17-03-2016 01:14 PM
Hi. I'm new to the forum.
My husband has an undiagnosed eating disorder. It has been excruciatingly difficult to flag anyone down because he is in complete denial, and as such, the disorder is invisible to everyone except us as his immediate family. We have been living the nightmare of watching him decline, mentally, emotionally and physically, while we are voiceless under the law until something breaks.
All online advice says that early intervention offers the best outcome in terms of recovery. It has been four and a half years, four of which I have been trying to reach him and access help to no avail as yet ... I say as yet, because I live in faith and hope of a positive outcome in time. It helps to read other people's stories and realise that while this is a long time to have been struggling, others have struggled longer and with more dire circumstances.
The most obviously disordered feature of my husband's condition is a large volume of chew and spit. This is supported with obsessive over-exercising and Orhorexia. I think we're dealing with. EDNOS. His BMI is within the normal range. He is set into a daily regimen that has left our family life scraped together around it. Attempts to talk to him and guide him towards help have resulted in emotional abuse and temper rages that have impacted our relationships and ability to function in our independent work and school commitments.
For self preservation the kids and I have pulled back to walking on eggshells around him, dealing with issues in the moment as they arise, and trying to remain detached while we await some sort of change in our status quo. That change might be in the form of a health crash for my husband. There are certainly the signs associated with eating disorders all present - feeling the cold more than anyone else (jumpers in hot weather), not sleeping, dry skin and hair, hair loss, fatigue, constant injuries, temper tantrums and rages, cognitive distortion, ritualisations, etc
We are living in this awful holding pattern, knowing he needs help but unable to access it.
18-03-2016 07:31 PM
Welcome to the forums, although I wish it was under better circumstances.
There seems to be not a lot of awareness out there for men with eating disorders. As @EDV (Eating Disorders Vic) pointed out in this discussion, men make up 25% of people diagnosed with eating disorders, and if your story is anything to go by, it's likely to be more. EDV have a great factsheet you might find interesting.
It must be so hard to watch your husband go through this.
You mentioned he's in denial so it's hard to 'flag anyone down'. May I ask, what assistance have you sought out so far - have you managed to get him to talk to a professional? It might just help others to give more relevant advice if they know what you've already tried.
I'm also sorry to read of his outbursts of emotional abuse and that he has a temper. Your safety is important and regardless of what is going on for him, compromising yours or your family's safety is not okay. Do you have any support around this?
Again, welcome to the forums - I hope you find them helpful.
18-03-2016 09:43 PM
Thank you for responding to me Nik, and thank you for the links. I will follow through with them.
I know it is important to share our experiences to help others find their way as well. I hope to share our breakthroughs when they come as well.
The first thing I tried was reasoning with my husband. Pre-ED he would have listened to reason. It was clear when he refuted good reason and countered it with personal attacks against my areas of health concern, care of our children, household management skills, etc that he was employing a deflection strategy - "lighting scrub fires" around me, if you will, so I became so involved with trying o defend myself it stopped me from questioning him or trying to reason with him. When I persisted, he applied the same strategy towards our kids, which really hurt, especially when they tried to speak up to him too. We had to retreat for our own emotional security and safety.
The next thing I tried was sending him links for online information. Instead of reaching him, he took note of how his ED behaviours could harm him, and took evasive action - eg drinking hydration solutions to try to keep his electrolytes balanced (chew-spit can throw these out of whack), cleaning his teeth and eating apples to protect against enamel damage, using a body building solution to try to keep his mineral balances, taking his recurrent injuries to different careers such as the doctor, physio, sports massage centre, so nobody had the full picture of his injuries. He is also careful to keep his BMI in the normal range to avoid detection. These are all bandaid strategies which will blow out eventually, and probably dramatically, because they ought to be the warning signs that he is approaching a health crisis.
