On Feb. 1, 2004, after abusing laxatives for a decade, Lisa Boltman decided she was done. No more sneaking out of bed in the middle of the night to use the bathroom while her family was asleep. No more spending hours in there, writhing in pain, after ingesting far more than the recommended dosage.
Leading up to that day, Lisa and her husband Rob, who had gotten married the year prior, had been talking about their desire to start a family. In these conversations, Rob urged Lisa to address her eating disorder — diagnosed as anorexia nervosa with purging tendencies — before they took this next step. Anorexia has the highest mortality rate of any mental illness.
“He said we can’t have kids until you’re better, physically, mentally, everything,” Lisa, who lives with her family in a suburb outside of Toronto, told HuffPost. “I went back to see a therapist. I remember when we talked about it, I was like, well, I want kids more than anything in the world and I will stop.”
And for a long time, she did. The couple went on to have three healthy sons; things seemed to be under control. They didn’t realize that after so many good years, her recovery would later be in jeopardy. When the disease resurfaced in 2014, it came back with a vengeance that took a major toll on her mind, body and relationships with friends, family, and especially, Rob.
Throughout their 16-year marriage, the Boltmans’ bond has been seriously tested but it never broke. This is how they went through hell and are slowly making their way out the other side.
How It Started
Lisa’s eating disorder began when she was 20 years old. It wasn’t brought on by a traumatic life event or a difficult upbringing, as it is for some people. She doesn’t recall having body image issues growing up. It all started one day in 1994 when she was feeling bloated and took laxatives to relieve the discomfort.
“There was really nothing major or catastrophic going on in my life,” she said. “They say the characteristics of someone who suffers with an eating disorder tends to be a perfectionist, people-pleaser, that kind of thing. I definitely fell into that.”
Soon, she began to feel that the laxatives provided her with a sense of emotional relief, too, a way to escape when life got overwhelming.
“When I couldn’t give 150%, I was like, OK, I need an out. That was my way of [dealing], instead of just stepping back and saying I just need a break from everything,” Lisa said. “I put everything on hold, not realizing that when all was said and done, it was all still gonna be there when I came back.”
Over time, Lisa began taking laxatives more often. Her body built up a tolerance that resulted in her taking more and more to feel the same effects. She would spend hours at night in the bathroom dizzy, sweating, out of breath, with heart palpitations, cramping and vomiting. Sometimes, she would even bring in a pillow and a blanket and sleep on the bathroom floor.
“Living with someone while you are in the depths of an eating disorder [makes it] impossible to hide. It becomes very lonely and isolating.”
Lisa was meticulous and secretive about her eating disorder behaviors, which is common for people who live with the mental health condition. Her mom and dad ― whom she was living with at the time ― knew something was wrong, but they didn’t know just how bad it really was. Her parents eventually encouraged her to see a therapist, who recommended she do an inpatient detox program at a local hospital to get off the laxatives.
A couple of weeks after she was released, though, Lisa was back to taking them again.
Falling In Love While Dealing With An Eating Disorder
Lisa and Rob met in 1998 through their best friends, who were dating one another at the time. Early on, Rob remembers noticing that Lisa had some peculiar eating habits — for example, she frequently ate the same meals, whether she was dining out or eating at home — but he didn’t think much of it. Lisa said she casually mentioned her eating disorder to Rob within a few months of them dating, but didn’t go into much detail.
“It was just, ‘I have a little problem,”’ she said. “Because I didn’t live with him, it was obviously very easy to hide, especially at the beginning of a relationship, when we weren’t seeing each other that often.”
Because Lisa appeared to be healthy at the time, Rob said he wasn’t overly concerned.
“I guess I saw what she wanted me to see,” he said. “I didn’t get to see all the indicators to wonder what was going on.”
The Boltmans got married in 2003. Once they were living together, it was harder for Lisa to hide her laxative use from Rob, a light sleeper who made note of her constant trips in and out of the bathroom throughout the night. That’s when he started to see evidence of her condition.
“It’s a very shameful illness so I was very private about it,” Lisa said. “But living with someone while you are in the depths of an eating disorder [makes it] impossible to hide. It becomes very lonely and isolating.”
When Rob would confront Lisa about these eating disorder behaviors, she would either downplay how serious it was or she’d get defensive. At that time, Rob didn’t know much about eating disorders, so he usually took Lisa at her word.
“This was new to me and it seemed that Lisa had it under control at times, or would tell me she did,” he said. “I was not equipped to help, other than to support the ups and downs. I seemed to be helpless in this situation.”
Starting A Family
By 2004, Lisa was so focused on having healthy pregnancies and becoming a mom that she just stopped restricting her food intake and taking laxatives altogether.
“I’m not going say I looked at myself and said, ‘Oh my God, I’m so gorgeous and beautiful.’ I still had those tendencies of poking my stomach or something, but I ate,” Lisa said. “I didn’t take any laxatives. I never restricted, nothing. It almost was literally as if it just vanished that day.”
Though she wasn’t engaging in eating disorder behaviors during this 10-year period, Lisa also hadn’t done much to address the psychological issues that contributed to the condition.
“I didn’t really uncover the issues and stop because I was ready to stop. I stopped because I wanted kids,” Lisa said. “I didn’t really delve in and find out why I was doing it and other ways to cope.”
In the spring of 2014, around the time of Lisa’s 40th birthday, the strong urge to take laxatives reemerged seemingly out of nowhere.
