Eating Disorders: Causes, Characteristics & Common Misconceptions

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Recent studies show that eating disorders have strong genetic and metabolic components.  These studies should help remove some of the stigma attached to suffering from an eating disorder, as they can no longer be called a faddish indulgence or a form of attention seeking or extreme vanity.  They are real illnesses and need to be approached in the same way as any other illness is.


People with eating disorders have diagnosable conditions which can be helped and the sooner help is sought, the better the outcome.  Due to the possible wide mix of causes for an eating disorder, a multi-disciplinary approach appears to offer the best chance of a quicker diagnosis and the most appropriate treatment.


The following various articles help give us a fuller idea of the complexities involved with these illnesses, while giving comfort in the knowledge that help is available, is getting better, and is becoming easier with the better understanding of the use of specific anti-depressants, Cognitive Behaviour Therapy, and the regular practise of Mindfulness. 


I don't suggest that this is a comprehensive overview of the many causes and types of eating disorder.  Rather, it's a starting off point for anyone who think someone close to them is in difficulties or, indeed, could be a nudge to the reader to consider getting help.


What comes across clearly is the isolation experienced by those suffering from eating disorders.  This element is something we can all help to alleviate.


The following topics are covered ~

Eating Disorders: Causes, Characteristics and Common Misconceptions

Anorexia ~ a Personal Story

Genetic Breakthrough on Anorexia Nervosa

Anorexia at Least Partly Metabolic Disorder – Study

Eating Disorders in Intimate Relationships




Iseult C O'Brien

Montessori Teacher & Supervisor  |  Volunteer Tutor






Dr Clare O’Toole, Consultant Psychiatrist, responsible for the Adult Eating Disorder Service, St Patrick's Mental Health Services


Anorexia, bulimia and binge-eating are clinical terms that have made their way into common usage.  They can be casually thrown around as hyperbole and in some ways have come to represent a collective misunderstanding of what eating disorders are.  The associated stereotypes can prove incredibly damaging both in terms of minimising the experience of living with an eating disorder, and contributing to under-recognition among those of us living with behaviours that could be categorised as an eating disorder.


Eating disorders aren’t faddish lifestyle choices that largely affect teenage girls.  They are illnesses with the potential to be extremely serious and hugely disruptive to a person’s life.  Although there are common risk factors, eating disorders can affect anyone across gender, age, ethnicity and socio-economic status.  The Department of Health and Children estimates that there are currently 200,000 people in Ireland affected by eating disorders and the fact is that the majority of them don’t fit into a neat diagnostic box of anorexia, bulimia or binge-eating.  Causes range from and may include all of the following ~biological, psychological, social and environmental factors.


Dr Clare O’Toole, Consultant Psychiatrist with responsibility for the Adult Eating Disorder Service at St Patrick’s Mental Health Services, shares her expertise about what characterises eating disorders, how they are treated, and what supports are available.


What is an eating disorder?

An eating disorder is a serious mental illness characterised by abnormal eating patterns, excessive exercise and preoccupation with body shape or weight.  It can take on different forms such as anorexia or bulimia for example, but what distinguishes eating disorders from unusual eating habits is the frequency and severity of the symptoms along with how enduring or persistent the symptoms are.


There are categories of eating disorder ~ anorexia nervosa, bulimia nervosa, binge-eating disorder or eating disorder unspecified.  While there are distinct differences in these, they are typically characterised by abnormal eating patterns, fear of weight gain and body image concerns.  Many people may struggle with eating disorder symptoms yet not quite fulfil an eating disorder diagnosis and these individuals need help too.


What causes an eating disorder?

There is no single cause of an eating disorder.  Like most other mental illnesses there tends to be a combination of biological, psychological, social and environmental factors at play that come together to create the conditions where an eating disorder is more likely to develop.


  • Risk factors associated with these illnesses include dieting and low self-esteem.  In fact, dieting is the single most important risk factor for developing an eating disorder eg, girls who diet moderately are five times more likely to develop a disorder, whereas girls who diet severely are eighteen times more likely to develop a disorder, than those who don’t diet at all.


