After about six months of seeing Michael and Claudia for couples counseling, Michael called me up crying, “She won’t stop, no matter what I do, I can’t get her to stop, she’s going to die! Please help me, how can I get her to stop? ” Michael and Claudia, both 35 years old with two children had been together since they were 17 years old. Claudia had been bulimic for the past twenty years, but despite them being together for more than half their lives, Michael had only recently found out about her eating disorder, which is what brought them to me. He was angry, depressed, and felt utterly betrayed and helpless. He couldn’t believe that Claudia had been holding this secret from him the whole time they’d been together.

It seems unlikely, insane even, that someone could actually hide an eating disorder from their partner for so long, but it’s actually fairly common. Eating disorders notoriously thrive in isolation, so the eating disorder itself is going to make sure that it has vast amounts of privacy. It does anything it can to protect itself. However, if you find out that you’ve been in a relationship with someone who has an eating disorder, you might feel betrayed, helpless, angry, scared and a whole host of other emotions. That’s normal.

Here are some important dos and don’ts for dealing with the situation.

1. DON’T try to fix it.
You, your relationship and your partner will all suffer if you take on the task of trying to fix them. You might be tempted to take on the role of Drill Sergeant, closely monitoring what your partner is or is not eating, noticing when he or she gets up to go to the bathroom, or even following your partner to the bathroom and trying to physically restrain him or her from vomiting. If your partner is under-eating, you might try to push him or her into eating, yelling at them or threatening them to start eating. This is not your job. This is going to create a huge amount of codependency in your relationship. It is also going to catapult your partner into a shame spiral, which will make his or her eating disorder worse. He or she will then become more isolated and in their behaviors while trying to hide it from you. This will pull you apart even more.

2. DO participate in couples or family therapy with an eating disorder specialist.
In my book I discuss how sometimes the eating disorder becomes triangulated into the relationship and gives the couple something else to focus on besides each other. Sometimes couples use the eating disorder as a way to avoid the health of their relationship. Couples counseling will help you focus on your relationship as well as teach you how to best support your partner through this. It will also help your partner understand how his or her eating disorder is affecting you. Your feelings and needs must to be addressed as well. Check out EDReferral or Something Fishy to find an eating disorder specialist.

3. DO encourage your partner to get individual help.
But don’t force it. Just as you cannot fix your partner, you cannot force them to get help.

4. DON’T mention Your partner’s weight or appearance.
Don’t tell them that they have gained weight or lost weight. Aside from the “you’re beautiful and I love you no matter what …” don’t engage with their eating disorder. Let them know that you won’t be playing the “do I look fat?” game with them. Tell them that that is their eating disorder talking and you won’t be answering. If your partner says “Do I look fat in these pants? Do you think I’m fat? Have I gained weight? I’m so disgusting …” Just simply tell them that you love them very much but you are not going to be engaging in that line of questioning. It doesn’t go anywhere and it just feeds eating disorder thinking and you are choosing not to align with their eating disorder

5. DO remember these five words: “How can I  support you?”
This is my absolute favorite  phrase to teach couples- all couples, whether they are dealing with an eating disorder or not.  It’s never, “I’m going to fix you,” it’s always “you do what you need to do to take care of yourself and let me know how I can be supportive.” Discuss in advanced with your partner how he or she wants you to handle it when you see them either inhaling large amounts food, or heading to the bathroom after eating, or restricting food. Perhaps they just want you to check in with them and say, “hey how are you doing? Do you want to talk?”

6. DON’T ask your partner about his or her food.
No, “don’t you think you’ve had enough?” or “should you be eating that?” Again, if you notice something, and you feel compelled to mention it, you can be more gentle about it, “I notice that you seem to be eating very little, is everything okay? Do you want to talk?” If they say no, don’t push it.

7. DON’T blame yourself.
Your partner’s eating disorder is not your fault. Don’t blame yourself for not knowing or for what your partner is doing. Eating disorders are very tricky and usually are not caused by one person or event. They are also sneaky and tend to be able to fool many people. That doesn’t mean that your partner is sneaky, it’s the eating disorder that has a hold of her that has taken on a life of its own.

8. DO get support for yourself.
Either in the form of psychotherapy or a group such as Codependents Anonymous. Living with someone who is a slave to their eating disorder is very difficult and it is okay for you to get support. You don’t want all of your energy to get sucked into your partner’s eating disorder. You can do very little to heal someone else’s eating disorder. That is very rough when it is affecting someone you love. It’s important to get support managing all of these emotions.