I tried to approach the family doctor, under whose supervision he had lost 79kg. We can now recognise that he moved from one eating disorder to a set of others, now that BED is a recognised category. He had been morbidly obese for the best part of 30 years, and elements of his chew-spit are what this has morphed to. The doctor pointed to his BMI being appropriate, and took offence to his judgement being questioned, citing patient privacy for my husband as a reason not to address my concerns without my husband present. My husband, of course, refused to come with me, and responded vindictively at home to dissuade me from trying to get him to the doctor, I was advised to stop criticising his "success" and work on my own health and fitness. The kids have been put under the microscope regarding their dietary and fitness habits as well - all part of the deflection smoke screen and adding to our stress. On a positive note, actually being mindful of our own health and fitness is an excellent counter-weight to this pressure, and an important part of remaining healthy ourselves.
From there I tried to approach the physio, who gave me general info but couldn't comment personally regarding my husband owing to a lack of diagnosis, but it was clear he was concerned about all of us. The same resulted from speaking with our dentist. Both are ready to speak up when any evidence of the ED does emerge. Eating Disorder clinics and hospital staff have offered moral support, and advised us all to guard our own health and well-being under the stress, but can't deal directly with my husband without evidenced based diagnosis. My husband is revelling in a sense of triumph and superiority. Very frustrating.
I attended a psychologist to try to find answers. Together we arrived at an exhaustion of ideas, but he did suggest all the strategies I was already trying, and supported the fact that we are actually powerless to do anything other than leave my husband, which has consequences of its own of course. In his wonky stare of mind, he is highly vindictive, something I know he will be very remorseful about in hindsight.
Approaching extended family of origin around my husband's isn't work. They can only see his weight-loss success, and have a family culture of idolising thinness (part of the source of the problem). I have confided in my own family of origin and a close group of girlfriends who provide us with empathy and moral support - very important this is !!! Nobody should be going it alone, and this is a very lonely walk otherwise. My husband's future recovery will be very lonely too, if his ED succeeds in alienating him from everybody around him. And that is the key to holding on to our dysfunctional circumstances - it's the ED doing this, and my husband is its hostage.
There is success in being able to persevere, even though we haven't arrived at breakthrough or solutions yet. Our United courage is holding us all up in the meantime, and we are wielding a wicked sense of humour wherever and whenever we can to get past the tears.
Thanks for listening.
18-03-2016 10:23 AM
I forgot to mention in my last post that I did end up going to the doctor with my husband. When he first started with the chew-spit, that confirmed for me that I hadn't been imagining things . His rigid small "spear-healthy" meals, amount of obsessive exercise, and the personality changes we were witnessing, including distortions in his ability to reason soundly, were in fact an eating disorder. I had previously thought that the mental disorder tag related to people seeing themselves as overweight when they weren't. Now it was becoming clear that it's a lot more than that.
To begin with he was chewing and spitting in his home office. When he became cockier, and tried to sit next to the kids in the lounge room with this, I confronted him and told him he needed to speak to the doctor. He next day he told me had had stopped the habit because he could see it was upsetting me. He lied. He just started to hide it. Because we knew it would result in arguments and emotional abuse, the kids and I didn't raise it with him, until it became clear his emotional control was continuing to decline. I confronted him over it again, seeing no option for outside help, and he was furious that the ruse hadn't held up. From there he started visiting his mother's house more often, where he practices this openly. She has labeled it a phase (?!) and supports him, both of them secretive about it.
Thinking it was now hidden well enough for me to believe the habit was gone, after one particular argument, he challenged me to come to the doctor and we would "deal with this once and for all!!" When we saw the doctor, and I still can't understand this, he was go smacked when I raised all the symptoms of his ED. He was completely blindsided, like he didn't see it coming at all !! The doctor had begun by praising my husband's weight loss, telling me that it had saved his life and indicating that as his BMI is in the right place, I just have to acclimatise myself to how thin and boney he is, because all his health markers are within the normal range. Once I spelled out the ED mentality we are faced with, and listed off behaviours and practices that are clearly disordered, my husband lied about them all, trying to paint me as deluded. The doctor addressed some of the behaviours with him in a cautionary way. I am hoping I have at least raised some doubts in the doctor's mind.