  • Pre-disposing factors include trauma, bullying, loss, critical comments about weight or shape.


  • Personality characteristics that can be associated with the development of an eating disorder include anxiety, perfectionistic, obsessional, hyper-sensitivity, rigidity of thought.


  • Genetics are also important.  Current research indicates that there are significant genetic contributions to the development of eating disorders eg, first degree relatives of people with anorexia nervosa are ten times more likely to develop the illness in their lifetime.


Are eating disorders all about food?

At its core, an eating disorder is a coping mechanism for someone in distress.  Food – or the deprivation of food – becomes a means through which emotional distress or turmoil manifests itself.  The disorder gives the individual a mechanism through which she or he can alleviate distress or achieve control, giving a certainty and safety in an otherwise unsafe world.  It’s understandable then that it can be very challenging and frightening for someone living with an eating disorder to let go of it.


What is consistent across all eating disorders is body dissatisfaction and certainly food can become the obsession fuelled by the negative perception of one’s body.


What is the best way to support someone living with an eating disorder?

Educate  If you suspect or know that someone close to you has an eating disorder, it’s important to educate yourself on the condition using trusted sources.  St Patrick's has a great support and information line (see below) and equally is a good online resource for information on eating disorders and support options.


Support  In addition to improving your knowledge of the eating disorder, it is important to try and create a safe, supportive environment where the person feels comfortable and can talk about her or his experience.  Avoid that being at the kitchen table, mealtimes or any space that might be associated with food and eating.


Be Patient  Patience is key in supporting someone living with an eating disorder.  It can be very challenging for her / him to remove a coping mechanism she or he has come to rely on, so it’s important to try an understand that and respect that it will take time.  People recovering from eating disorders often describe the isolating nature of the condition, so it’s hugely helpful for them to feel supported.


Is recovery from an eating disorder possible?

The short answer is yes.  There is a range of treatment options available for people with eating disorders that vary depending on the stage and severity of their condition.  We do know that there can be an under-recognition of eating disorders and people can live with them for long periods without seeking intervention or getting a diagnosis.  The best outcomes are for people who receive a diagnosis within three years of the onset of the illness, but even those who carry an eating disorder for a long time before they receive treatment, can achieve good outcomes.


If you suspect you – or someone close to you – may have an eating disorder, look up information on some of the trusted sources mentioned below, then have a conversation with your GP who can help to direct you to a service and start a plan if necessary.


If you, or someone you know, think you might be living with an eating disorder, you can find more information on or  

You can also contact the St Patrick’s Support and Information Line, staffed by experienced mental health nurse on Dublin 249 3333 or



Anorexia Nevosa

Old typewriter and inserted white sheet of paper with medical report on anorexia. Image ID : 95688071




Anorexia: it’s not about Image. It’s about Control.



Niamh O’Keeffe is one of those people that is just a pleasure to be around.  She is warm, engaging and open, with a great sense of humour and brains to burn – she works with hedge funds, mergers and complex financial services that feel impenetrable to most of us mere mortals, but she loves it.


Sitting in a busy city centre café, having an animated chat, none of the people sitting at the tables around us could possibly guess what we’re talking about.


“I was a monster; I hated myself; I wanted to die.  The one thing I was excelling at, in my mind, was anorexia”.

 Niamh spent much of her adolescence and early ‘20s living with anorexia and depression.  Spoiler alert – she’s fine now, but, for a long time, she really wasn’t.


I didn’t feel the best at anything.  I didn’t have a close group of friends.  I wasn’t wanted.


It all started when she began secondary school.  Essentially, Niamh felt as though she wasn’t wanted and just didn’t fit in.  Like anyone starting a new phase in life, Niamh had ideas about what she’d be good at academically, what her social circle would be like and generally how the experience would feel.  Essentially, she wanted to do well at her work and click with new friends.


