‘Why doesn’t she just…?’ The experience of intimate partner violence and eating disorders

Content warning: This blog post shares the lived experience of intimate partner violence, coercive control and eating disorders, which may be triggering for some readers. For free and confidential support for domestic, family or sexual violence, call 1800 RESPECT (1800 737 732), 24 hours a day, 7 days a week, or visit 1800RESPECT.  For support with eating disorders, connect with the Butterfly National Helpline by calling 1800 ED HOPE (1800 33 4673) or chat online or email, 7 days a week, 8am-midnight (AEDT).

In my late teens and early twenties, I was diagnosed with an eating disorder – a struggle deeply rooted in early childhood trauma that I felt ill-equipped to understand or manage. Not long after my diagnosis, I met the man who would soon become my husband.

He was much older than I, charming, and attentive – even accompanying me to appointments with my treating team as I faced the daunting process of recovery. I welcomed his support during the initial phase of our relationship, which was marked by a phenomenon I now recognise as “love-bombing” – a powerful mix of affection and attention that can feel grounding when your world is in chaos.

Over time, however, what had once felt like genuine interest and warmth began to grow incrementally colder. Comments about my appearance and eating habits, which initially seemed caring, took on an edge that left me questioning myself and my reality – especially as they began to accompany acts of physical, sexual, financial, and psychological abuse.

The comments were often subtle but always intentional, targeting my specific sensitivities and vulnerabilities. They centred on his intimate knowledge of my insecurities, fears, and already distorted relationship with food and my body. Even the smallest aspects of recovery became battlegrounds for interpersonal control. The food I ate, my body’s appearance, and my health were items on his list to monitor, critique, and regulate.

Sometimes the monitoring was rationalised as “support” to help me comply with my treatment plan. At other times, he would demand I weigh myself in front of him, teasing me about the number on the scale, or loudly read out the calorie content of foods before insisting I eat them, joking about where on my body these calories would “stick.”

Later in my treatment journey, emboldened by the tacit approval of my treating clinicians – who viewed his involvement as long-suffering support – he began physically restraining me and forcing me to ingest prescribed nutritional supplements “for my own good.” To this day, I cannot taste Ensure without experiencing a traumatic reaction.

His torment was deliberate – designed to exacerbate my struggles with food and my body, rather than alleviate them.

The issue for those around me was that, in the grip of my eating disorder, my cognitive capacity was so compromised that every effort to ‘make’ me eat felt threatening and terrifying. This makes it incredibly difficult for clinicians or helpers to discern whether the fear and trauma are solely related to the eating disorder or if they stem from something more sinister, such as calculated abuse happening behind closed doors, where the abuser co-opts the illness as a pretext for their actions. In my case, it took many years to untangle the tightly knotted threads of fear—fear of food, fear of my abuser, and fear of how these two things had become so deeply intertwined.

While bruises and physical injuries could have served as convincing evidence of the violence occurring in my home, I explained these away, attributing them to the known physical impact of my eating disorder. “I guess it’s the low iron?” I would say evasively to my doctors, shrugging. “I have no idea how I got those, but I bruise very easily.”

My loyalty to the man I loved, combined with the belief that no one else would want someone as unworthy and burdensome as I felt, drove me to hide the reality of my home life from the very people who could have helped me escape.

I assumed they wouldn’t believe me anyway; my diagnosis of Anorexia Nervosa seemed to make those around me doubt my credibility. My secretive, cagey, and admittedly strange behaviour around food appeared to be interpreted as evidence that my perspectives and views weren’t to be trusted at all.

Unlike overt physical violence, coercive control is often hard to recognise, articulate, or prove. Subtle, controlling behaviours can be as simple as a gesture or a ‘look’ – something innocuous to a bystander but deeply significant in the context of the relationship.

A comment like “Are you going to finish that?” over dinner with friends might seem like gentle encouragement but, to me, it meant: “If you don’t finish the meal I paid for, I’ll make you pay for it later.” My friends, unaware of the subtext, admired my partner’s patience as he gently urged me to eat the most challenging meal on the menu. In truth, he had chosen it unilaterally as punishment for displeasing him earlier that day.

Later, he recounted this incident to my treating team as a triumphant example of his successful encouragement of me to “face a food fear.” To my dismay, they applauded him. “She’s lucky to have you”, they said. On the way home, he took this opportunity to remind me that I was the “crazy” one and that “they” would always believe him over me. I had no reason to doubt him.

These tactics amplify a sense of isolation common to both experiences of intimate violence and eating disorders, and they are easily misunderstood or misinterpreted by those around you.

It was just as hard for me to describe the dysmorphic image I saw in the mirror as it was to describe the tumultuous hell I was living at home to an audience of concerned others who saw only the benevolent image he projected to them. Both my eating disorder and the turmoil of my marriage made seeing anything clearly almost impossible. I was cognitively compromised by malnutrition and an almost constant state of fear.

Subtle forms of abuse are often dismissed as ‘he said, she said’ situations by cautious onlookers reluctant to ‘take sides.’ In a society that values objectivity, many victims feel unable to meet an unspoken burden of proof when deciding whether it is safe to share their subjective experiences of violence or coercive control.

For me, the fear of being disbelieved was profound. The intersection of two highly stigmatised identities – being a victim of gender-based violence and living with an eating disorder – left me feeling voiceless, powerless, and unable to reach out for help or to even believe that help would be forthcoming if I did.

For someone with an eating disorder, speaking out about violence occurs in a context where their credibility is already frequently questioned – including within treatment settings. Practices like being accompanied to the bathroom or closely monitored during meals – while commonly used to ensure compliance in inpatient care – convey implicit messages about our trustworthiness and make it even harder for us to believe we will be taken seriously if we find the courage to speak about violence at home.