My husband's response to move into the spare room and tell his brother we were separated. It took a week of arguing about it, but I managed to talk him down from that, and we went back to just ignoring all his symptoms and focussing on getting through the day at hand.
In faith I believe that these are all small building blocks that will eventually come together as a part of the solution. Baby steps - difficult but necessary. It's only later that we will be able to see what they were worth.
20-03-2016 01:19 PM
Hi Faith and Hope,
Your courage and perserverance to gain support and guidance for the care of your husband, and the management of you and your families life around this is extraordinary, and I imagine mindlessly frustrating.
To further your support, I wonder if you have been in contact with Carers Victoria (1800 242 636), who provide 6 Counselling sessions for those who find themselves in your situation. The EDV helpline (1300 550 236), is also available to you if you need to talk about different situations which arise that are hard to manage.
It is difficult to hear of the abuse and manipulation that has become part of this time for you and your family. The safety of your family and yourself is most important here.
20-03-2016 04:02 PM
Thank you for responding to my post. Your empathy is a kindness that is soothing. I have to keep smiling on the outside when I know I'm crying on the inside. We all are, and reading comments from people who are in recovery from eating disorders, I imagine my husband must be too, even if it's entirely suppressed.
It was the EDV Helpline team that suggested this forum to me last year, but it has taken until now for our situation to settle enough for me to find the brain space I needed to engage. The helpline team have advised me to take care of myself and my family's well being as a priority, and to try not to feel guilty that we can't access help for him. It's not our fault. It was hard coming to terms with the fact that it's not his fault either, or the doctor's fault in not being able see the forest for the trees. This illness shape-shifts, and hides, and lies, and keeps to the shadows where you only see glimpses of it, and wonder whether you're imagining things, or exaggerating things, or making mountains out of molehills ... It has the power to cause emotional illness in those around the main sufferer. It certainly destroys relationships. We have had to disengage emotionally for my husband to be able to survive, and we have to weigh up his conversations and behaviours for truth, ulterior motives, manipulations, playing one off against another, etc. It's a demoralising existence if you allow it to be.
We are choosing as a family to shoulder as much of the rubbish as we can in order to stay close to my husband in hope of his recovery. We have to be careful to monitor depression, and our own eating and exercise habits. It can make you want to shy away from healthy practices for yourself because you are witnessing an unhealthy obsession associated with them. Your head needs to stay on straight to see clearly in this mire.
Because we are not challenging my husband's ED, the dust has settled a lot. He's coming and going independently in his regimen, rarely eating meals with us and sleeping and rising in his own pattern. There are only isolated dramas where he takes offence to something, or challenges a decision, and we take the shortest route to pacifying him that we can, and move on. He is spending a lot of time interstate on business, which helps. He's being pleasant on the phone, and keeping in touch with the kids as individuals. It feels like we are drifting apart from him, and he may yet choose to separate from me, but emotionally, he's already long gone.
My biggest fear is his risk of sudden death, which I believe is a reality. There are heart problems and diabetes in his family. A low heart rate and blood pressure are signs of a high level of physical fitness, which is how he is presenting. They are also signs of an eating disorder reaching a crisis point. He has suffered kidney stones, but the signs of adrenal collapse are similar. Are his electrolytes running dangerously low underneath his daily ingestion of hydrolyte solution ? I don't know. It feels like we are living with a ticking time-bomb, but if all the relevant tests were done, maybe we're not in fact ...
The health professionals I have spoken to, on the basis of my description of his behaviour, all predict that it cannot be sustained and he will eventually crash. Meantime we have to carry on as if nothing is wrong in our social, work and school settings. It's a strange reality. I am battling inertia at the moment, just putting one foot in front of the other to get through the needs of the day, mindful not to allow depression through the door. I'm just considering it a form of off-duty resting while there are no current dramas to face down.
26-03-2016 11:20 PM
Hi Faith and Hope,
It sounds like your husband has made an enormous achievement to lose all the weight he lost.