Instead, what happened was a relentless exercise in comparison, with Niamh always coming up short, in her eyes at least.  There was always someone smarter, prettier, cooler, more popular – and on and on it went.  What cut through the noise of these insecurities was image.  Niamh noticed that some of the other girls in school were thinner than her: 

“I gradually started looking at calories, working out a lot, competitive swimming.  I lost a lot of weight during that time”.


Understandably concerned by these changes, Niamh’s parents sought some help for their daughter in the form of a spiritual healer.  No one knew at that time that what was emerging was an eating disorder.  The general consensus was that this was a kind of blip, common enough at a time of great change in an adolescent’s life.  Niamh felt as though she got some peace from that initial intervention, and things began to settle down again – but the underlying causes of her unhappiness weren’t addressed, and soon they resurfaced.


“Two years later, I saw one of my friends had lost a significant amount of weight and it just triggered me”.


The smaller I am the better my life will be.

By the time Niamh was in fifth year at school, she was depressed, eating less than 500 calories a day, and trapped by the thought that she could only achieve what she wanted in life if she was as skinny as she could possibly be.  Her body was feeling the effects of starvation:

“my periods stopped; my mind was in bits; I could feel how weak I was and I had completely lost the ability to think rationally – but I didn’t want to get better”.


Niamh was prescribed a number of different anti-depressants at this time, none of which worked for her.  She also had trouble accessing appropriate services as her Body Mass Index (BMI) was so low that a number of psychiatrists advised she was unsuitable for treatment.  She attended a dietician, but, in the grip of her eating disorder and depression, Niamh had no interest in eating or changing her relationship with food.


“At the start, it was tough, but I had a little bit of body weight to carry me through it.  The thinner I got, the more fixated I became and my body had no reserves; the impact of that stress on my brain had a really negative impact on my thoughts and mood”.


I gained one kilo and started screaming, shouting, pulling out my hair.  I just wanted to die.


The rigid thinking, perfectionism, and need for control that characterises anorexia is perfectly illustrated by an incident that happened during this time.  A weigh-in during a consultation showed that Niamh had gained one kilogram (kg) since her last appointment.  Her reaction to this slight increase in weight was extreme.


“I went crazy: I was screaming, shouting, pulling out my hair.  I kept shouting ‘I hate my life, I hate my life, I hate it’.  I just wanted to die.  Basically, I felt that I had nothing if I wasn’t 40 kgs”.


That evening, Niamh went home and walked 30 kilometres (km).


Throughout four years of depression and anorexia, Niamh never thought she was too thin, never identified as anorexic, and was never happy with her weight.


The worst part of the experience?

“There wasn’t one day for four years where I didn’t have a panic attack about my weight.  I’d get dressed for college and take multiple photos of myself from every angle, and, if I didn’t look skinny in them, I’d rip off my clothes, pull my hair and just wouldn’t go to college.  It was so intense and so exhausting”.


One day I started to smile again.

The turning point in Niamh’s story came when she began attending St Patrick’s Mental Health Services (SPMHS).  Her consultant at the time, Dr Sarah Prasad, instantly recognised that the various anti-depressants Niamh had been prescribed over the years were incompatible with her biochemistry. 


“She prescribed a different type of medication and, honestly, within two weeks, my whole mindset changed”.


The improvement in Niamh’s mood meant that, although her relationship with food remained the same, she started to feel as though she might want to get better.  It was the tiniest spark, but a spark nonetheless.  Niamh even started to consider her future, but ~


“skinny was still the most important thing at that moment”.


The spark that had reignited in Niamh, gradually grew.  It meant she could draw on the positive energy of those around her. 


“I got to a stage where I could enjoy being around other people. I was able to occasionally laugh with my friends. Some of my taste buds started to come back around this time too”. 


These embers of joy stoked Niamh’s desire to get better and live her life again. 


“I had to let myself let it in though … the medication let me enjoy other people’s company again but stubbornness can, and does, stop people from getting there”.


Regaining weight was one of the hardest parts.

