Hello everyone, my beautiful girlfriend is 27 and has recently told me that she has been bulimic since she was 12 (we have only been together for 7 months). I always knew since we started dating that she had issues surrounding food and exercise but now I am really struggling to know what to say or do and I feel like I am treading on egg shells. I have encouraged her to go to the doctor which she did and an appointment with the specialist has been made but I know that will be months away. Initial blood tests also revealed she is anemic. She would/will not let me attend any appointments with her. In some respects this is the most progress she has ever made with addressing the illness (for example she tells me I'm the first person she's ever told about it - I'm sure that's true to some extent in the detail we've talked about it but I do wonder sometimes as there has been a gradual way of peeling away lies and half truths. She then told me she told her ex boyfriend but he did not understand so it went no further than that? I don't really know what to believe or not believe.). There is so much to think about that I don't know what to do.
She is currently just within a healthy BMI range but insists that she feels/felt much better at approximately a half stone lighter then she is now. Her life is consumed somewhat by exercising and eating healthily. She has started to keep a food diary and it appears that even if she does not suffer from a binge episode she is still sick once a day. I find it all incredibly confusing: what she terms as a binge might only be 10 chocolates/sweets but this is then classed as a "bad" day - do I say "10 sweets isn't bad?!?" or do I say "don't worry about a little slip it's going to happen" etc?
I find it hard to know whether to be supportive when she is super excited to have lost 2 lbs or to encourage exercise in general. I can see that regular exercise improves her mood and also makes her less likely to binge - so in that respect it is good, but I have also told her that I can't realistically support a weight loss goal that puts her within an unhealthy BMI range. Her argument to this is that she still has a bit of fat on her tummy/bottom half so she can't be at an optimal weight. The amount of fat she is talking about is perfectly normal but she won't consider being in a bikini without this gone (we are going on holiday in a month which has further fueled the fire). She hates being seen in her underwear even by me and will not go swimming etc due to this and fear of people commenting on her body. She looks amazing and I am definitely not the only one that thinks so! She praises friends for looking trim that are not even remotely as trim as her. I read that I am not supposed to comment on weight or appearance during treatment but this is impossible as it is at least 40% of what she talks about. The other day she was chuffed that she had been to the gym and then done a 10 mile walk and was disappointed that I wasn't more happy about it! I am at a complete loss. Even if she has eaten what she terms as "well" (which I am confused by too as this is to me a calorie controlled diet day for an anemic already thin girl!) she says she has to be sick and doesn't know how to stop it. It seems she is able to control the "binges" but finds it impossible not to be sick. She says she doesn't make herself sick but feels compelled to be sick and can't control it and describes it as the food "won't go down properly" so she has to be sick.
I can't tell or get support from her family as they are best described as very dysfunctional. She had an awful upbringing by her mother with lots of drama and traumatic experiences. She knows that part of therapy will be counseling etc but has already told me that she doesn't want to live through those childhood experiences again. Whenever we talk about anything like psychology she (maybe rightly) believes that trawling through her past will do more harm than good - but this makes me worry that the root cause will never be addressed. She thinks CBT is what will work for her. She also immediately refused Prozac when the doctor offered it on her first doctors appointment. I understand there are risks with any meds and understand her concerns but from what I have read it is the most successful form of treatment in conjunction with psychological therapy. I asked if she would consider going to a support group but she said no way.
I feel so confused even writing this. I get some days where I think I can handle everything but then others where my thoughts are consumed by it. She claims to be happy/not depressed and that it is just something that she needs to deal with. Shes now started a new job where's she working full time and some odd & some unsociable hours combined with the anemia and is always tired. I worry that I am not assertive enough in order to guide her through this and am always afraid of upsetting her or making her angry. Does anyone know the next thing I should do? As it stands all I am doing is trying to say the wrong things and wait till the appointment with the specialist. And even when that comes, I really don't trust her to tell whoever that is everything totally truthfully. Any help or comments would be greatly appreciated. Thank you.