Ask Ursula: My wife’s eating disorder is affecting our whole family, what do I do?

Dear Ursula,

I’ve been married for 13 years. Five years ago, my wife was diagnosed with an eating disorder and entered a treatment program based on a “healthy at every size” approach.

The treatment shocked me. She was required to eat foods like cookies, cake, and muffins, stop exercising, and get rid of her scale. She gained a bunch of weight, which she still carries today.

I thought recovery would take time, so I set a one-year check-in to evaluate her progress. When that passed with little improvement, I set another check-in for two years. Now, five years later, I feel like nothing has really changed.

She still does not recognize her hunger cues until she is starving and panicked. Then she eats whatever is quick, usually cereal or junk food. We have not eaten regular meals together in years.

She does not exercise, and even walking the dogs is difficult for her. She often excludes herself from family activities, so most outings involve only me and our children. She is probably twice the size she was before treatment, although I don’t know her actual weight because I keep the scale hidden because I don’t want that to become another argument.

Fitness and healthy eating have always been important to me. For five years, I have felt unable to discuss food, exercise, or body size without triggering her issues. I have bottled up a major part of my life.

This is also affecting our children. My wife gives them more junk food than I would prefer, but I am afraid to say anything because every conversation about food circles back to her eating disorder.

I love my wife and want her to recover, but this illness has affected every part of our marriage and family life. We have been in marriage counseling for four years and are both in individual therapy, but nothing seems to be improving.

How do I support my wife without ignoring what this is doing to the rest of our family?

Signed,

Worried Husband

Dear Worried Husband,

I hear how exhausted you are. Five years is a long time to feel like your marriage and family life have been consumed by one issue. You are not wrong for feeling frustrated, lonely, or resentful.

But, I have to be honest. I also see red flags in the way you are measuring your wife’s recovery.

You keep coming back to her size. You connect her weight to her lack of exercise, her difficulty walking, and your belief that she has failed to improve. You also mention deadlines that you have set for checking in on her progress, and you’re disappointed that she hasn’t lost weight.

Her body cannot be the scoreboard! I talked to a mental health therapist who specializes in these kinds of cases, and she says eating-disorder recovery can go on for a long time and does not follow a tidy little spreadsheet. Patients often make progress and then relapse. Her eating disorder may still be active but in a different form. She could also be dealing with depression and anxiety or another health condition that affects her eating, energy, and motivation.

Look, I’ve never been diagnosed with an eating disorder, but I understand the struggle of being overweight. I also know what does not help: feeling like your worth changes with the number on a scale.

I’m fortunate to have a husband who has supported me regardless of my size. While I’m sure it’s not your intent, I wonder whether your wife is getting the message that she was more acceptable to you when she was thinner.

To be very clear: That does not mean you caused her eating disorder. You did not. But it is also clear the current situation is not working.

You are already in therapy, which tells me both of you are trying, and you want things to get better. But after years without any real progress, it may be time for a different therapist or a treatment team that specializes in eating disorders and family dynamics. Your children need support too.

Your messaging to her should be: “I love you. I am not asking you to lose weight. I am worried about how isolated you are and what this is doing to our family. We need a new plan.”

Then stop waiting for things to change on their own. It’s time to find better treatment options, together.

I wish all the best for you and your family.

With love,

Ursula

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