Maybe,its little wonder that after a person has been through such as situation that they might become a little "imbalanced" and obsessive having a fear that they might gain the weight back again.
Your husband has taken some proactive steps (drinking the electrolyte drinks) so perhaps this is a good sign that he still has some reasoning skills.
If you dont mind the question,what are the exact food groups that he is feeling he needs to avoid?
Is he able to take a multivitamin or protein drink etc so he gets balanced nutrition?
Is his blood pressure and/or heartrate actually now low or are they in the normal range?
Its also been my experience that doctors 95%+ of the time ignore low blood pressure as being "fine" and only pay attention to high blood pressure.
How often is your husband spitting out his food,like is it only some foods or is it all meals every day?
Is he skinny now or muscly?
If hes resistant to any mention of eating disorders or psychologists etc then maybe another practical solution might be for him to see a Nutritionist or Physical trainer who could help formulate a meal plan suitable for him that can ensure it meets minimum callories but with maximum nutrition and also an dailyexerciseplanfor burning excess callories.
Maybe this structured approach might be something he would be comfortable with and would then loosen his anxiety/fear and might stop the chew and spitting?
26-03-2016 02:46 AM
Yes, it was an enormous achievement to lose all that weight, and he did it by working with the advice of the family doctor, getting his blood pressure monitored and weight checked along the way. All of that seemed fantastic at the time.
He had lost 75kg previously, then regained it, plus some. At that previous time, he had started out using a well-known weight loss organisation, and was going for regular weigh-ins, nutritional advice, etc. All good. The only issue was that, for the foods on offer on their meal plans, he would only eat one of the two dozen breakfast choices, three choices of lunch, and three dinners - he was too restrictive about what he would eat to accept anything else in the 30 choices or so for lunches and dinners. After a few months he decided he preferred to create his own diet from low-energy frozen dinners in the supermarket, a low fat / high fibre cereal, and salad based lunches. That seemed fine too, but it meant that he was moving away from professional support. As he began to lose weight, and got a kick out of that, he began restricting his portion sizes and increasing his exercise to lose weight faster and faster, going right past a beautiful weight (according to my taste), and only slowing to maintain when he was very thin. In order to maintain that thin size, he was on a perpetual diet and trying to exercise off every calorie he ate. I figured with time he would balance out, if we just kept to healthy meals and exercise levels around him, and he would eventually find that point where you are at a weight that can be maintained without being extreme.
Unfortunately, now that BED is a recognised eating disorder category, it is clear that he had that form of ED, and hadn't moved out of it within his psychology.. He was thin only on the basis of trying to maintain an iron will and inflexible regimen. When he did try to eat a few of the foods he craved occasionally, and work commitments increased so he couldn't exercise as much as he wanted to, the BED broke back through and took over his life again. He piled the kgs back on even more rapidly than he had lost them. At no point would he listen, even to gentle advice, to return to the weight loss organisation, or hire a personal trainer, etc. it's an all or nothing mentality that drives him.
it is absolutely a fear of regaining the weight that is driving him now. He even admitted that these behaviours are an addiction for him, but he believes he can't be addiction free - that it either has to be BED or EDNOS. He won't listen, at the moment at least, to any suggestion that he can be free of both with help from specialists.
The proactive steps appear to be driven by a fear of being found out, or a fear that negative consequences of what he is doing will undermine his regimen and he will lose control. Along with the hydrolyse he is drinking a high protein sports drink, which will be helping to keep his mineral balance.
He went through a phase of trying to avoid almost all grain carbs. Somewhere that altered - a good thing - and he realised not all grain carbs are equal. He now sticks rigidly to "superfood" carbs (quinoa, oats, freekah, linseed) and combines them all in a porridge that he is cooking in large quantities together with a wide range of nuts and seeds and "superfood" powders. An aunt of mine who has worked nursing ED patients took a look at the recipe and said it is so extremely high in fibre that it will be going straight through him like a laxative. He eats this several times a day.
