Codependent Spouses and Participation in Treatment

Husband And Wife Discussing Family Therapy

Codependency can be considered a behavior. It emotionally and behaviorally affects relationships, and the person suffering with a codependent personality has much difficulty maintaining or even forming healthy relationships. Typically, when a person is codependent, their relationships are one-sided, destructive both emotionally and mentally, and are often times abusive [1].

Anyone can be codependent. A person who is codependent usually has a family history of addiction, abuse, or significant mental illness. Codependency can create a family dynamic of chaos, where the other members in the family may have feelings of fear, anger, pain, or shame. Typically, these emotions are ignored or denied by the codependent family member.

Often, the members of a family in this type of dynamic, one with a codependent member and one with an eating disorder member, tend to have both the emotional development and personal identity stunted [1].

Codependency in Family of Eating Disorder Sufferers

The codependent family member will tend to put all of their energy into helping the eating disorder partner, even putting their own physical, emotional, and mental needs of the ill partner above their own, until the caretaking becomes self-defeating and it turns into a martyr role. Codependents also can lose sense of their own identify, needs, and self within the caretaking dynamic.

Tired Woman Looking On

Like someone who is an addict, codependents tend to look outside themselves for ways to ‘fill’ up internally. This may take the form of alcohol, drugs, excessive spending, or sex. As the cycle continues, the codependent feels needed and rewarded in their behaviors.

The codependent may begin to feel they have no say or choice in the relationship. Typically, the codependent person views himself or herself as a victim within their relationship. This individual might have a tendency to give more within the relationship, or have an unhealthy perception of relationships.

They may strive for extreme approval and recognition, but feel guilt or shame when being assertive. Codependents may also struggle with identifying and expressing emotions, have issues with anger, and poor communication skills.

Many couples who have both an eating disorder and codependency within a relationship can find it to be a struggle [2]. Typically, the eating disorder person feels shame and guilt about their disorder and its effect on the relationship, wanting to hide it from the partner.

Whereas the codependent may be all too willing to ‘help’ with the treatment process, and taking over the eating disorder person’s recovery.

Secretive Nature of Eating Disorders

Eating disorders can also take over a relationship. They are negative, obsessive, and take precedence over a person’s family, friends, and own needs [3].

This is partially due to the eating disorder inside the person’s mind and body, but also other comorbid issues, such as depression, anxiety, personality disorders, or other mental health concerns.

It can be a challenge for family and friends to understand the disorder and see their loved one hurting himself or herself with the disorder symptoms. Eating disorders can develop out of a chaotic or unhealthy relationship. It can be a way to control when feeling very out of control within their marital or partner relationship.

Working on Skill Building in Family Therapy

There is value of codependent spouses participating in family therapy and family programming of a partner who is in eating disorder treatment [4]. Together, both can learn concrete skills to gain emotional health, respective boundaries, and communication skills that can decrease both disorder symptoms, and increase protective factors of the couple.

Couple Working On Skills In Family Therapy

Helping couples build a healthy relationship can empower both members to learn how to identify emotions and issues, and communicate them appropriately.

Helping the eating disorder partner be able to express their fears of lack of identity, lack of control or equableness within the relationship can be helpful. Helping the eating disorder spouse to express what they do want in a relationship and allowing the partner to respond.

Education of both codependency and eating disorders can be extremely helpful to the couple in terms of learning about the aspects of each. Gaining communication skills and phrases to help the couple learn how to talk to each other with respect and concern and care is also essential.

Family of eating disorder sufferers can also be of value in therapy. If the sufferer is in a higher level of care setting, it can be extremely beneficial for the codependent spouse and children to gain education and training on how to best help and support their loved one.

It can give the non-eating disorder partner a look into what their spouse goes through during the day, meal plan and eating challenges, therapy, as well as meeting other family members who are in similar situations.

Woman struggling with an eating disorder

One challenge that can arise within family therapy is that the codependent partner may not be willing or able to change. They may not have an individual therapist or want to seek one. The partner may be in denial of their own contributing factors to the unhealthy dynamic.

This all is true for the eating disorder partner, as well. It is a case-by-case situation, based on the decision of the patient and treatment team if a codependent spouse can be helpful or hurtful in the recovery process.

In summary, both codependent spouses and eating disorder spouses share some common tendencies. Together, both contribute to an unhealthy family dynamic and can benefit from working together in ongoing treatment.

Family therapy and participating in family programming can be extremely helpful, but discussing with the treatment team is necessary to ensure that both members agree to family inclusion in treatment.

Image of Libby Lyons and familyAbout the Author: Libby Lyons is a Licensed Clinical Social Worker and Certified Eating Disorder Specialist (CEDS). Libby has been practicing in the field of eating disorders, addictions, depression, anxiety and other comorbid issues in various agencies. Libby has previously worked as a contractor for the United States Air Force Domestic Violence Program, Saint Louis University Student Health and Counseling, Saint Louis Behavioral Medicine Institute Eating Disorders Program, and has been in Private Practice.

Libby currently works as a counselor at Fontbonne University and is a Adjunct Professor at Saint Louis University, and is a contributing author for Addiction Hope and Eating Disorder Hope. Libby lives in the St. Louis area with her husband and two daughters. She enjoys spending time with her family, running, and watching movies.


[1] (n.d.) Retrieved June 8, 2017, from
[2] Company, I. G. (2012, July & Aug.). EST and Binge-Eating Disorder. Retrieved June 09, 2017, from
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[3] International, I. A., & Maine, M., PhD. (n.d.). Eating Disorders. Retrieved June 09, 2017, from
[4] A. (2014, February 24). In a Relationship and It’s Complicated: Eating Disorders in Intimate Relationships. Retrieved June 09, 2017, from

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published on July 29, 2017.
Reviewed By: Jacquelyn Ekern, MS, LPC on July 29, 2017.
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About Baxter Ekern

Baxter is the Vice President of Ekern Enterprises, Inc. He is responsible for the operations of Eating Disorder Hope and ensuring that the website is functioning smoothly.