Expert: Joanna Lhulier, Psy.D. - 8/16/2008

Question
I have been worried about my boyfriend, and I was hoping you could help.  It recently came to my attention that he throws up quite a bit after eating out at resteraunts, or sometimes even after eating at home.  He generally  eats normal size portions, eating as much as me. Other times he will only eat bowl of cereal for lunch.  But I have noticed that he seems to being throwing up (self-induced) about 1-2x a week.  He tries to hide the fact that he was throwing up, by going to a spare bathroom for instance.  Or running up to the bathroom upstairs if I'm downstairs.  

We have been dating for almost 3 years now.  During this whole time I have noticed that he would always complain about being feeling sick after larger meals, and then he would disappear for for while.  I always thought he might be throwing up.  But it wasn't until recently I really started paying attention.

He is a normal sized guy who isn't underweight or overweight.  He is about 6' and weighs around 160lbs.  He is always concerned(worrying)about how many calories are in things and that he might be gaining weight. He even goes to the point of pointing out how many calories are in foods I'm eating! I am 5'6 and 110 lbs.

Do you think he has anorexia or bulimia, or something else? I am around him a lot and I have never witnessed the bingeing on huge amounts of food. I discussed it with him, and he didn't deny it, but says he throws up b/c his stomach feels sick.

What can I do to help him out and stop this?  I know this isn't healthy!   

Thank you for your time!!!

Answer
Hi Sally-
It sounds like your boyfriend does have a problem.  Bulimia does not always include binging and purging.  Purging (i.e. throwing up) on a consistent basis is a difficult habit to break, and you are right, it is not healthy.  

You need to have a serious talk with your boyfriend and let him know that you are concerned and want him to get help.  He will very likely resist and give you plenty of excuses as to why he is fine or does not need help.  Try not to let him convince you that he has it under control.  If he has been doing this for several years, he does not have control over it.  You need to let him know that there is nothing to be ashamed of, but that he needs to get help, professional help.  Ask him to consider a therapist, even encourage him to pick one out, preferably one with experience with eating disorders.  Last thing, you should let him know that there are a lot of men who do the same thing and that he is by no means alone in his struggle.

I wish you the best of luck, Sally.
Take Care,
Dr. Lhulier