As Niamh’s treatment under Dr Sarah Prasad, and then Dr Clare O’Toole continued, she slowly began to recover.  Confronting the underlying causes of her unhappiness helped her to challenge the beliefs that fuelled her eating disorder.  Learning Cognitive Behavioural Therapy (CBT) techniques allowed her to examine situations, see thought patterns more clearly, and identify the choices that were available to her.  Her support network provided the positive energy that sustained her when her reserves were low.


As her recovery progressed, one of the biggest challenges was yet to come.  


"The hardest part for me was regaining weight.  Because my mood had been gradually getting better, I could hear what the doctors were saying to me about needing to give my body nutrients”. 


Niamh’s body had been in starvation mode for so long that she had to be really careful about how she did this. 


“I started to do it through exercise – I’d go to the gym, working on weights rather than cardio.  I’d feel really hungry afterwards and feel able to eat well as a result”.


Choosing balance over obsession.

It wasn’t easy – and it can still be a challenge.  Niamh says she still cares about not wanting to be overweight, but that is coming from a place of health now rather than a need to control.  Having obsessed over every calorie in every morsel for years, Niamh can’t unlearn that information, but she can choose not to be controlled by it.


“I can feel tempted to go back to it, but I can catch it.  I have the tools to manage it.  I’m always going to be aware of it – but now, I just try to keep a handle on roughly the calories I’m consuming – but more from the perspective of being healthy.  Plenty of people who’ve never had an eating disorder, or disordered eating of any kind, do that.  The difference is that during my anorexia, every fraction of a calorie was calculated and if I went over my limit, that was unbearable, I believed everything would fall apart – that was how intense my need to control was.  Now though, I know it’s not the end of the world if I have a slice of cake with my cup of tea: I can enjoy it”.


Niamh finds that CBT helps her to keep things balanced, to catch triggers, and to see potential problems before they happen.  Incorporating meditation into her CBT practice allows her to slow down, and to develop an awareness of her thoughts and feelings and how they, in turn, might influence her choices.


I’m excited about my life.

It’s hard not to be struck by the hard work Niamh has put into her recovery and how she continues to prioritise her health.  She is keen to highlight the role of her support system in helping her to get there though. 


“Imagine watching your child hate herself so much, wanting to destroy herself. It was so hard for my parents, but they saved me”.


The combination of self-obsession and exhaustion that dominated life during her illness meant that Niamh didn’t – or couldn’t – really care about anybody else, but her parents and close friends never gave up on her


“When I had literally no strength in me, they brought positive energy – I fed off that. I got to a stage where I was able to absorb that energy and it helped to fuel my recovery”.


Sitting opposite someone so clearly full of life, it’s hard to comprehend that, at one time, she hated her life, hated being alive.  Control was everything. 


“I felt as though I had a lack of control over my life, how I wanted my experience to be.  My anorexia happened at transitional periods in my life.  I felt unfulfilled: I compared myself to peers and I turned to anorexia for control.  If I have this under control, everything will be under control - but the opposite is true”.


Niamh’s desire to have some kind of future began to emerge during treatment, but her idea of what that might look like has changed significantly since then. 


“At that time, any future I imagined was one where I’d be living a cold, workaholic, business-based life; existing rather than living, I guess.  I had no desire for a future with family, babies and now I can’t wait for that phase of my life.  I’m excited about my life”.


And you can’t help but be excited for her.


St Patrick's Mental Health Services, James's Street,

Dublin 8, Ireland.



From the St Patrick’s Mental Health Services, Empowering Recovery





Genetic Breakthrough on Anorexia Nervosa

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This genetic breakthrough on anorexia should transform how the disease is seen.



A study showing a genetic link to the eating disorder shows how wrong it is to simplistically blame people for their illness.


Once upon a time, disease was thought to have been sent by God as a punishment for sin.  If not, then it must surely be the work of demons, witches or groups regarded as social outcasts.  Thankfully medicine has moved on from the days when Jews were blamed for outbreaks of the plague across medieval Europe, yet with psychiatric illnesses something of the old accusatory myths seem to linger.  


