And what you can do or say to help.

On one of my first dates with my current partner, at a now-defunct Indian fusion restaurant in Philadelphia, they placed down their fork, looked at me poignantly, and asked, “How can I support you in your eating disorder recovery?”

Although I’d fantasized about having this conversation with a handful of partners over the years, I suddenly wasn’t sure what to say. No one from my past relationships had made a point to ask me this question. Instead, I always had to force the information about how my eating disorder might show up in our relationship on these people.

The fact that my partner understood the necessity of this conversation — and took responsibility for initiating it — was a gift I’d never been offered before. And it was more important than most people realize.

In a 2006 study that looked at how women with anorexia nervosa experience intimacy in their romantic relationships, these women pointed to their partners understanding their eating disorders as a significant factor in feeling emotional closeness. Yet, partners often don’t know how their partner’s eating disorder can affect their romantic relationship — or even how to start these conversations.

To help, I’ve compiled three sneaky ways that your partner’s eating disorder might show up in your relationship, and what you can do to help to support them in their struggle or recovery.

When it comes to body image among people with eating disorders, these issues can run deep. This is because people with eating disorders, particularly those who are women, are more likely than others to experience negative body image.

In fact, negative body image is one of the initial criteria for being diagnosed with anorexia nervosa. Often referred to as body image disturbance, this experience can have a number of negative effects on people with eating disorders, including sexually.

In women, negative body image can lead to complications in all areas of sexual function and satisfaction — from desire and arousal to orgasm. When it comes to how this might show up in your relationship, you might find that your partner avoids sex with the lights on, refrains from undressing during sex, or even gets distracted while in the moment because they’re thinking about how they look.

What you can do If you’re a partner of a person with an
eating disorder, your affirmation and reassurance of your attraction to your
partner is important — and
helpful. Just be sure to remember that it might not be enough to solve the
problem on its own. Encourage your partner to talk about their struggles, and
try to listen without judgment. It’s
important to remember that this isn’t about you and your love — it’s about your
partner and their disorder.

So many culturally accepted romantic gestures involve food — a box of chocolates for Valentine’s Day, a night out to the county fair to enjoy rides and cotton candy, a date at a fancy restaurant. But for people with eating disorders, the mere presence of food can cause fear. Even people in recovery may be triggered when they feel out of control around food.

That’s because, contrary to popular belief, people don’t necessarily develop eating disorders due to thinness as a beauty standard.

Rather, eating disorders are complex illnesses with biological, psychological, and sociocultural influences, often related to feelings of obsession and control. In fact, the presence of eating and anxiety disorders together is very common.

According to the National Eating Disorders Association, anxiety disorders co-occur in 48 to 51 percent of people with anorexia nervosa, 54 to 81 percent of people with bulimia nervosa, and 55 to 65 percent of people with binge eating disorder.

What you can do Food-related activities can spike
stress in people with eating disorders, and because of this, it’s best to avoid
these treats as surprises. Whether someone currently has, or is in recovery
from, an eating disorder, they may need time to prepare themselves for
activities involving food. Check in with your partner about their specific
needs. Moreover, make sure that food is never sprung on them — no matter how
sweet your birthday cake intentions are.

Telling someone that you have — or have had — an eating disorder is never easy. Mental health stigma is everywhere, and stereotypes about eating disorders abound. Paired with the fact that people with eating disorders often express insecure attachment and that women with eating disorders show a higher likelihood of negative relational experiences, having an intimate conversation about your partner’s eating disorder may prove to be tricky.

But creating the space for your partner to talk to you about their experiences is central to building a healthy relationship with them.

In fact, studies have found that, when looking at how women with anorexia nervosa interpreted their needs around intimacy, their eating disorders played a role in the level of emotional and physical closeness they felt in their relationships. Moreover, being able to openly discuss their eating disorder experiences with their partners was one way to build trust in their relationships.

What you can do Being available to discuss your
partner’s eating disorder openly and honestly, and with demonstrated interest, can
help them feel safer and more genuine in the relationship. Just remember that
you’re not required to know the perfect response to their sharing. Sometimes
listening and offering support is enough.

Dating someone with an eating disorder isn’t unlike dating someone with a chronic condition or disability — it comes with its own set of unique challenges. There are, however, solutions to those challenges, many of which depend on communicating openly with your partner about their needs. Safe, open communication is always a cornerstone of happy, healthy relationships. It allows your partner to share their problems, ask for support, and therefore strengthen the relationship as a whole. Giving your partner with an eating disorder the space to make that experience part of your communication can only help them in their journey.

Melissa A. Fabello, PhD, is a feminist educator whose work focuses on body politics, beauty culture, and eating disorders. Follow her on Twitter and Instagram.