Illicit Lovers and Unwanted Guests: Treating Disordered Eating Issues

Last Friday, I gave a presentation at my state professional organization’s fall conference entitled, “Illicit Lovers and Unwanted Guests: Treating Eating Disorders in Individuals, Couples and Families.” My organization, the North Carolina Association for Marriage and Family Therapy, comprises Marriage and Family Therapists who address all sorts of different problems that bring people to therapy, including, but not limited to, issues that cause problems in relationships.

The field of Marriage and Family Therapy sees people as creatures of relationship, and is based on the following notions:

  • We develop our individual senses of identity in the context of relationships
  • Families operate as a system of interdependent parts
  • The problems that bring people to therapy often play a role in sustaining the balance in a relational system (i.e., a couple or familial relationship)

I named my presentation “Illicit Lovers and Unwanted Guests,” because I wanted to illustrate the dynamics that are often present when a family member or partner is a disordered eater. Psychotherapists unfamiliar with eating disorders who are working with couples and families might miss important aspects of the situations they are addressing. Disordered eaters are usually secretive about their relationships with food, exercise and/or their bodies, and eating disorders often fly under the radar, mistaken for normal concerns about weight, or even for healthy eating and exercise habits.

In a couple’s relationship, if one partner has an eating disorder, he or she has a relationship with that disorder that influences his/her relationship with their partner, much as does an extra-relational affair. Her thoughts are preoccupied with concerns about weight, shape and calories. She will go to great lengths to hide vomiting, saying when leaving a restaurant that she has to stop to pick something up on the way home and will catch up with her partner later, or mask undereating by saying that she had a big, late lunch at work and isn’t very hungry for dinner, or will wait until her partner has gone to bed so she can binge in private.

I’ve often seen disordered eaters find themselves in relationships with partners who abuse alcohol or drugs or gambling. Others find codependent partners who get a sense of worth and value from taking care of them. Improving the relationship involves increasing both partners’ connection to their own emotions in order to increase intimacy by verbalizing those emotions to their partner. A hidden eating disorder can throw a monkey wrench into this process without the therapist’s understanding. A thorough assessment for addictions and compulsions, including disordered eating, is a must. A skilled therapist can help both partners understand and appreciate the protective intent of the eating disorder—to enable the partner to participate in the relationship without the inherent anxiety—while strengthening the relationship by allying the partners against the eating disorder, e.g., “I’m not going to let you out of my sight after dinner. I love you, so I’m not going to let the eating disorder take over and have you throw up.”

When it comes to families, the eating disorder can often lurk like an unwanted guest, wreaking havoc at mealtimes (“You can’t leave the table until you’ve eaten more!”) and during shared family time (“Are you eating again? We just had dinner an hour ago!”). It’s important that a therapist working with a family in which a child or adolescent has an eating disorder help parents take a stand for their child against the eating disorder. Part of this means helping family members understand that the eating disordered behaviors are not something the child is doing willfully, rather, he/she is in the grips of a powerful compulsion. Family members can learn how to provide a wellspring of loving support for a disordered eater while refusing to tolerate the behaviors.

At the same time, the therapist should engage the parents in examining their own attitudes about food, weight, body image, expression of emotions, and achievement. Parents must recognize that an adolescent with an eating disorder is probably an emotionally sensitive soul who needs more attention paid to her emotions, thoughts, wants, needs, hopes and dreams, and less to appearance, achievement, ability and accomplishment. Validation of a child’s inner world versus what is visible to the naked eye is a potent factor in defusing the power of the eating disorder and strengthening the child’s sense of worth, as well as the parent-child bond. Eventually, the climate in the family will shift so that it is no longer a hospitable environment for an eating disorder to dwell in. The family dynamics developed over time to include the eating disorder, and must change so that there is no longer room for this unwanted guest.

Related Articles:
Full Recovery from Eating Disorders: Is it Possible?
Vulnerability and Eating Disorders
Creative Approaches to Treating Eating Disorders

© Copyright 2011 by Deborah Klinger, MA, LMFT, CEDS, therapist in Durham, North Carolina. All Rights Reserved. Permission to publish granted to

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Sean


    November 2nd, 2011 at 1:21 PM

    I guess I have never thought of eating issues like this, but reaing about it from this point of view I can definitely see how it influences my own family.

    I have a sister who has anorexia although she is very reluctant to admit it or to talk about what is going on with her. This is something that I feel like she has struggled with for a very long time but just like any good family I suppose we have chosen to ignore all of the signs. She chalks it up to being concerned about her weight but will not admit that there is anything wrong.

    It consumes he rlife and I know it does. It is hard to look at her without wanting to help, and family times are so stressful that it makes me not wnat to go around any of them anymore because things inevitably end up tense.

  • Deborah Klinger, M.A., LMFT, CEDS

    Deborah Klinger, M.A., LMFT, CEDS

    November 2nd, 2011 at 5:58 PM

    Sean,an unacknowledged eating disorder in a family member can make life miserable for everyone. But ignoring it only allows it to increase in severity. Anorexia is a deadly conditions, and the sooner your sister’s anorexia is addressed and treated, the greater the chances that she will recover. I encourage you to read the book, “Biting the Hand That Starves You: Inspiring Resistance to Anorexia/Bulimia” by Maisel, Epston and Borden. It has excellent guidance for family members. Good luck!

  • Jake


    November 2nd, 2011 at 11:56 PM

    The analogy is so true. Many many people hide their eating disorders,I have seen this in my mid-20s sister. She undereats and has a new excuse ready during every meal! I am pretty sure she enjoys being out during meals-for she does not need to make up excuses.

  • Millie C

    Millie C

    November 3rd, 2011 at 4:25 AM

    Where did our relationship with food go so wrong? This is such a present tense thing, nothing like these eating problems occurred in the past. As a matter of fact we used to worry about how to get enough to eat, but now we have to worry about putting it away. I say that the real issue here is how our whole society has turned eating and enjoying food into something bad. It isn’t. You have to eat what you need to get the energy that you need to survive. There is nothing wrong with that.

  • Deborah Klinger, M.A., LMFT, CEDS

    Deborah Klinger, M.A., LMFT, CEDS

    November 5th, 2011 at 6:43 AM

    Jake, I’m sorry to hear about your sister, but glad you are aware of what’s happening with her. I hope she is getting professional help, and I encourage you and the rest of your family to support her in this and to get professional guidance as well.

    Millie, I agree that societal attitudes toward food and eating have become increasingly complicated. We have plenty, and refined processed foods that didn’t used to exists are now commonplace and inexpensive. Overeating and resultant weight and health concerns is a big problem. However, eating disorders like anorexia have been around for a long time, camouflaging themselves with cultural values. For example, in medieval times, young women who apparently did not need to eat because they were so spiritually evolved were emulated. We now believe that this was anorexia nervosa “masquerading” via the cultural values of spirit over flesh. Now it can “hide” behind cultural values of health and thinness.

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