I'm worried my boyfriend has bulimia

Originally Published: October 28, 2011 - Last Updated / Reviewed On: December 27, 2011
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I've recently just found out that my boyfriend of 4 years is bulimic... He hasn't told me, but I have put the puzzle pieces together after living with him for the past 18 months... I had even heard him purging in the bathroom while we were on vacation. I'm really struggling with this information and I don't know how to approach him about it... I'm guessing it has been going on for around 6 years now. How do I confront him about it??

Dear Reader,

It can be tricky to check in with a loved one about the concern that they may have an eating disorder. You may be afraid that you'll say something that might shut them down or hurt their feelings. You may be afraid that you're mistaken. This worry may be especially great for you since eating disorders are more prevalent in women (though eating disorders are more common among men than many people realize). Don't let these worries stop you from having an honest conversation about what you have observed and what your concerns are.

First, how might you recognize if a loved one has an eating disorder? There are a few different types of eating disorders, but you need not worry about making an "exact diagnosis." The following may be warning signs of bulimia, but a loved one need not exhibit all these signs in order to have it.

  • Frequent complaining or worrying about being overweight.
  • Use of "purging" tactics for weight loss, including excessive exercise, herbal weight loss supplements, weight loss medications, laxatives, or forced vomiting after eating.
  • Not wanting to eat in front of other people.
  • Eating large quantities of food in one sitting.

Warning signs of Anorexia can include:

  • Significant weight loss.
  • Enjoyment of cooking and preparing meals for others without eating much.
  • Significantly distorted body image — sees self as overweight, when he or she is likely significantly underweight.

Some people with eating disorders recognize that they have one, but are afraid to reach out for help. They may be afraid of being judged and/or losing loved ones if they open up about their eating disorder. Others may be in denial about having an eating disorder, while others may have such a low self-esteem that they feel, either consciously or unconsciously, that they do not deserve help. If you are afraid to check in with him about the possibility that he has an eating disorder, it may be helpful to know that eating disorders do not go away on their own and they can have severe health consequences. So the sooner he seeks help, the better his chances of recovery and the less damage that will be done.

But how to bring this up? There are a few good guidelines to cover that will help you convey a nonjudgmental attitude and also help ensure you are respecting your boyfriend's privacy:

  • Make the basis of the conversation about your worry. Try to remain positive while also explaining that you care about him and because of this, you are worried about his health and his emotional state.
  • Avoid comments about his appearance. Some people with eating disorders will not be affected, while others will be extremely affected by hearing your assessment of their weight (e.g. they may be flattered or they may be horrified. Either way, you may inadvertently reinforce their restricted eating or purging).
  • Do not demand that he eat or change his behavior.
  • Avoid placing blame or giving advice.
  • Watch out for accidental "fat phobic" remarks that you might make inadvertently (in other words, avoid making disparaging remarks about weight or overweight people). Avoid making remarks even about your own body weight.

Aside from offering you nonjudgmental support, the most important thing you can do for a person with an eating disorder is to encourage him or her to get treatment. The longer an eating disorder remains undiagnosed and untreated, the harder it is on the body and the more difficult to overcome, so urge your boyfriend to see a therapist or his health care provider right away. If your boyfriend is a Columbia student, he can make an appointment with Counseling and Psychotherapy Services (CPS) or with his primary care provider through Open Communicator.

It may also be worth checking out the following resources:

Recovering from an eating disorder usually takes time. Kudos to you for your patience and your willingness to support someone struggling with an eating disorder. This may at times be difficult for you, too, so make sure you are getting support, as well, whether it be through friends, family, and/or therapy.

Take care,

Alice