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My boyfriend of four years is kind, wickedly funny, very bright, and also my physical opposite: tall and lean. When we started dating I was struggling to control my obsessive compulsive disorder. He has depression and anxiety, and is relatively sympathetic. Now that I’m on medication and in cognitive behavioral therapy, I’ve put on 30 pounds. I recently had a myriad of blood tests performed and am surprisingly healthy, more so than when I was at my thinnest. Recently, my boyfriend told me he was “worried about my health,” and when I pressed him, he told me he was worried about my weight in particular. For the first time in my life I don’t feel the need to obsess over my food intake. How do I handle this situation?

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M.C./ Boston

Your own physical and mental health have to be your first priority; it’s something no one else can do for you. However you handle the situation has to come from that place.

That said, I’m going to bend over backward to give your boyfriend the benefit of the doubt here, because that’s almost certainly the perspective you are coming from. A knee-jerk “Dump him!” response from me will, reasonably enough, only get a knee-jerk denial from you. So here goes: It’s possible your boyfriend simply doesn’t grasp the entirety of the situation.

It sounds as though he has a fast metabolism, and so he might not realize that other people gain weight more easily. He’d have to eat five whole cakes a day to gain 30 pounds, so maybe he’s thinking you’re eating five whole cakes a day, which is at least four too many.

Your implication is also that the weight gain was rather sudden, and rapid weight changes in either direction aren’t optimal for health, though sometimes they can’t be avoided. Maybe he’s alarmed by a relatively fast change and doesn’t understand that it’s positive. Fat prejudice is rampant in our society and a lot of people incorrectly perceive weight as the only metric that matters in relation to health. Your boyfriend could be operating from insufficient and incorrect information.

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So, explain it to him: This is what health looks like for you! Your mental health is vastly improved, your physical health is excellent, and your body is finding its set point for weight. He has no reason to be worried. This is not an argument, mind. This is an explanation. Put it in exactly those terms if you need to. “I’m not arguing about this with you, I’m explaining it to you. I will not argue with you about my own body and mind.” And then don’t.

I truly hope this is all that it takes to set things right again. If the only bothersome thing he’s done is to say that your recent weight gain worries him, it may well be.

But what’s with that “relatively” sympathetic? If he’s undermining in other ways, or won’t let the weight thing go, please work with your therapist to set boundaries and develop scripts.

I congratulate you on how far you’ve come on your journey!

Miss Conduct is Robin Abrahams, a writer with a PhD in psychology.