The first time Julie*, a 28-year-old who works in marketing in Chicago, went to her boyfriend’s house, she noticed a pair of latex gloves on which he’d written “Do Not Use.” She thought that was weird and asked him about it. He said they were for an art project, but didn’t elaborate. “Forget it,” he told her. So she did.
After just under a year together, they moved in. Immediately before they did, that’s when he finally told the truth about the gloves, that he wore them when he forced himself to throw up (which he said he no longer did). Julie had no idea what to do. “I didn’t want to say, ‘You’re really sick. Let me get you some help,’” she says. “I didn’t think that would be useful.”
Women who are dating or married to men with eating disorders aren’t talked about much, mostly because as recently as ten years ago, eating-disorder specialists and clinicians believed that only 5 percent of anorexics were male. But current estimates, based on research by Roberto Olivario, Ph.D., at Harvard University, suggest one out of every four people with an eating disorder is male — and that percentage is rising. Our increased (and increasingly public) fetishization of men's bodies is thought to be part of the reason for the increase. Think Cristiano Ronaldo, Ryan Lochte, or any one of the stars of The Bachelor. But because men don’t go for treatment in the numbers women do — either because they feel too stigmatized to go to the doctor or their early symptoms aren’t recognized — they’re less aware of the disease.
Women, however, are warned about anorexia and bulimia at an early age. They understand the symptoms and often see eating disorders up close. Because of this, they’re in a prime position to be a first responder, to recognize the disease and help — especially among women. But if doctors can’t fully comprehend male anorexics, just imagine how much harder it is for their girlfriends and wives to intervene. “In all honesty, 70 to 80 percent of [sick] guys don’t get any treatment at all,” says Dr. Mark Warren, Ph.D., the medical director and co-founder of the Cleveland Center for Eating Disorders. “They may be in relationships, but they’re essentially invisible.” So, once she learns about his illness, the female partner of a guy with an eating disorder often finds herself as the main support for someone who doesn’t think he needs any, and she’s usually unsure how to help.
Knowing that Julie’s boyfriend was anxious about what he was eating, she cooked only nutritious food and always made sure they had lots of healthy snacks. And when he stayed late at work, she tried to make sure he had food. “But you don’t want to be like, ‘Hi, did you eat dinner?’” she says, adding that she never wanted to imply he was throwing up. At the same time, Julie’s boyfriend never said anything to her about what she was eating or how she looked, but she often wondered if she should be exercising more. “It put a weird pressure on me,” she says. After three and a half years together, they broke up.
For other women — especially in previous decades, when anorexia among men wasn’t as recognized — this sort of pressure has manifested itself as a form of abuse. In the early nineties, Barbara Lawrence, a writer in Massachusetts, never went to parties with her husband. He never wanted to, sometimes even going so far as to throw out an invitation. If they did socialize, the event had to be business-related (they ran a real-estate company together), and they usually had a terrible time. Every time Barbara so much as took a single hors d’oeuvre, he’d frown and say, “You shouldn’t eat that.” He was just as critical at the grocery store. If she’d put some ice cream in the cart, it’d be, “How could you want something so disgusting and fattening?” She usually bought it, anyway. But when she’d look for it days later, it’d be gone. “It went bad,” her husband would tell her. “I had to throw it out.”
They had been married nearly 27 years before she quit denying that her husband — six-foot-one, a former collegiate tennis player — was anorexic and bulimic. For most of their life together, he had been lying to her about what he was (and wasn’t) eating. The ice cream, for example: He was bingeing on it. “It must have been torment for him to have stuff like that in the freezer,” Barbara says now. “It’s hard for me to imagine that I lived with him for so long and was so clueless.”
Being a woman trying to prop up an eating-disordered man “is a very lonely place to be,” says Dr. Margo Maine, Ph.D, a clinical psychologist and advisor to the National Eating Disorders Association. Often she doesn’t know who, if anyone, to talk with about what’s happening once she recognizes the disease. Then, if she is able to find and join a support group for spouses or partners of those with eating disorders, she will most likely be the only woman in it.
Just like Julie, Barbara (who eventually wrote a book about coping with her husband’s eating disorder called Bitter Ice and has a new novel out called Islands of Time) also couldn’t pretend everything was okay forever. The end came when a co-worker, a strawberry blonde who was red in the face, accused her husband of stealing the meat out of her sandwich. As she told Barbara, “He went in the ice box, took the meat out of my sandwich, then put the sandwich back.” Only then, after seeing the meatless, rewrapped sandwich, did Barbara understand that her husband had a very serious problem. She wasn’t helping him get better, so she decided to walk away.
It’s so common for the disease to cause breakups, no matter which partner has it, that many treatment centers now offer couples therapy as part of their programs. “Regardless of sex and sexual orientation, partners want to help but don’t have a clue how to proceed,” says Dr. Cynthia Bulik, Ph.D., the author of Midlife Eating Disorders and the director of the UNC Center of Excellence for Eating Disorders, which developed a specific couples’ treatment that helps partners work together toward recovery.
And sometimes, in fact, the partnership can save the patient. “There are few things that help more,” Dr. Warren says. “I’d say to any guy, if you’ve lost the ability to feed yourself, you’re lucky to have a supportive relationship.” Besides cooking or meal planning — basically changing behavior by making eating routine again — doctors advise devaluing how important looks are. “If you’re in a relationship based on something besides appearance, you’re a huge step ahead of the game,” Dr. Warren says.
If two people in a couple both have eating disorders, however, it can be impossible to support each other. Lauren, 24, a teacher in Salt Lake City, and her boyfriend met while they were patients at a treatment center and were once so smitten they discussed marriage, but broke up last weekend.
During their recovery program, they got so close that they decided to live together. Once they were in their own apartment, Lauren’s boyfriend relapsed almost immediately. He’d wait for her to go to bed and then binge while she slept. “I didn’t know what the correct way to step in was or how I’d support him to get through it,” she says. “That’s a very helpless feeling to have.” Then she also fell back into her old routine of skipping meals. “The empathy is absolutely there, but it’s hard to know what’s going to make him better,” she says. “Sometimes you need to take a step back.”
Barbara also doesn’t regret her decision to divorce her husband, even though she got critical letters after her book was published, with readers calling her a “mean woman” and asking “how could you do this to that man?” To her, “it became so obvious,” she says. “The best thing for me was to get out, to leave the place I lived and loved. I hoped that would free him.” Even now, eighteen years after the divorce, she’s heard from friends he’s still struggling.
*Some names have been changed.