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What's Love Got to Do with Thin?

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They do it because they want to help. The husbands, partners -- even children -- of women with eating disorders are performing striking feats of "support." ("We love you, mom!") But are they really that?

An eye-catching story comes from Tom Cramer, whose wife Meg slipped into the grip of anorexia. As she continued to waste away, Tom tried to cajole a skeletal Meg into eating a cheeseburger and fries: "If you really love me, you will eat this," he begged. She didn't. So he starved himself by her side, just to experience her pain.

The "if you can't beat 'em, join 'em" philosophy is an interesting one, especially in the outcome for Tom. After running three miles daily, eating little more than juice and a banana for breakfast and a small salad for dinner, he eventually pushed through hunger to encounter "the voice." It's one that many eating disorder victims report they hear in their minds: "Come on, you can do it. Don't give in. You're better than everyone else."

As Tom heard it, he got it: "Now I understood the seduction of the words in (Meg's) head," he says. "And I saw her as a hero -- who had to be incredibly strong in her fight to recover."

Is she a hero? Better yet, did Tom really get it? Hard to say. Tom's self-starvation experiment only lasted about a week. Eating disorders can last a lifetime, waxing and waning in rhythm with triggers caused by the stresses and transitions of life. One of Meg's triggers might have been, actually, motherhood. The birth of her second child nudged her body weight to an all-time high. Or, much to Tom's consternation, some hidden dissatisfaction with her marriage might have catalyzed her fall.

The idea that marital struggles can actually trigger eating disorders is not a stretch. More than a decade ago, psychologist Stephan Van den Broucke, research coordinator at the Flemish Institute for Health Promotion in Belgium, did a provocative series of studies with couples in which one partner suffered from an eating disorder.

Van den Broucke peeked behind closed doors at how these couples viewed their intimacy and happiness in love. He found that wives with eating disorders were very unhappy in their marriages, while their husbands were not.

To find out why, Van den Broucke gathered three types of heterosexual couples: one in which the wife had an eating disorder, another in which neither partner was ill, and a third in which the couple was seeking counseling for run-of-the-mill marital problems. It turns out that couples in which one partner had an eating disorder reported more marital distress than couples with either marital problems or no eating disorder but less distress than couples generally fighting. At the same time, couples with eating disorders scored lower on intimacy measures than did normal couples and only scored slightly higher than did couples seeking counseling for general problems.

What this means is that "eating disordered couples are fighting less because they're interacting less," Van den Broucke concludes.

Simply, an eating disorder starves basic intimacy.

Indeed, Tom Cramer notes that as his wife's disease progressed, she began shunning sex, closeting enticing clothing in favor of baggy sweats that hid her wasting body, and generally falling asleep by 8 p.m., exhausted from self-starvation. Frustrated, Tom starved himself to reconnect. The whole dynamic is complex, as many marriages are. But when it comes to love and eating disorders, it's pretty simple -- the guys are intrinsically, if not intimately involved.

In researching Lying in Weight: the Hidden Epidemic of Eating Disorders in Adult Women, I learned that there are five basic categories of men in partnership with women harboring eating disorders:

1. The Nice Guy: Passive and Compliant

This is the "rescuer" who genuinely wants to help her. He compromises, concedes, and sacrifices -- for her. Or so it seems. But sometimes taking care of her is a distraction from taking care of himself and his "stuff." So he stays. Until she gets better, that is. Because then he's out of a job.

2. The Knight in Shining Armor

A variation on the passive theme, a Knight in Shining Armor wants to save and protect his eating-disordered damsel -- until he realizes that she doesn't really want to be saved. She wants her eating disorder. Lacking gratitude from her, he tires of fighting her dragons and fights her. He may make sly comments about her eating at parties or he may recognize his helplessness and withdraw. Withdrawal can take the form of an affair, immersion in work, or divorce.

3. Macho Man: Control and Conquer

A Macho Man may be either controlling or kind and loving. Either way, he sees her as an extension of himself. Whether an executive, doctor, or minister, this man is accustomed to managing people. He brings his job home and chooses they type of woman with an eating disorder because she will go along with his behavior. In the worst case scenario, he is abusive.

4. Mr. Clueless: He Just Doesn't Know That a Problem Exists

By far the largest category of partners, many men have no idea that their partner is sick. That's hard to believe in the case of anorexia. But with bulimia, in which women can be normal or even overweight, not knowing is not a stretch. Without any real idea of how seriously their wives are suffering, these men genuinely love their partners and believe their marriages are pretty good. An anecdote to illustrate the point -a husband was clueless that his wife who he had been married to for 35 years was actively bulimic until she checked into a treatment center and told him. He was a detective.

5. The Ostrich: Denial and Distance

Question: "If you have a partner with a marked weight fluctuation, how could you NOT notice?" Answer: Denial. In many eating disordered marriages, no one wants to rock the boat. And so the partnership goes on, lacking honest, open communication - and true intimacy.

Overall, partners of women with eating disorders are not any more neurotic or insecure than the norm. However, partners may be ignorant of the disease and all its permutations and manifestations. So if you are intimately involved with someone with an eating disorder, you don't have to self-starve. But you'd be wise to educate yourself about what eating disorders are and are not. For help, you can click through a wide variety of good resources created by reputable organizations.

Eating disorders don't go away on their own. They don't heal by love alone. They don't affect her alone. Eating disorders play out in partnership and intimacy in profound ways. Yes, love has everything to do with them.

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