How Eating Disorders Affect Relationships and How to Maintain the Good Ones
Written by ‘Ai Pono Hawaii Staff Writer
Relationships and eating disorders are tough to navigate. How much do relationships matter when it comes to fueling an eating disorder, and when it comes to recovery? Does one person have the ability to make you sick? And can one person force you to recover?
Read on for:
How eating disorders and relationships are related
The difference between helpful and harmful relationships
What a codependent relationship is, and how to spot one
How codependency and eating disorders are related
When to end a codependent relationship
How to navigate relationships while in eating disorder recovery
Relationships and Eating Disorders: Can someone cause an eating disorder?
In many families and relationships, someone may blame themselves for their loved one’s eating disorder. And some people with an eating disorder may blame someone else for their behaviors. But is it possible for one person or group of people to cause an eating disorder, or an eating disorder relapse?
Not exactly.
While things like childhood bullying and insecure relationships in the family may contribute to an eating disorder, they don't cause an eating disorder all on their own. Many people are exposed to these same environmental factors, but only a portion of them go on to develop an eating disorder.
This is because eating disorders have no one cause — they are a combination of genetic, psychological, and social risk factors. Some people are predisposed to the disorder and go on to develop it.
Other people are predisposed to substance use disorders, and end up developing a substance problem. Others have resilience and optimism in their genes, and are more equipped to handle the stressors that come with negative relationships in their lives.
What about traumatic experiences?
Instances like sexual assault and war are commonly associated with trauma. There are also more types of trauma than you may know. Chronic bullying, childhood neglect, and witnessing domestic abuse, are all forms of trauma.
Can these forms of traumatic relationships cause an eating disorder?
Trauma causes a biological response in the body, one that is commonly related to eating disorders. Individuals look to escape emotionally from their surroundings or flashbacks, or maintain some level of control in their lives. These experiences alone do not cause an eating disorder. They do, however, seriously contribute to the onset and maintenance of an eating disorder, simply because eating disorder behaviors are a way to cope.
Imagine it like this: An eating disorder is like a car. And hurtful, maladaptive relationships are like fuel for this car. But you have to already have a car before any fuel can be put into it. Essentially, the eating disorder has to already exist in some genetic or psychological way before it can be fueled by something else. The "something else" is any and all traumatic experiences and maladaptive relationships.
Related: For more on the relationship between trauma and eating disorders, read this.
Helpful vs Harmful Relationships: What’s the difference?
If harmful relationships can fuel an eating disorder, it makes sense that supportive relationships can help someone heal from an eating disorder. Helpful relationships offer sufferers a form of support in times of trouble. Supports can also be a way to be held accountable for meeting a meal plan and stopping behaviors. Even something as simple as committing to having meals with a supportive family member or friend every night can steer your recovery in the right direction.
But you need to recognize your helpful and harmful relationships before you can start to lean on anyone for support.
More ways to tell the difference
Helpful Relationships
People who can help you in recovery:
Listen to your needs and struggles without judgment
Make you feel safe when confiding in and spending time with them
Do not make your eating disorder about them
Do not engage in any weight or diet talk
Educate themselves about eating disorders as best they can
Understand that eating disorder are not a phase, attention speaking, or a display of vanity
Change their behaviors when you ask them to (e.g. they stop commenting on how you look when you ask them to)
See you as someone besides a person with an eating disorder
Do not make you feel like a burden
Do not make you feel guilty or selfish for using behaviors
can stick to any set boundaries
Feel free to express any of their needs (such as stepping back if they cannot be there one hundred percent of the time)
Offer gentle support and encouragement during things like meals or when you feel you need to use eating disorder behaviors to cope
Will never encourage you to use eating disorder behaviors such as fasting, dieting, over-exercising, etc.
Your relationships with these kinds of people are helpful for your recovery. Focus on these relationships, as they serve your recovery well.
Maladaptive, Harmful Relationships
People who are not good for your recovery:
Do not take your eating disorder seriously
Are not willing to talk to you about your eating disorder, treatment, or recovery
Openly engage in eating disorder behaviors, even when you ask them not to
Create more stress than calm in your life
Fat shame or view weight gain in a negative light
Minimize your problems
Only want to talk about their problems
Make your eating disorder all about them
Wish they had an eating disorder
View eating disorder behaviors as a good thing
View eating disorders and weight loss as a competition
Cause you to use eating disorder behaviors
Consider how valuable these relationships are to you. You may be able to build a more positive relationship over time, but you also might not. Remember, your recovery comes first. And you don't owe it to anyone to sacrifice your healing to please them.
