What’s eating him

Dr. Daley on Sex and Relationships

What’s eating him


Dear Dr. Daley: I’m a 26-year-old guy who’s been dating a really, realllllly skinny girl for a few months now. We’re talking 5’7, 110 pounds. I was initially attracted to everything about her, but now the skinny thing is starting to gross me out – especially when we’re in bed and her hips are digging into my body like little fists. I love her and really don’t want to end things, because I could honestly see myself settling down with her some day. How do I ask her to gain a little weight?

Oh, yeah. That will really go over big. How about I ask you to get a little more in touch with your gay self?

One thing we are talking about here are phobias, and one thing that doesn’t really work with phobias is the suggestion that you just go ahead and do whatever it is you are (profoundly, irrationally) afraid of. They had even considered calling anorexia nervosa “food phobia” there for a while, but it’s so hard for the medical community to give up Latin and other things that make them so very special. It would have been a useful change of nomenclature, because even us regular people can comprehend a phobia even if by definition they don’t make much sense.

Despite its glorification on every page of every magazine and in every set of pixels on every single screen in the developed world, anorexia nervosa is still a serious illness. Some defining points include: remaining less than 85% of your ideal body weight, having a distorted sense of what your body actually looks like, intense fear of gaining weight, and amenorrhea (your periods have stopped for at least three consecutive cycles). We are also talking about monumental control issues, perfectionism, lying about food intake, obsession with food and eating, wearing extra clothes under your clothes so no one will notice you have no flesh on your legs because when people notice they get upset and want to make you do disgusting things like eat more. We are also talking lots and lots and lots of exercise – why waste time just brushing your teeth when you can do lunges while brushing your teeth? Why walk straight across a room when you can burn six more calories walking around the perimeter? Because you better believe every single calorie counts!

Meanwhile, your bones are being damaged by loss of adequate nutrition, your hair is breaking, fuzz may be sprouting all over your body, and your heart is doing its best to pull a Karen Carpenter. And if you are the binge-purge type, your esophagus, trachea, and teeth are being eroded by all that acidic puke you are pulling up through your mouth and nose umpteen times a day. Yummy!

photo / Editrrix 

Boyfriend, you are dealing with a problem here that is beyond your expertise, and I strongly advise you to seek expert help. Your girlfriend’s BMI (body mass index, run a Google) isn’t even on the chart. I looked. You can easily find an eating disorders clinic (pretty much every college in America can handle this at the counseling center), or some sort of self-help outfit (your local hospital or your own physician can help you find a connection). You are living with a serious illness and you need the right behaviors and language for dealing with it. Whether your girlfriend will seek help cannot be guaranteed, but you may be able to name names about what’s going on and let her know there are better options. After all, like millions of American women (and an increasing number of American men), she has been told she’s fat since she was old enough to see. It’s a hard obsession to shake.

Some of the new antidepressants are remarkably helpful in intervening with obsessions, phobias, and distorted self-perceptions (most people with eating disorders look in the mirror and see FAT where we see clavicles, ribs, pelvises, and knobby knees). A period of time on meds can clear up enough mental space to deal with the other fears and furies that are roiling beneath the surface. Some of the terrors include: fear of losing control, fear of getting fat, fear of growing up, fear of sexuality/pregnancy, fear of real life and all its warts. For many, control over food intake feels like the only corner of the universe they are actually in charge of. A lot of anger may stem back to childhood and adolescence, and a tendency to be way too polite and nice when genuine anger ought to have been expressed. Now all the anger seems to explode when you try to get them to risk a second piece of lettuce.

Eating disorders are notoriously difficult to treat; there will typically be lapses back into old patterns. But that shouldn’t stop you from at least trying. Whether this relationship is for a lifetime or not, you recognize in this girlfriend of yours some genuinely excellent human qualities, and I’m sure you’d like to see her have a longer, happier life. Good luck.

About the author Dr. Nancy Daley is a licensed psychologist and adjunct assistant professor who teaches Human Sexuality at The University of Texas at Austin. If you would like to submit questions for her to answer in this column, please send them to drdaley at thatotherpaper dot com.

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Justin West's picture

…but I have to. The person asking the question made no mention of an eating disorder - that’s a conclusion you jumped to.

I, myself, am an incredibly skinny guy. I’m 6’4” and I weigh around 130 lbs. Get that? Yeah, I’m friggin’ scrawny, but I do not have an eating disorder. Fact is, I have an extremely high metabolism and nothing more. I’ve been accused of having an eating disorder once or twice and it’s damned annoying.

Don’t hate on skinny people! A lot of us just don’t gain weight. You should be so lucky…

no one's picture

new column soon, please!!!!

Anonymous's picture

Agree with the other poster about jumping to conclusions. I’m “off the charts” skinny too (5’9” and 115lb), but eating isn’t a problem. My metabolism is very good, my body fat is around 8%, and I’m very active. Skinny doesn’t necessarily mean sick.