Eating Disorders in Couples: A Fish Story
Even Goby fish do it.
Dieting, that is.
Why, you may ask? You’d think that dieting would be a death sentence for a tiny osteichthyes, no bigger than a bloated paper clip. But some goby fish see slimming down as survival.
In essence, gobies lower on the ladder of piscine hierarchy starve themselves to minimize their threat to plumper, more powerful leaders. Starving is a way out of imminent confrontation.
This fish story doesn't just have import for our marine friends; it bears on human behavior as well and brings to mind several of the marriages I profiled in Lying in Weight: the Hidden Epidemic of Eating Disorders in Adult Women.
“Who partners up with a woman weighing 85 pounds?” I asked.
The answer: any one of five categories of men (or women if the male is the one with the eating disorder or the relationship is same-sex). The so-called, “Macho Man, Control and Conquer,” is like the superior goby acting in concert with his inferior, anorexic wife/girlfriend.
The husband/boyfriend could be an executive, doctor, attorney, military officer, or minister. He’s the man used to managing other people, assigning duties, and being aggressively IN CHARGE. He chooses a partner with an eating disorder because she will accept his alpha position, and by extension, her subordinate one. She starves to shrink into her Stepford role. As a bonus, she’s slender and trophy-like in appearance. All the more reason for him to stay with her.
This tragic dynamic and others have prompted psychologist Cynthia M. Bulik, PhD, Director of the University of North Carolina Eating Disorders Program, and her colleagues to pilot an intervention for couples in which one member is suffering from anorexia nervosa.
Called, Uniting Couples (in the treatment of) Anorexia Nervosa (UCAN), the intervention starts with the premise that adults develop anorexia, too. And when they do, they are often in relationships.
Intimacy is tough and tougher still when one partner has an eating disorder. Both partners feel the effects. Therefore, both might benefit from treatment, in this case cognitive-behavioral couple-based interventions that have been successfully employed for the treatment of depression, anxiety disorders, smoking cessation, and cancer.
Will it work?
We do have measured success stories with family-based therapy, traditionally with child, parents and siblings. So there is great hope for family therapy in marriages or partnerships.
The time has never been riper. Bulik’s group, in conjunction with Self Magazine, just published a survey of 4,000 American women aged 25 to 45. Nearly two-thirds (65 percent) of the women reported disordered eating behaviors, and 10 percent report symptoms of eating disorders such as anorexia and bulimia nervosa or binge eating disorder.
That’s a frightening number of adults, the majority involved in partnerships. Couples intervention might be a sorely needed option for those who are struggling.
Another scenario -- and one I like so much better: the woman reaches her breaking point. She taps that strength buried inside her and fights back, not with food, but her voice. She swells up in her body, as well as personality. And the couple renegotiates their relationship. Or she, healthier, leaves him to look for a better partner. After all, there are more fish in the sea.