Eating Disorders and Codependency: How it Works
A lot of the characteristics of harmful relationships are also characteristics of codependent relationships, which will hold you back in your recovery.
Codependency is a term that describes individuals who are extremely preoccupied with and dependent on another person. You can be dependent on someone else in a physical, mental, and/or emotional way. You may become so dependent on that other person, and feel so responsible for their emotions and actions, that you put off your own recovery. Worrying so much about someone else keeps you from focusing on yourself, especially if they put all their problems on you and don't care about yours.
Codependent relationships come in many forms:
One-sided, controlling and/or abusive romantic relationships
Family members/friendships with people who are sick
Relationships with narcissistic or alcoholic parents
Maladaptive relationships with friends you have made from eating disorder treatment
Related: Here’s how to know if your treatment friends are actually helping your recovery.
People with codependency and eating disorders may also share similar traits, such as:
Low self-esteem
Familial dysfunction
Depression and anxiety, which are co-occurring illnesses associated with eating disorders
Stress
Low emotional expressivity
Need for control
Low sense of self, which affects sense of self-worth and identity
Related: Take a codependency scale quiz to determine whether you show signs of codependency.
The Research: Codependency as a Connection Between Stressful Life Events and Eating Disorders
In this study, ninety-five undergraduate women were asked to describe their relationship with an alcoholic parent or significant other, as well as stressful life events. They were also evaluated for their sense of self and eating disorder behaviors.
Researchers found that stressful life events and alcoholic relationships contributed to eating disorder behaviors. They also found that women with more codependent traits (i.e. caretaker, need for control) showed more eating disorder symptoms.
Researchers concluded from this study that having alcoholic family members and significant others intensifies the likelihood that stressful life events will cause codependency and eating disorder symptoms.
Codependency also created a lower sense of self. Their identity, values, and self-worth were attached to others rather than themselves. They often did not seek help because they were so focused on others.
Related: If you have trouble creating an identity for yourself outside of your eating disorder, this will help.
When do you end a harmful and/or codependent relationship?
In every relationship, ask yourself:
Are you unable to find satisfaction and meaning in your life outside of the relationship?
Do you recognize behaviors that are unhealthy to themselves or to you, and stay with them in spite of this?
Are you supporting the other person in your relationship at the cost of your own physical, mental, and/or emotional well-being?
Do you feel the need to "save" the other person in the relationship, even if it puts you and your recovery at risk?
Are you focusing more on the other person than your own recovery?
If you answer “yes” to any of these questions, and/or recognize any of the signs of a hurtful relationship (listed in an earlier section of this article) then strongly consider ending the relationship.
How do you navigate relationships in eating disorder recovery?
First, recognize that no one can force you to recover — not really. Your loved ones can send you to treatment, beg you to eat normally, and try to guilt you into recovery. This may make you change your behaviors around these people. But real recovery comes from within. It comes because you want it. Then, analyze your relationships and decide whether they affect your recovery in a positive or negative way.
Spend time with those who help you stay in recovery. Ask for support when you need it. But make sure you're not creating a one-sided or codependent relationship yourself. If you believe you are strong enough and the relationship is with salvaging, talk to the negative influences in your life.
Explain to them what's not working in the relationship. Try not to accuse or place blame on them. Remember, no single force can cause an eating disorder. Instead, explain how they may influence your eating disorder, and what changes could be helpful so they can become a positive force in your recovery.
If there appears to be no change, consider couple's or family therapy, or simply speak to your therapist about the relationship. Ask them about what to do, what may be fueling a negative/codependent relationship, and whether the relationship is worth continuing. If they seem to hold a grudge against you for advocating for yourself, or they are unwilling to change, that's a big red flag. Take that as a sign that your relationship with this person is not worth maintaining.
Related: These are four things to consider while you find an eating disorder therapist.
Most importantly, remember that you don't owe anyone anything.
You don't owe anyone anything in terms of caretaking, hyperfocusing, solving their problems, or "saving them." It's not your place to be their therapist, doctor, or hero. You do owe it to yourself to focus on you and your own recovery. It's not selfish to focus inward. And you are not a bad person for creating space between yourself and others who do not serve your recovery.
You are worthy of recovery, even when you don't feel like it.
If you or a loved one is suffering from an eating disorder, take the first step today and talk to someone about recovery or simply learn more about the holistic eating disorder recovery programs we offer.