Food groups he is avoiding - apart from no bread or pasta, he is cutting every scrap of fat off meat, using no lactose milk, eating only Parmesan cheese in small quantities to get through salad greens, and judging food intake anyone is eating within his vicinity. He tried to demand a restaurant char-grill fish with no oil. He told the maitre-de he would have to work his butt off in the gym for half an hour to burn the little spray of oil they wanted to use. The table of people next to us were staring with their mouths open. He is very thin. He would accept a small drizzle of oil on his salad with no fuss (??)
i beleive his heart rate and blood pressure are at the low end of the normal range. He has had dizzy spells. I don't know if these are resulting from drops in blood pressure.
He is not spitting out meals. His meals are prescriptive - exactly this food, in this portion size, at this time of day. He needs 24 hours or so warning to swap meals around on his regimen if we are going to go out for lunch or dinner, and even then, we can only go somewhere that has the right sort of fish on the right day, or the right cut of meat, or the right salad, etc.
Around these healthy-food meals he is chewing and spitting excessively on junk food and cakes - up to seven times a day, as far as I can work out. It may be more when he is away. It's a large volume of food in each episode. This is the BED behaviour, only he is not ingesting the food so he is not gaining weight from it. I am not sure the amount of food he is ingesting is enough for the amount of exercise he is doing, so if there is some "weight gain" from CS, his body is likely to be craving the energy anyway.
He is very skinny with pumped up wirey muscles in places - upper arms, calf muscles, chest. He is jogging many km a day (not sure if I should be listing how many here) seven days a week, lifting excessively heavy weights that turn his face purple in a home gym he has bought half a dozen new machines for - so you can hardly move in the room for an hour or more a day seven days a week, and before the doctor confrontation, he was also swimming laps for an hour a day, seven days a week. In the first couple of years he was working out up to seven or eight hours a day.
He is resistant to any suggestion of a Nutritionist, Dietician, Personal Trainer, etc who might take too close a look at what he is doing and interfere with his control.
A lot of the emotional abuse issues we were encountering with him were centred in trying to control his environment, and us within it. They were also in defence of his ED, making life so difficult for us that we would leave him alone, and all the emotional chaos served to conceal his behaviour patterns. Going to the doctor with him was a double edged sword. He was furious that I had exposed him and has shut off emotionally from me, but in doing so it also reduced the abuse. He also realised that he could lie to the doctor, and either the doctor would believe him, or at least be uncertain about whether to believe me. This has provided him with a sense of immunity, which also reduced the abuse, but also appeared, in his mind at least, to be the doctor sanctioning his ED behaviour. Catch 22 !!
Sorry, long answer again. So much to tell. It's an all-day every day in-your-face thing.
29-03-2016 12:57 PM
You think and write so clearly @Faith-and-Hope.
Some people avoid certain foods or adopt certain eating plans like Paleo or Vegan etc and this is ok,provided that it doesnt affect the persons health or relationships or that they become"evangelical" about it..
For example,i also don't eat bread,pasta and dont eat grains(cereals) but i weight 60kg and still get all nutrients.Coming from a European background its also not so common to eat cereal for breakfast.
Avoiding certain foods/ some greater thought may now need to go into where to to eat when dining out etc.To use an analogy,some people with Celiacs disease (and their families) for example have to become somewhat prescriptive and choose certain restaurants and avoid others.
It seems your husband though has become very rigid and obsessive about it,beyond reasonable caution and compromise.
What do you think is the "rootcause" of his ED/issues with food and what made him become overweight in the first place?
Eg: do you think hes an emotional eater that uses food for comfort?
Or do you think its a control issue where he needs to control food to feel in control?
Or is it a body image issue?
If you tell him you(his wife) or other women dont find excessively thin men to be attractive how does he respond?
Does he buy into a cultural notion of an ideal male body or does he feel worth more or loved more if his body is thin as opposed to bigger or is this not the issue with him?
Does he play any sport for the fun of it instead of for the goal of staying thin?
