Expert: Joanna Lhulier, Psy.D. - 7/24/2008

Question
I recently started dating this girl from work and I am worried about her health. From what I know, her ex boyfriend of two years has told her she is fat and need to exercise more, while her parents have treated her very poorly as well her whole life. The thing is, she is the sweetest, most caring and beautiful girl I know and I cannot understand why she cannot see it.

She is 19, weighs in the 120 lbs area and is 5'6". I dont know if this counts for anything either, but today when she tried to "prove" to me she was fat, she showed me her pants size and it is 2.

Well I don't know where to begin, so i will just describe her eating patterns and what she has said to me.

She will go days without eating anything. She will always tell me she isn't hungry, or that if she eats anything she wont feel well. Sometimes I can convince her to eat something, but lately all my attempts fail. When she does eat, its usually only vegetables, and not many at all. She will also put a lot of hot sauce on her food because she says that the hot sauce causes her stomach to burn more calories. I don't know if she purges ever, but I dont believe she does. I have tried to tell her that her body needs the nutrition from food to function but she just says thats why she takes vitamins.

She has told me that she does have an eating disorder and mentioned she was getting help for it before but that her ex talked her out of it and told her the doctors were brainwashing her. She will tell me all the time through out the day that she isn't cute because she is fat and that she cant believe me when I tell her she is beautiful because "I have a mirror and can see me with my own eyes." She has also mentioned that not eating isn't just because she thinks she is fat, but that it lets her prove she has self control of her life and that when she eats she feels depressed and when she doesn't she feels happy.

Can you please tell me what I can do to help? How can I be properly supportive? I care for her too much to watch her do this to herself and let herself be hurt.

Answer
Hi Michael-
First, you're girlfriend is very lucky to have you, not only because you want to help but also b/c you want to help in the most supportive way possible.  The big problem is that there is not one right way for everyone.  It sounds like your girlfriend has had some pretty bad experiences which will make it difficult for her to trust anyone.  Therefore, what you need to do is be as supportive and consistent as possible.  There will be times where her self attacks will be too much for you.  Instead of yelling at her or getting too frustrated, I would just explain to her that you care too much to watch her do this to herself and then take the time you need to cool off but tell her when you will be back and then be there.  I guess the most important advice I can give is to let her know that you are there and then be there consistently.  She may not be able to make use of your support right now but as she gets better she will need you.  I would also encourage her to get professional help, she will need it.

Good Luck and I wish you the best Michael.
Take Care,
Dr. Joanna Lhulier