For a guy who is astute or caring enough to notice that a woman's behavior might be signs of anorexia, bulimia or another eating disorder, it may only be the tip of the iceberg.
This recognition might be lifesaving, but a solution with treatment and therapy will not occur overnight, according to Lauren Strobeck, program coordinator of the Eating Disorders Program at the Belmont Center for Comprehensive Treatment in Philadelphia.
People in the midst of a serious eating disorder do not think clearly, she said.
"Their sense of reality can be really sordid," she explained. "It's very hard to watch someone who doesn't understand how bad they are. It's heart-wrenching. Someone could be in a very, very precarious medical situation."
Dealing with an eating disorder is a lot like dealing with someone suffering from drug or alcohol addiction, or a serious illness, according to Linda Smolak, a psychology professor and eating disorder expert from Kenyon College in Ohio.
"This is a little like having cancer, you need to know this is a serious problem," she said. "I'm not trying to suggest that you go dumping her, but you can't change this overnight. You need to know that this is not something that goes away in two weeks."
How to React
Guys should look for warning signs. But after assessing the situation — the woman's behavior in conjunction with analyzing the symptoms — she said that open, nonjudgmental communication is important.
"I typically suggest, the guy might want to talk to a friend in a place where you can have a quiet conversation, and say he's concerned about her because of this, and list things that concern him: 'I've noticed that you don't seem very comfortable eating in front of me, noticed you always disappear after meals, or eat large amounts of ice-cream.' "
Conversations or confrontations over eating disorders often generate two reactions: denial or indignant responses. When faced with this type of response, Smolak recommends that the guy approach the girl's friends, family or someone who "can be more effective in a conversation."
She said to keep the comments specific, without judging: "Open the door for her to talk to someone or know who her doctor is, know of a clinic or someone to find a resource."
Added Smolak: "Maybe she will confess, at that point, and you'll need to decide whether you want to stay on board with her at all because it is hard to recover. A lot of women don't. You need to be aware of what you're getting into."
Women often complain that men think that they are fixers, and that the problem will be resolved in a week or two, said David Wall, a psychologist who specializes in eating disorders at the Remuda Ranch, a nationally-known treatment facility in Arizona and Virginia.
Treatment and therapy will not cure the disorder overnight.
Serious cases require in-patient treatment, which provides around-the-clock treatment and therapy. For less severe cases, Strobeck noted that a patient could receive half-day treatments or even attend weekly meetings.
The goal is to stabilize the patient, and restore a healthy mental outlook and eating habits, she said.
Strobeck said that the most severe cases can result in death or serious long-term health problems, so necessary treatment is crucial.
And, she said, know this: "If someone is 5'6" and 73 pounds, the stay will be longer."
However, getting the woman into therapy, may be rife with problems, added Wall, requiring the guy to stand firm, especially in the face of denial.
"He should talk to her about what her meals are. 'What's going on? I want to support you. I don't want to support you dying,' " he said.
But Wall also explained that the guy must be aware of what stage the woman might be in: pre-contemplation, contemplation, beginning the process, action, maintenance and recovery.
"Sometimes, boyfriends draw a line in the sand," he said.
The solutions also depend on the strength of the relationship, adding that "we get some women who come in on the threat of splitting up or divorcing."
No matter how caring a man might be, at times, experts said, there may be nothing at all that he can do.
For more information, check out the American Anorexia and Bulimia Association of Philadelphia Web site at: www.aabaphila.org, which includes phone and e-mail hotlines for information and referrals; or the National Eating Disorder Association at: www.nationaleatingdisorders.org.
Roy S. Gutterman is a Syracuse, N.Y.-based writer. To contact him, visit: www.Lrev.com.