. www.sciencedirect.com/science/article/pii/S0165178123003657

Have you ever spent 24 hours with her to know how much she is actually eating and when? As you say, you don’t know how much of the food she’s eating when at home. It would be really useful if you could establish how much she’s eating, when and how many times a day.

I would recommend discreetly making notes on her intake then calculating the number of calories when home that she is consuming with each meal. If you can establish her intake per 24 hours, that would be really useful. You’d then know how much she’s eating and if this is really concerning.

People with eating disorders often have a number of rules, such as they won’t eat before x time, will only eat y number of times a day and won’t eat z type of foods etc. Eating with someone else, ideally more than one person is important for recovery. This is called family based treatment and unless the sufferer is dangerously underweight, this is the most effective treatment. Can you have your gf over and cook for her regularly? And go out for meals regularly? Does she have any safe foods? You could try eating buffet style and putting lots of foods on the table and include her safe foods. See what she is able to eat then.

I suggest you buy the book Skills based caring for a loved one with an eating disorder and have a read to see if you recognise anything from the book in your gf’s behaviour. https://www.amazon.co.uk/Skills-based-Caring-Loved-Eating-Disorder/dp/1138826634/ref=sr_1_1?crid=3GP6LUEQ5E1AI&dib=eyJ2IjoiMSJ9.eYFE5MxbhYEcCq9yMKwuxNbO4Pldg0BywbTawjCOpahYHVBMUcDZcc4kbaA2i6Ex47eyaiRSGueyRs-cTwMW160PWoOpaA1fbmENCjds2g0IR-sbecNvrQVHNQmQMUQc9uVtKKsY7POE0r04XqwAWYJk1f35pSWMGL6xGLdvxlnaPLVj03U9a9M3t8WXRfPLnVfzr95UuV0NwGzhTOnZiVcP1eocxlYpk7GbgRTVmt8.rRFQcAho57kF5WdgxYoi-bNIfV35NyNULy2SL76wSVY&dib_tag=se&keywords=caring+for+a+loved+one+with+an+eating+disorder&qid=1725937022&sprefix=Caring+for+a+loved+one+with+an+%2Caps%2C129&sr=8-1

As for menstruating. Are you sure your gf is having periods? As in have you seen evidence and more than a few spots of blood?

If your gf has anorexia, it is a mental illness and denial is a big part of this. How much energy does she have? Anorexics seem to have boundless energy then fall off a cliff and need to rest / sleep an inordinate amount.

With the weight your gf is at, she really should have a full panel of blood tests even if she isn’t purposefully restricting her intake to see if there is something else going on. Does the GP monitor anything? It is important to establish her bp, pulse and oxygen sats as a minimum. A low pulse is a medical emergency.

@IhateHPSDeaneCnt

It’s really common to want to be around food with ED. Part of them wants to eat normally but feel unable to do so. My dd has anorexia and used to love going to the supermarket even though she wouldn’t choose any food for herself and at her worst would go to restaurants with friends and order a Diet Coke.