Reciprocal Influence of Couple Dynamics and Eating Disorders

Abstract

Little research has focused on the ways that eating disorder processes and adult couple dynamics influence one another. The purpose of this study was to investigate the reciprocal influence of couple dynamics and eating disorder illness and recovery processes. We conducted 51 interviews with 17 couples where one member identified as currently suffering or having recovered from an eating disorder. Using grounded theory analytical methods, findings include the systemic interplay of the eating disorder and relationship, both partners' perspectives on the eating disorder and its role in the relationship, the noneating disorder partner's impact on the eating disorder, and coping strategies for recovery as a couple. Clinical implications for supporting couples experiencing eating disorder illness and recovery are discussed.

A pilot open trial of UNITE‐BED: A couple‐based intervention for binge‐eating disorder

“…Partners need guidance on how to facilitate change constructively. Couple‐based treatments target potentially detrimental interpersonal dynamics and may improve outcomes, reduce relapse (Linville et al, ), and improve patient and partner quality of life (Macdonald et al, ). UNITE‐BED targets BED psychopathology, co‐occurring symptoms, and relationship functioning (Kirby, Runfola, Fischer, Baucom, & Bulik, ; Kirby, Runfola, Fischer, Baucom, & Bulik, ) by integrating core cognitive‐behavioral therapy (CBT) for BED principles (Fairburn, Cooper, & Shafran, ) with cognitive‐behavioral couple therapy interventions (CBCT; Epstein & Baucom, ).…”

“…Notably, such stressors frequently occur in women with BED, as they report lower marital satisfaction, less frequent positive interaction, and increased negative interaction in their relationships than non-ill women (Whisman, Demetyeva, Baucom, & Bulik, 2012). Partners also experience challenges as they find it difficult to understand EDs, struggle with ED-related secrecy, and express powerlessness and ineffectiveness (Linville, Cobb, Shen, & Stadelman, 2015).…”

The Role of Family of Origin in Current Lifestyle Choices

“…During childhood, food choices and exercise behaviors are largely contingent on parent’s lifestyle. 51,52 Several studies suggest that children who develop poor lifestyle habits (e.g., food and exercise) usually continue those habits into adulthood, which increase risks for chronic diseases that are prominently found in ethnic minorities (e.g., obesity, diabetes, heart disease, etc.). 4,63–65 Other studies highlight the important role of romantic partners for each other’s lifestyle choices.…”

Interventions to Empower Adults with Eating Disorders and Their Partners around the Transition to Parenthood

“…For instance, partners of individuals with BED may accommodate their symptoms, for example, enable and reinforce cognitions and behaviors associated with the eating disorder, in an attempt for emotional coregulation (Weber et al, 2018). These patterns can inadvertently reinforce or exacerbate the eating disorder symptoms as well as its shame, secrecy, and self‐critical nature, creating a damaging interactional cycle (Arcelus, Haslam, Farrow, & Meyer, 2013; Linville et al, 2016). Thus, typical difficulties involved in the transition to parenthood may be intensified in the context of a maternal eating disorder (Bradford & Hawkins, 2006; Sadeh‐Sharvit & Lock, 2018; Sevigny et al, 2016; Squires et al, 2014), thereby potentially leading to decreased parental involvement and partner support, both of which are crucial to the maintenance of the family system in general, and the child’s development in particular (Cimino, Cerniglia, & Paciello, 2015; Epstein & Baucom, 2002).…”

“…Spousal support is essential for parental functioning. Due to the secretive and insidious nature of eating disorders, partners are often unaware of the presence, severity, or course of the patient’s eating disorder symptoms (Bulik, Baucom, Kirby, & Pisetsky, 2011; Linville, Cobb, Shen, & Stadelman, 2016). Additionally, partners commonly report trust issues, isolation, confusion, and difficulty understanding the disorder (Huke & Slade, 2006).…”