What To Do When Your Spouse Relapses into Bulimia

Couple happy after understanding eating disorder assessments

What does it look like when your spouse relapses into bulimia? Your husband or wife was on the mend from bulimia and now seems to be relapsing.

They were eating healthy, not purging, and exercising moderately. They had been meeting with their ED treatment team regularly and seemed committed to recovery from bulimia.

Everything begins to unravel and fall apart. Appointments are missed, meals are skipped and there is a return to obsessive exercising.

Next, you notice prolonged periods of time in the bathroom after meals, more weight concerns, declining optimism about recovering from an eating disorder. You may also observe increased anxiety and depression.

You Are Not Alone

You feel bewildered and disappointed in your spouse and just want this eating disorder nightmare to end! It is absolutely frustrating and discouraging for a husband, wife or any loved one to observe relapse into bulimia. You are not alone and entitled to feel disheartened. Any spouse in your situation would likely feel the same!

But, I have good news for you! Many of us in recovery from an eating disorder experience a two-steps forward, two steps backward process in recovery.

Lifetime ED Treatment Table

Source: https://www.nimh.nih.gov/health/statistics/eating-disorders.shtml

Seeking professional treatment by eating disorder specialists is a wise course of action. It leads to the most likely recovery outcome. About 43% of adults who struggle with bulimia seek treatment. Females are more likely to pursue treatment than males.

However, there are ups and downs along the way. Ongoing support through outpatient eating disorder therapists and nutritionists is generally necessary for long term recovery from bulimia.

It does not mean that your spouse has to be in therapy for life or endlessly completing meal plans with a nutritionist. It is just wise to have a significant period of step-down care following inpatient or residential eating disorder treatment. Additionally, maintaining contact with a team of experts over the years can provide a wonderful safety-net to return to if relapse occurs.

So, if you suspect that your spouse is practicing bulimic behaviors again, it is best to address the concern.

Basic Signs of Bulimia Nervosa

  1. Sore throat complaints
  2. Swollen neck and jaw glands
  3. Cuts on knuckles
  4. Excessive exercise
  5. Fasting
  6. Vomiting
  7. Dehydration

Find a time when you can discuss your concerns privately with your spouse. Seek a location where you will likely be uninterrupted. Avoid consuming alcohol during the talk about your bulimic relapse concerns.

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Communicating Bulimia Relapse Concerns

State something like: “I feel concerned that you may be struggling with bulimic tendencies again. This is because I have observed ______________________ (example: vomit residue on the toilet, your exercising for very long periods of time, and you seem to have lost interest in your bulimia recovery behaviors). I understand that recovering from bulimia is very difficult and challenging. Would you please share with me your thoughts on your recovery progress and how I can be of help?”

Couple enjoying sunset and discussing Eating Disorders in Transgender CommunityListen to your spouse with compassion and reflect back to them what you heard them say. This is important to ensure you heard their response correctly and to assure them that you are listening and truly understanding what they are conveying.

Next, if your concerns are accurate and your wife or husband is struggling with bulimic behaviors again, suggest a meeting with a therapist and nutritionist.

Make sure the professionals you choose are well versed in eating disorder treatment protocol. If you have a prior treatment team that was effective, reach out to them and ask for guidance and suggestions.

If your spouse denies any relapse into bulimia, then you must decide whether to accept their response and let it go or follow up with another discussion about your concerns again, if you continue to observe signs and symptoms of bulimia.

You can also reach out to the treatment team yourself, and discuss your concerns and how to best support and help your spouse get back on track. In some cases, it will be wise to seek inpatient, partial hospitalization or intensive outpatient care with an eating disorder treatment program.  Bulimia relapse does not have to be a disaster or permanent. It simply needs to be addressed.

Your spouse may need to revisit their recovery plan and put a renewed effort into it. Relapse can be overcome when your loved one is using skills and tools to effectively cope with life without relying on bulimia nervosa as a crutch.

Your faith and hope in your wife or husband, as they face this ongoing recovery journey, is the best gift you can give to them.


Eating Disorders. (n.d.). Retrieved April 25, 2019, from https://www.nimh.nih.gov/health/statistics/eating-disorders.shtml

Article Sponsored By Texas Eating Disorder Treatment Program:

Eating Disorder Solutions

At Eating Disorder Solutions, compassion is at the root of everything we do. We understand that eating disorders are complex, deeply rooted mental health and medical conditions which require personalized treatment for successful recovery. By integrating behavioral health modalities and clinical interventions, we endeavor to address disordered eating at its source. As one of the nation’s few adult eating disorder facilities offering residential and outpatient programs, Eating Disorder Solutions is fully prepared to help people reclaim control of their lives and future.

At Eating Disorder Solutions, recovery is a community effort. We believe by addressing and processing feelings such as shame and guilt, we can begin the journey to recovery. Eating Disorder Solution focuses on the individual, not his or her diagnosis, to better understand the underlying cause and best treatment approach for each client. We offer a residential home to clients who need that extra support to begin the journey to recovery while also giving him or her the freedom that many other facilities are unable to offer. We pride ourselves on staying connected with each individuals support system, whether it is family or outpatient treatment providers, to ensure that our clients have the best continued care after treatment.


About the author:

Jacquelyn EkernJacquelyn Ekern, MS, LPC founded Eating Disorder Hope in 2005, driven by a profound desire to help those struggling with anorexia, bulimia and binge-eating disorder. This passion resulted from her battle with, and recovery from, an eating disorder. As president, Jacquelyn manages Ekern Enterprises, Inc. and the Eating Disorder Hope website. In addition, she is a fully licensed therapist with a closed private counseling practice specializing in the treatment of eating disorders.

Jacquelyn has a Bachelor of Science in Human Services degree from The University of Phoenix and a Masters degree in Counseling/Psychology, from Capella University. She has extensive experience in the eating disorder field including advanced education in psychology, participation, and contributions to additional eating disorder groups, symposiums, and professional associations. She is a member of the National Eating Disorder Association (NEDA), Academy of Eating Disorders (AED), the Eating Disorders Coalition (EDC) and the International Association of Eating Disorder Professionals (iaedp).

Jacquelyn enjoys art, working out, walking her dogs, reading, painting and time with family.
Although Eating Disorder Hope was founded by Jacquelyn Ekern, this organization would not be possible without support from our generous sponsors.

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 a 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 May 1, 2019.
Reviewed & Approved on May 1, 2019, by Jacquelyn Ekern MS, LPC

Published on EatingDisorderHope.com

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.