Eating Disorders in Couples Therapy

0 Commentsby   |  03.13.12  |  Uncategorized

By: Loren Morcomb

Since high school I have been very interested in the effects of eating disorders on individuals, and more recently, the effects of eating disorders on marriages and families.  One of my high school friends has a severe eating disorder and has attended several rehabilitation centers.  As she continues to suffer from the addiction, I have noticed the dramatic emotional, physical, and social effect the condition has had on her life.

Eating disorders involve extreme emotions, attitudes, and behaviors surrounding weight and food issues.  According to the National Eating Disorder Association (2011), there are three main types of eating disorders: anorexia nervosa, bulimia nervosa, and binge eating disorder.  As the most common eating disorder, anorexia nervosa is characterized by self-starvation and excessive weight loss.  Individuals with anorexia nervosa fear gaining weight or being “fat”, feel “fat” regardless of dramatic weight loss, and concern with body weight and shape.  Eating large amounts of food in short periods of time, then getting rid of the food and calories through vomiting, laxative abuse, or over-exercising characterizes bulimia nervosa.  Individuals with bulimia nervosa have repeated episodes of binging and purging, feel out of control during a binge and eating cycle, diet frequently, and have extreme concern with their body weight and shape.  Lastly, binge eating disorder is portrayed primarily by periods of uncontrolled, impulsive, or continuous eating beyond the point of feeling comfortably full.  While there is no purging, there may be sporadic fasts or repetitive diets and often feelings of shame or self-hatred after a binge (National Eating Disorder Association, 2011).  The cause of eating disorders is believed to be a combination of biological, psychological, and/or environmental abnormalities.  However, the exact cause of eating disorders is unknown.

Overall, individuals suffering from eating problems experience difficulty in emotional connectivity and attachment in intimate relationships.  Specifically, individuals display characteristics consistent with anxious and avoidant patterns in attachment, low levels of satisfaction, fear of intimacy, distance with partners, and poor sexual functioning.  According to Cockett (1995), therapists should not assume that an individual suffering from an eating disorder will have marital problems, however, there are implications for both spouses and children, which, while often resolvable, should not be ignored.  Long term, individuals who are experiencing or have experienced an eating disorder will suffer from relationship and depression difficulties.

Clinically, treatment varies depending on the severity of the eating disorder and marital problems.  Cognitive Behavioral Therapy proves effective in changing the individual’s feelings and behaviors towards self-image and control.  According to Evans and Wertheim (2005), “attachment theory, which examines emotional regulation and subsequent behavioral reactions in interpersonal functioning, may offer an additional valuable framework to examine the processes by which women with an eating disorder relate in intimate romantic relationships” (pg. 286). Proving most effective, Interpersonal Psychotherapy addresses clients’ interpersonal processes and aims to moderate emotional reactions to interpersonal events.  Additionally, non-traditional therapy such as music therapy, recreation therapy, and art therapy have provided alternate means for improving martial relations.

In conclusion, partners (male or female) with an eating disorder cause emotional and psychological strain in a marriage.  Specifically, attachment, intimacy, and satisfaction are inhibited.  Although some researchers believe an eating disorder does not automatically cause marital dysfunction, implications in the marriage should be addressed.  Cognitive Behavioral Therapy, attachment theory, and interpersonal psychotherapy are effective interventions to be used.



National Eating Disorders Association (2011). What is an eating disorder? Some basic facts. Retrieved from

Evans, L., & Wertheim, E. (2005). Attachment styles in adult intimate relationships: Comparing women with bulimia nervosa symptoms, women with depression and women with no clinical symptoms. European Eating Disorders Review, 13, 285-293.

Cockett, A. (1995). Eating disorders and marriage – The couple in focus. [Review of the book Eating disorders and marriage – The couple in focus by Woodside, D.B., Schekter-Wolfson, L., Brands, J., & Lackstrom, J.]. European Eating Disorders Review, 3, 56-58.

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