Couple Relationships and Eating Disorders

The importance of close relationships as a system of support for individuals with eating disorders cannot be overstated. As well as the family of origin, romantic relationships can provide a close connection and a source of comfort and support to deter from eating-related distress and promote recovery. On the other hand, such relationships can add another layer of complexity to the ED picture, and the intimate nature of the couple relationship is unique; thus, it cannot be assumed that support and interventions developed for the family of origin are directly relevant to couple relationships also. For such relationships to facilitate recovery, and to provide appropriate support, the nature of these relationships and partner experiences must be explored and better understood. Existing research is somewhat limited with regard to romantic relationships and EDs, but suggests that people with EDs experience low levels of satisfaction in romantic relationships, and this is associated with ED symptomatology, perhaps bidirectionally. People with EDs also report high levels of insecurity in their relationships. Furthermore, the ED impacts upon sexual relationships, including libido, and the anticipation of a partner’s physical expectations can drive ED behaviors. Studies examining experiences of the partner who does not have an ED highlight distress, and a sense of helplessness and powerlessness. There is a reported desire to help their loved one, but a need for more external support. Positive emotions such as responsibility and gratitude for being able to help are also noted. The importance of supporting recovery via the couple relationship as well as supporting those within the couple relationship is clear, including consideration of unique factors inherent in romantic and couple relationships, and necessitating a different approach from those provided with other family members. Research into couples-based treatments for specific EDs, such as UCAN for AN and UNITE-BED for binge eating, has emerged over the last decade and shown early signs of efficacy. Further work is required to demonstrate the impact of such approaches and refine these therapeutic programs. This should include consideration of greater diversity in relationships, including sexuality, gender, ethnicity, and culture.