Until relatively recently, autism was still wrongly blamed on so-called “refrigerator mothers”, who supposedly damaged their children by being cold and unloving.  The discovery that autism has a genetic component turned our understanding of the role it plays in families upside down, and now something similar may be happening with anorexia.


New research on DNA samples from thousands of anorexics has found a link to genes involved in regulating metabolism, as well as those connected with anxiety and obsessive compulsive disorders.  


The deadly compulsion to starve yourself, to put it crudely, is not all in the mind but also has something to do with the way the body processes food.  That may not necessarily come as an enormous surprise to doctors – it’s not the first time research has linked eating disorders to a broken metabolism – but it’s potentially a breakthrough in how broader society views those who suffer from it, and perhaps how they see themselves.


For years, recovering anorexics have argued that it’s dangerously simplistic to blame their illness on looking at pictures of stick-thin models in fashion magazines, or on over-anxious parents driving perfectionist children to succeed.  


Now the evidence is starting to back them up.  The researchers involved in this Study argue that while the families of anorexics do tend towards perfectionism, the cause and effect relationship might not necessarily work the way we think it does: it might be that the genetically influenced anxious mindset linked to anorexia makes people push themselves too hard.


Just because a disease has a genetic component doesn’t mean that the environment in which the sufferer is steeped is suddenly irrelevant, and in this case the researchers estimate genetics explain only about half of anorexia.  It’s a piece of the jigsaw, not the whole of it.  But the greater our understanding of the complicated interaction between genes and environment, the more likely we are to find that conditions once blamed on human weakness – the idea that sickness must be someone’s fault, or that they could get well if only they chose to snap out of it – have much more complicated pathologies.


What starts with anorexia doesn’t necessarily stop there.  

What about other eating disorders that tend to run in families, such as bulimia, or less compulsive and more common forms of overeating?  Are there biological reasons why some people find it relatively easy to eat a sensible, balanced diet and others fight a lifelong losing battle with temptation?


Studies exploring these questions tend to face an irritable popular backlash, because for healthy people, the idea of blaming the sick (or, for that matter, the poor) for their own misfortune is in some ways a comforting one.  It’s more soothing to think of disaster as avoidable, controllable, something that needn’t happen to people who make the “right” choices in life.  But the more we unravel of our genetic inheritances, the less true that seems.


This Study of what drives anorexia will have real, practical benefits in tackling a disease that’s often frighteningly resistant to treatment and prone to relapses.  But like all the best science, it also has a useful lesson to teach the rest of us.


Gaby Hinsliff, Guardian Service, 16 July 2019.

Gaby Hinsliff is a Guardian columnist.




Anorexia at Least Partly Metabolic Disorder ~ Study

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Genetic basis of anorexia overlaps with ‘metabolic, lipid, body measurement traits’


Anorexia affects between 1 per cent to 2 per cent of women and 0.2-0.4 per cent of men.  



It has the highest mortality rate of any psychiatric illness.




Anorexia is at least partly a metabolic disorder and not just psychiatric as previously thought, new research suggests.


The genetic basis of anorexia nervosa overlaps with metabolic, lipid and body measurement traits, according to researchers.


They say this is independent of genetic factors that influence body mass index (BMI).


Dr Gerome Breen, from the National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre and the Institute of Psychiatry, Psychology & Neuroscience, at King’s College London, said: “Metabolic abnormalities seen in patients with anorexia nervosa are most often attributed to starvation.


“But our study shows metabolic differences may also contribute to the development of the disorder.


“Furthermore, our analyses indicate that the metabolic factors may play nearly or just as strong a role as purely psychiatric effects.”


  • 'Many eating disorders start as a healthy eating regime.'


  • Anorexic patients feel ashamed over coercive feeding orders, court told.


  • Judge welcomes 'remarkable' recovery of man with anorexia.


