Ask the Expert - Week 3

Each Friday, I will post a question answered by Dr. Kathryn J. Zerbe. The questions are part of an on-going coversation with Dr. Zerbe from the New York Times.

NY Times Bio
Dr. Zerbe is the author of “The Body Betrayed: A Deeper Understanding of Women, Eating Disorders, and Treatment” (Gurze Books, 1993) and “Integrated Treatment of Eating Disorders: Beyond the Body Betrayed” (Norton, 2008). She has had 25 years of experience working with individuals with eating disorders and directed the Eating Disorder Unit at the Menninger Clinic for five years. She also served on the American Psychiatric Association’s Work Group on Eating Disorders in 2000 and 2006.


Week Three

I am fairly certain that my sister in law (mid-30s) suffers from bulimia–she is extremely thin and looks unhealthy, but eats a lot whenever I see her, typically at family meals/restaurant visits. She always leaves to visit the bathroom fairly obviously not long after we’ve finished eating and I’ve occasionally smelled vomit when I follow her into the bathroom. I understand she had an experience with an eating disorder about 10 years ago but I don’t know that she ever stopped having a problem. The family doesn’t speak openly about it so I don’t feel comfortable approaching her myself, and I’m also not 100% sure of course. Do you have any suggestions on how to handle this situation?

From Dr. Zerbe:
These situations in a family are always difficult to handle. It does sound to me as if your sister-in-law could have relapsed into bulimia based on your observation of her leaving to go to the bathroom after eating large amounts of food and sometimes smelling vomit.

I suggest you talk to her and express your concerns. You might also try to enlist at least one other family member who shares your observations to sit down with you. Because denial of the problem is so common in those with an eating disorder, she may not listen or tell you the truth immediately, but at least you know that you have done what you could. You might also suggest a book or looking at the Academy for Eating Disorders Web site, which has valuable information about these life threatening illnesses.