Dear Annie: My husband confided to me that his mother had an eating disorder in the past, and there are possible signs she may have relapsed. When she visits us, she will exercise for hours daily, regularly disparage her physical appearance and skip meals claiming that she is “too bloated” to eat. I’m never sure what is the best way to respond to her self-criticism or behaviors. My husband states that she saw a therapist years ago for this problem but has not received any treatment since. He thinks she would be resistant to any further treatment, but I can’t figure out why.

Recent visits with my in-laws have grown more tense, with my husband getting angry at me for buying too much food and “tempting” his mother to binge eat. I’ve noticed that my husband and his side of the family will also significantly restrict their food intake whenever they’re dining with my mother-in-law, possibly to accommodate her worries about overeating or out of habit. I’m not sure what is the best way to handle this situation, both to reduce conflict between my husband and me when his family visits and to support my mother-in-law. Would it be best to let them do all the grocery shopping, meal planning and cooking for themselves? I’m not accustomed to having my house guests take care of themselves, but I don’t want to inadvertently make the problem worse either. I would appreciate your thoughts. — Concerned Daughter-in-law

Dear Concerned DIL: You are doing a good thing by looking out for your mother-in-law. I’m sure your husband and his side of the family are well-intentioned, but it sounds like they are inadvertently enabling their mother’s behavior, which will only make her eating disorder worse. According to the National Eating Disorders Association: “Family and friends can play an important role in identifying worrying symptoms … Many individuals now in recovery from an eating disorder say the support of family and friends was crucial to them getting well.”

NEDA suggests confronting your loved one in private and using only “I statements” — for example, “I noticed that you haven’t been eating a lot recently, and I am concerned that you aren’t getting enough food.” Let her know you are coming from a place of love, and prepare yourself for denial, resistance or anger. Finally, offer to help find a physician or therapist who can help. Contacting the NEDA hotline at (800)-931-2237 is a good place to start.

Before you take this step, however, I recommend having a conversation with your husband. Voice your concerns, and come prepared with research on eating disorders and their consequences. Once he realizes what is at stake, he will likely be more inclined to intervene. And seeing as it’s his mother, you will want him on your side.

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