Another finding was that the genetic basis of anorexia overlaps with other psychiatric disorders such as obsessive-compulsive disorder, depression, anxiety, and schizophrenia.


Genetic factors associated with anorexia also influence physical activity, which could explain the tendency for people with anorexia to be highly active, the research indicates.


Led by researchers at King’s College London and University of North Carolina at Chapel Hill, the Study is published in Nature GeneticsEight genetic variants linked to anorexia were identified in the large-scale genome-wide association Study.


Anorexia is a serious and potentially life-threatening illness, and symptoms include a dangerously low body weight, an intense fear of gaining weight, and a distorted body image.


It affects between 1 per cent to 2 per cent of women and 0.2-0.4 per cent of men.  It has the highest mortality rate of any psychiatric illness.


Researchers combined data collected by the Anorexia Nervosa Genetics Initiative and the Eating Disorders Working Group of the Psychiatric Genomics Consortium


The dataset included 16,992 cases of anorexia and 55,525 controls, from 17 countries across North America, Europe, and Australasia.


Prof Janet Treasure, also from the Institute of Psychiatry, Psychology & Neuroscience, King’s College London, said:

“Over time there has been uncertainty about the framing of anorexia nervosa because of the mixture of physical and psychiatric features.


“Our results confirm this duality and suggest that integrating metabolic information may help clinicians to develop better ways to treat eating disorders.”


The Study concludes anorexia may need to be thought of as a hybrid “metabo-psychiatric disorder” and that it will be important to consider both metabolic and psychological risks factors when exploring new avenues for treatment. – PA.



Eating Disorders in Intimate Relationships

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Copyright : Tero Vesalainen.









Regardless of the type of relationship between the family member and the person experiencing the eating disorder (ED), family members commonly experience a disruption to their personal well-being.


Eating disorders (ED) are serious mental health problems where mortality of one subtype, Anorexia Nervosa, is as high as 20 per cent for those who experience it over a prolonged period.  


People do recover from EDs however, the recovery journey is not a linear process as it often takes the form of improvements interspersed with setbacks.  


Over the time it takes to recover, all aspects of the person’s life can be affected along with the lives of others who are close to them, including family members.


Family Members’ Experiences

Most of what we know about the experiences of family members who are living with a person with an ED is from the perspective of parents.  This is understandable given that EDs are most commonly associated with young people and the fact that many adults experiencing a long standing ED remain living in the family home.  Living with a loved one experiencing an ED impacts on family members’ psychological, social, and physical well-being, giving rise to many unmet needs.  Family functioning as a whole is also impacted on, particularly where conflict exists around coping with and managing the ED behaviours and associated health risks.


Understanding parents’ experiences and unmet needs has been important for the development of appropriate interventions which can help them support the recovery of their loved one while improving their own well-being.  However, interventions focused on supporting parents are not always appropriate for other family members such as partners, who might also be providing care to their loved one.  


As recent studies have found an increase in people of middle age presenting for treatment, many of whom are in an intimate relationship, a focus on understanding partners’ experiences is welcomed.


This way partners too, can be provided with appropriate supports that will assist both themselves and their loved one in recovering from the distress of living with an ED.  Findings from a recent research study presented below, goes some way to understanding what partners experience.


Partners’ Experiences

Regardless of the type of relationship between the family member and the person experiencing the ED such as a partner, parent or sibling, family members commonly experience a disruption to their personal well-being.  These disruptions apply to partners in the following ways.


  • Psychological distress is experienced in the form of low mood, anxiety, poor sleep, stress and / or frustration, which initially arise from concern and worry for their loved one.  This distress tends to increase over time and is more intense in times when an ED setback is occurring.


  • Physical health is impacted on when partners adopt coping strategies to manage their distress such as overeating, increased alcohol intake or ignoring their own self care needs.


