Eating Disorders Are a Family Affair


Mary Anne Cohen 

Eating disorders do not develop out of the blue. They are often born and develop within a family context, and for this reason, family therapy can be extremely valuable in helping to resolve these problems.  


Rachel had a binge eating disorder that she tried to hide from her husband Ben. She would secretly binge when he was at work or had gone to bed. Ben began complaining that Rachel was gaining weight and pressured her to “keep her figure.” The more Ben criticized, the more Rachel felt anxious and was driven to binge. The more Rachel binged and gained weight; the more Ben commented. Rachel finally began therapy without telling Ben, but the therapist pointed out that keeping secrets from her husband was keeping Rachel in a guilty downward spiral.  


With the support of her therapist, Rachel told Ben she had started therapy and asked if he could come to some sessions. Ben was hurt and annoyed that she hadn’t told him before but agreed to go. In the session, Rachel revealed that she had a “binge eating disorder,” something that Ben had never heard of. The therapist and Rachel explained what this was and how stress – like Ben’s comments about her weight – provoked her to eat more. 


Ben wanted to be helpful but asked, “So what happens if you wind up 400 pounds?” This aggravated Rachel who started to yell that she never felt Ben loved her  unconditionally and began listing a series of examples that caused her to feel insecure. 


Now, not only was Rachel’s bingeing out of control but her and Ben’s communication was also spinning out of control. How to help this couple? What’s a therapist to do? Their yelling at each other didn’t seem productive. Or was it? 


Sometimes things feel worse before they get better. If a couple – like Rachel and Ben – have stifled feelings of resentment, bringing them out to the light of day can feel scary and upsetting. But only then can the healing truly begin! 


As this couple became interested in improving their communication, we learned many helpful things. Ben revealed that he had never gotten over the hurt of his mother dying from breast cancer when he was ten. He had heard that eating sugar increases the risk of cancer and was alarmed that Rachel was eating sweets and, therefore, he believed, putting herself in harm’s way. He was angry at her, anticipating that she would die prematurely and leave him like his mother.  


Rachel and I sat in stunned silence as tears and sobs began pouring out of Ben. She got up out of her chair and began to hold him as he cried. Later she said it dawned on her in that moment, that her husband, who could often seem cold and critical, was a scared ten year old who never got over the grief of his mother’s death. She felt a wave of compassion for him. 

Did this experience cure Rachel’s bingeing once and for all? No, but it certainly changed the tide, as a door of tenderness opened between them as the therapy helped both of them feel better understood. Ben decided to go for some individual grief therapy for himself, and Rachel continued working to separate her emotions from her eating. 


Family therapy can help identify specific family dynamics, conflicts, or stressors that may contribute to the eating disorder. This can include issues related to control, perfectionism, self-esteem, or body image. By identifying and addressing these triggers, the family can work together to heal their loved one’s eating disorder. 


Only by bringing a family’s struggles out to the clear light of day are we able to begin healing a family problem. We help couples and families move from conflict to connection. 

The Mindful Eating Project recognizes the value of couples and family therapy to help resolve eating disorders for a family member. We have now added two therapists who specialize in couples and family therapy to our team. Help is now available for the couple and the whole family. 


Schedule an initial assessment with The Mindful Eating Project, and we’ll help you determine if you and your family can benefit from treatment. To start a confidential conversation, please contact us. Your contact with us is absolutely confidential. Please feel free to call (718)336-MEND. 

The Mindful Eating Project is a division of The Safe Foundation. 

Mary Anne Cohen, LCSW, BCD is Director of The New York Center for Eating Disorders. She is also author of French Toast for Breakfast: Declaring Peace with Emotional Eating and Lasagna for Lunch: Declaring Peace with Emotional Eating. Mary Anne is the professional book reviewer for, the largest international resource for eating disorders. www.EmotionalEating.Org.