“I really tried to fight them. I kept saying to myself, just do it one more time. It’s like you just need to get it out of your system,” she said. “But I knew that if I did one more time, that it would just be an invitation back in.”
She was sitting at home when she said something “just snapped.” Before she knew it, she was at the drug store buying laxatives again.
“Part of me was like, ‘Oh shit, I know what I’m getting myself into,’ and the other half was like, ‘Thank God. I’m so sick and tired of fighting the urges,’” she said. “It was kind of like this odd relationship that I had with it. It came back really, really quickly.”
Within six months, Lisa had dropped a startling amount of weight, she said. Her family stepped in to try to get her help, though treatment options for women in their 40s were limited, as most of the help available was geared toward teens and young adults. The programs that were more targeted to Lisa’s demographic often had long waitlists or BMI requirements that Lisa could not meet.
“I went to my doctor very often for blood tests,” Lisa said. “I was really steps away from death.”
This time around, the severity of the eating disorder really drove a wedge between the Boltmans. Lisa’s feelings of shame and secrecy around the disease, coupled with Rob’s fear of upsetting Lisa by voicing his concerns, destroyed their communication. And when they would discuss the issues, it would often escalate into a fight.
“It was a challenge to manage my feelings because if I expressed them, then Lisa would feel a lot of guilt, a lot of hurt, and I would always be wary of that,” Rob said. “I don’t want to make her feel any more guilty than she already probably feels.”
Physical intimacy also went out the window — everything from sex to other forms of affection. For years, every morning before Rob left for work, he would sit at the edge of the bed and tickle Lisa’s back. At a certain point, that morning ritual just stopped.
“I was afraid to touch her,” he said. “She was a fragile individual.”
“It just pushed us apart to the point where there were thoughts of divorce.”
There were practical concerns, too. When Lisa was sick in the bathroom for hours or unable to get out of bed, she couldn’t help take care of the kids. She called out of work a lot and took a couple leaves of absence, which stoked some financial fears. She often couldn’t make it to family gatherings and other social outings, so Rob would attend alone.
“It just pushed us apart to the point where there were thoughts of divorce,” Rob said.
As much as Lisa was consumed with fighting her own internal battle, she recognizes the impact the eating disorder also had on her husband.
“I do know how hard it was for Rob to watch my body turn into a skeleton,” she said. “I do know how hard it was for him to protect our kids when I was so violently ill ... I know that I changed. As difficult as it was for me, I can appreciate the turmoil it caused for him.”
Lisa came to the stark realization that her options were either to recover from the eating disorder and live or to keep going down this path and die.
“I really was like, ‘I just I can’t live like this anymore. I have to do what I have to do to get better,’” she said.
In the last year and a half, Lisa assembled her own treatment team, including a therapist, a dietician and a nutritionist, to aid in her recovery. She’s also been writing and speaking about her experience publicly for several years — a decision she knew Rob fully supported.
The Boltmans also attended some therapy sessions as a couple, which allowed them each to speak their minds and better understand the other’s perspective.
“We probably should have gone a lot sooner. We probably should have gone a lot more,” Rob said. “You’re allowed to vent, and in a controlled environment, without the other person walking away and getting upset. And having your feelings justified is important.”
Though Lisa and Rob have gotten more comfortable talking about the eating disorder, there are still times when Lisa feels like she just can’t discuss it. Rob is respectful of that, she said.
“We can just be in like a really in-depth conversation, but if I’m just in that moment where I just need to shut off, he totally gets it,” Lisa said.
For the partners of those struggling with an eating disorder, Rob recommends learning more about how the mental illness works, building your own support system and making sure to take care of yourself, too.
“Caregivers need care, too,” he said. “This may come in many forms such as therapy, talking to friends, exercise and stepping away if need be.”
“I do know how hard it was for him to protect our kids when I was so violently ill. I know that I changed.”
For Lisa, there was no magical advice or profound words of wisdom that got her on the right path: “The only one thing that has helped me in recovery was making the decision to recover,” she said.
“I hit rock-bottom hundreds of times yet continued to torture my mind and my body for decades,” Lisa continued. “Making the decision for myself and believing it is the only thing that has helped me be successful to begin recovery.”
Their Relationship Today
As Lisa’s health has improved, so has the couple’s marriage. It may not be perfect, but it’s moving in the right direction, Rob said.
“We don’t have a normal relationship, but it’s getting better. It’s night and day compared to where we are today versus where we were two years ago,” he said. “I’m very proud that she’s been able to turn this around, but it’s very difficult to have conversations that normal married couples would have, whether it’s about money or the kids or moving forward with things. But it’s getting better. I’m starting to feel more comfortable.”
By continuing to share her story, Lisa hopes to inspire and connect with others who are struggling, letting them know that recovery is possible.
“A lot of people have reached out to me and said I give them hope that there is light at the end of the tunnel, that there are things that can be done to save someone, to save a marriage, to save a family, to save a daughter,” she said. “That there is a way out. That you’re not alone. There’s a lot of other people going through it and there are resources available.”
If you’re struggling with an eating disorder, call the National Eating Disorder Association hotline at 1-800-931-2237.
“Tough Love” is a HuffPost series about the real-life challenges couples face during the course of a relationship. Have you gone through a major challenge or difficult period in your relationship and come out the other side? Email us about it at ToughLove@huffpost.com, and we may feature your story in a future installment of this series.