  • Social connectedness diminishes over time as partners, in support of their loved one who is finding socialising more and more difficult, choose not to go out.  In addition, partners also want to avoid having conversations with other people about the ED for several reasons:


    • Their experiences suggest other people have little understanding of EDs and therefore it is difficult to talk about it;


    • They do not want themselves or their loved one to be judged by others, because of the ED;


    • Partners do not want to break the confidences of their loved one by discussing the ED with other people.


 The distinct and different experiences for partners, as opposed to other family members, is in the context of the intimate relationship, where there is change to the order and balance of the relationship that had previously been established by the couple.


  • There are changes to their roles within the relationship, the primary one being that of becoming what most people would consider ‘a carer’.  Although partners are more than willing to provide care and support for their loved one, sometimes this can become like a parent / child dyad rather than an intimate couple relationship.  For example, they may feel like a parent when they are trying to encourage the person to eat or when, through concern, become more watchful of their loved ones behaviours.


  • Sexual intimacy diminishes particularly when their loved one is experiencing poor body image, low mood or low self-esteem.


  • Communication and trust between the couple changes, particularly around the ED issues.  This can be in the form of conflict where both people are finding it difficult to negotiate around the ED.  Increased silence is also commonly experienced where, talking about the ED is difficult or a partner does not want their loved one to know how distressed they may be feeling.


What do Partners do?

From the outset, similar to parents, partners desperately want to be able to help their loved one recover from the ED, which they believe will help their own recovery and recovery of the intimate relationship.  However, particularly in the early stages of the ED when partners have little or no knowledge or understanding of it, they are at a loss as to how to help.  Many partners express their fear of providing the wrong kind of help which they worry will only make things worse.  In fact, this is a reality for many people who, when they look back on how they initially dealt with the problem such as getting angry at their loved one or not confronting the ED issues, they are left feeling guilty and distressed.  But what are they to do when they are faced with such a devastating problem, have little information about it, don’t know how to manage it and have little support or help?


  • Becoming informed about the ED is an initial and ongoing strategy which helps partners develop an understanding of the ED, think about ways of supporting their loved one and identify options to access professional help.


  • Translating this information into practical help and support for their loved one is the next logical step.  However, this is very, very challenging, particularly when ED related conflict or silence is experienced in the relationship, when there is little support from others or there is poor access to professional help.  Developing appropriate supportive strategies for their loved one tends to be a matter of ‘trial and error’.  In this way over time partners begin to build on those strategies they find helpful while relinquishing the less helpful ones.  However, what this means is, precious time is lost in the fight against the ED which in turn prolongs the recovery process for both the partner and their loved one.


  • Developing a resilience against the ED disruptions to their lives is an important skill that partners begin to build on over time and is achieved by:


  • Maintaining hope for recovery.  This is not always easy to do particularly when their loved one experiences ED setbacks.  Often partners need to reframe their hopes for recovery for example, hope that their loved one can have a better life even if living with ED setbacks;


  • Working around the ED disruptions eg a meal out is planned in advance by checking the menu and going out with people they feel comfortable with;


  • Availing of family, friends and professionals where possible to support them and their loved one through recovery;


  • Acknowledging and responding to their own self-care needs.  This usually takes quite some time to master however, as they tend to prioritise the needs of their loved one over their own needs.  Becoming aware of their limitations regarding how they can support recovery coupled with handing over responsibility for recovery to their loved one, goes some way to facilitate partners to self-care.


… Pause for Thought

How difficult it must be for a partner to be living with a loved one who is experiencing an ED.  Not only is there worry for the health of the person but there is also a sense of loss as the ED impacts on the intimate relationship.  


Compounding their difficulties is the general lack of understanding regarding EDs which makes access to social support problematic.  This coupled with the limited access to professional help can leave partners feeling very alone and lost in their fight for the recovery of their loved one, recovery of the intimate relationship and their own personal recovery. 



The above is based on an article by Dr Toni O’Connor, Advanced Nurse Practitioner of 22 February, 2019




Best of Luck!

Regards, Iseult

Iseult C O’Brien


If you see any errors, typographical or factual, or if you disagree with any of my ideas, I should be very glad to hear from you.

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