I had many experiences in treatment where it felt as if I were regarded as inherently difficult, dishonest, and sneaky – simply by virtue of my diagnosis. My wishes and views were often disregarded or overruled in the name of care.

On one occasion, I ‘tested the waters’ by disclosing an unkind comment my husband had made about my body the previous evening. My well-meaning treating practitioner encouraged me to “consider that [my partner] is probably just very worried about [me]” and that I “need[ed] to understand how hard it is to live with someone who has Anorexia.” This indelicate comment sent me into a spiral of guilt and shame about the burdensome impact of my illness on others. It also left me with the impression that my partner’s violent and controlling behaviour may be deemed understandable, or even acceptable, in context.

My eating disorder convinced me I was to blame for everything – that I was ‘too much,’ ‘too difficult,’ ‘too needy,’ and the list went on. In my distorted mind, the solution was simple: be less. This messaging was echoed by my husband, making it nearly impossible to believe I was worthy of help or that anyone would believe me if I ever found the courage to reach out.

Personal agency and bodily autonomy are routinely constrained in eating disorder treatment, particularly when the cognitive impacts of the illness raise questions about one’s decision-making capacity.

Additionally, eating disorders themselves often mirror the dynamics of interpersonal coercive control, leaving individuals under duress both from within and without. It was difficult for me to find a way to simultaneously challenge, counter, or resist the voice of my eating disorder’s demands as well as those of my abuser. It is no surprise to me that involuntary or coercive intervention is frequently deemed necessary when one’s ability to truly act autonomously is so thoroughly overwhelmed.

It is important however, for outpatient services and discharge planning after inpatient stays to avoid outsourcing monitoring or ‘caring’ tasks in ways that unwittingly amplify problematic power imbalances in intimate relationships where one party’s decision-making capacity may be temporarily impaired.

For me, leaving the hospital as a young adult felt like an “out of the frying pan, into the fire” situation – I had made significant inroads in challenging the duress I experienced at the hands of my eating disorder, but was returning to an environment where my sense of self and independence was being stifled by violence of a different kind.

The system of eating disorder care must navigate the delicate balance of weighing (pun intended) risk versus benefit and harm versus help – an endeavour fraught with complexity.

Even with the best intentions, coercive or restrictive treatment practices can unintentionally reinforce the perception that self-determination and autonomy are unattainable.

For victims of violence, this dynamic may intensify feelings of disempowerment and entrapment, echoing the control they experience at home. This erosion of agency can compound a profound sense of helplessness and deepen the belief that their voice and choices are irrelevant and impotent – in treatment and beyond.

Eating disorders and gender-based violence share a common theme of control.

For me, my eating disorder was a desperate attempt to cope with a chaotic and unsafe early life, and it became – in the context of my abusive marriage – a goal-oriented distraction from the day-to-day realities of living with unpredictable, life-threatening volatility. My brain became adept at creating and clinging to illusions of psychological and emotional control amid the turmoil at home. Some of my eating disorder behaviours even felt like subtle acts of defiance and resistance, a way to reclaim dignity and self-respect when I felt powerless.

The multidirectional impacts of my eating disorder and experiences of interpersonal violence collided in ways that kept me stuck in a situation where my life was at risk from both internal (my eating disorder) and external (my husband) threats. I remember once being told by a clinician that I was my “own worst enemy.” I remember wondering, as I made my way home to the man whose violence had left me traumatised the night before, if it was, in fact, some kind of perverse competition.

With threats coming at me from every direction, my brain and body in a constant state of fight, flight, or freeze, I had no voice, no safe way to scream for help, and no trust in any individual or system to understand the survival challenges I faced. I turned in desperation to my eating disorder as a way to use my body to communicate the things I could not say out loud. The cost to my body, mind, and health was significant, and I wish younger me had known a better way. Had I felt I had any other safe way to speak my truth, I like to hope I might have found the courage to do so. Had I believed my disclosures might be met with compassion and prompt, appropriate action by a trauma-informed system of care, I like to think I might have dared to speak up.

I’ve often heard well-meaning but bewildered bystanders ask, “Why doesn’t she just leave?” For me, the analogous question, “Why doesn’t she just eat?” feel like two sides of the same coin.

While the answer for each person will be unique, the underlying truth for both is often this: because it does not feel safe. Our first step, if we are to start to improve outcomes for those navigating the complexities of eating disorders and gender-based violence, is to remove the systemic and attitudinal barriers women and girls face to reaching out for help.

I don’t pretend to have all the answers to this complex social problem, but I want to play my part in starting the conversation. By sharing my story, I hope to encourage others to do the same.

A powerful way to unite, invest, and act to prevent violence against women and girls is for all human service organisations – including Butterfly – to recognise that neither gender-based violence nor eating disorders discriminate and that both are everyone’s responsibility.

Siloed approaches are failing. Addressing this wicked problem requires multidisciplinary, cross-sector collaboration and a renewed commitment to amplifying the voices of lived experience.

It is my sincere hope that we can find ways to ensure everyone experiencing these issues will feel (and be) safe to seek support – and that the support they find will guide them not just to surviving but to thriving in a future free of coercion from deadly mental illness and gender-based interpersonal violence.

Get support

For free and confidential support for domestic, family or sexual violence, call 1800 RESPECT (1800 737 732), 24 hours a day, 7 days a week, or visit 1800RESPECT.  For support with eating disorders, connect with the Butterfly National Helpline by calling 1800 ED HOPE (1800 33 4673) or chat online or email, 7 days a week, 8am-midnight (AEDT).