Expert: Joanna Lhulier, Psy.D. - 6/6/2008

Question
Hey Joanna.  Let me tell you first that I am glad the internet allows such sites to enable me to contact professionals as yourself.  It helps a lot.

My questions regard my girlfriend who is a former anorexic.  It seems that she started slipping into some of her habits starting this last college year.  She had anorexia thoughout middle school, recovered during high school and slipped back into some of her habits during the summer of the start of her freshman year of college.

I am a psychology major, so I know some basic principles.  However, I'm definitely not a professional.  She realizes her problem and I tell her that her problems are once again surfacing, but I'm not 100% sure how to take the situation.  I tell her to go to see counselor, but she rebells the idea and overall hates that scenario.

She feels she is in "control" of something when she can control her weight.  She is a fanatic in exercising....almost too much.  She runs at least an hour a day.  She does, however, eat and doesn't exactly starve herself, but none of her foods are calorically dense (soups, fruit, veggies, etc.) I can't even take her out to eat at a pizza restaurant because she won't actually eat the pizza....rather slam down diet coke.  

This is also another class case of how the media distorts the youth image.  She is tall(5'10) so she believe she has the "model" body.  She bases everything off stats.  example:  "Models average height and weight are 5'11 117 lbs and im 5'10 115 lbs".  The thing is, she realizes that this belief is distorted, but obeys by it anyway.  

I feel some of this occurs from her permanent home.  Every ingredient in her house is fat free and unprocessed.  Don't get me wrong, I'm a health nut too, but it is taken to the limits.  She also was a dancer her whole life.

I asked her how she kept weight on during high school and she said her friends ate everything, therefore, she ate what they ate.  She was afraid of gaining the freshman 15 in college, which is when she started running constantly.  Also, I should note that she had to go on birth control because she wasn't getting her periods....perhaps from a lack of body fat.  

She is 19 and I am 21.  We go to the same college and we are separated this summer from different towns.  She is a business major and I am a psych major going for my Ed. S in school psychology.  Again, I realize the situation and there is something wrong.  She has been at the same weight for 9 months, which she believes is adequete.  Yet, everyone tells her she needs to gain weight and she knows it.  I talk to her about it all the time, and she promises she is trying to gain weight this summer.... but I can't be sure.  Besides taking her to counseling, what should I do with this scenario?  I want her to have good support, and I know she can overcome this.  I just have to make sure I'm not doing something wrong.  Thanks.



Darren


Answer
Hi Darren-
I am glad that you wrote, your girlfriend is lucky to have someone as aware as you.

About what you should do, I would start with telling yourself and coming to terms with the reality that your girlfriend is very likely in the midst of a relapse.  She is significantly underweight, over-exercising, and trying to deal with things by controlling herself and her environment.  Unfortunately, these are not good signs.  Once you accept and come to terms with this being a relatively big problem, you will be in a better position to help her acknowledge that she cannot continue in this way.  She needs to get professional help, it does not sounds as though she has the luxury of this being  an option.  I can guarantee that she will not like to be confronted but the fact is that on a deeper level she knows she needs help (hopefully).

About doing something wrong, I understand your concern but if you are acting out of love, it will be difficult to do major damage.  Of course you might make a mistake, but that is inevitable and you can both talk it through.  Instead of forcing her to try to get help, you might want to talk to her about the reasons why she will not get help, and what she is afraid might happen if she confronts the ED.  Your constant support will be invaluable to her.  Try not to let her distract you from the reality, she is suffering and needs to change.

I wish you and your girlfriend the best of luck.  If you need further help, do not hesitate to e-mail.
Dr. Lhulier