You mentioned he feels the cold more than others and other symptoms-has he been checked for Hypothyroidism?
29-03-2016 02:47 PM
Thank you for your compliment about my writing.
I appreciate what you are saying in terms of different tastes and eating styles. I have taken all of this into account, as there is no "one size fits all" when it comes to eating, exercise, and lifestyle in general.
I don't want my husband to be ill, so I went through all the self-talk, trying to convince myself that I wasn't seeing what I was seeing, or sensing what I was sensing. This is absolutely affecting my husband's health and relationships. It was really when the chew-spit emerged that this identified it quite clearly as some sort of eating disorder. Everything else might have been excusable as a passion for exercise, or the need for strict eating patterns for fear of regaining weight when he has struggled so long with obesity prior to this.. My husband is of European decent, and the body type of his culture is beautifully slender in its ideal form. Probably most cultures are. When he passed from slim to worryingly thin it began to stand out even to people of his own cultural heritage. I have been asked outright whether he is ill, based on his appearance alone.
I want to reiterate that we don't have a professional diagnosis yet. It may be Bulimia, as the pattern of extreme self-denial, followed by extreme indulgence coupled with an extreme form of avoiding the consequences of ingesting it (chew-spit, obsessive exercise, and possibly laxative-type foods), is all there. For both Bulimia and EDNOS, a person's BMI can be within the normal range. It's the fact that Orthorexia is also present, and chew-spit is listed clearly under EDNOS that makes me think he falls into this atypical category. He also seems to alternate between his symptoms, sometimes reducing the chew-spit in favour of eating more of the porridge, or reducing his intake of what he does ingest when he has been too injured or exhausted to work out, that fits the "shape-shifting" nature of EDNOS.
When I first started to reach out for help, support services both online and over the phone strongly advised me to learn as much as I could about eating disorders so I would understand the nature of what we are dealing with. This does not make me an expert. It has helped us (the kids and I) to recognise when we are trapped in a useless argument, being manipulated, exposed to emotional abuse and why, and how to defuse, exit, create boundaries or shut down destructive dynamics as they arise. We have to try to isolate the most harmful aspects of this to be able to keep living in the, presence of it, and probably most importantly, be able to recognise what is the ED, and what is still the husband and father we love.
Possible causes are:
A family of origin emotionally damaged by war trauma - WW1 and WW2 and civil war that followed, experienced as children by his parents, as well as from their parents.
A family of origin that doesn't identify well with, or express emotions easily **
A family of origin that idolises thinness **
A family of origin that reward achievements with rich foods like chocolate and cream cakes in huge quantities **
A family of origin that comfort eats with high salt and sugar foods like chips and soft drinks in huge quantities **
A dysfunctional relationship between the family of origin parents, resulting in strong emotional dependence of the mother on her male children even while they are children **
My husband, while not the eldest, became the surrogate father to his siblings in many ways, and an emotional surrogate "husband" to his mother - too heavy an adult responsibility borne by a child **
A divorce of the family of origin parents in later life, leaving the mother living alone.
A personal expectation to meet the family of origin lifestyle ideals resulted in 30 years of workaholism, which also brought a "rags to riches" end result. Workaholism is now recognised as ocd **
We married quite young, and had several children, whom I raised as if I were a single mother to a large extent, as my husband was so physically absent with work, but we operated as a team from the same value system regardless. Our kids seem pretty stable, given the circumstances. I think we have done a decent job as parents. Not having an able role model in his father has meant learning on the job about managing emotions and raising kids without being over-controlling with them, which meant not following his mother's advice either. There may be some guilt feelings buried there.
Our children have grown up and started to marry out. He may be struggling to cope emotionally with this - "Empty Nest Syndrome".
Our family business sold several years ago, and that was the point where my husband turned his attention to sorting out his obesity. His workaholism seems to have been redirected into this channel as he is applying the same hours and energy to his regimen. My first thought was that it was a mid-life crisis, which an ED at this age and stage in life might well be.
Two of his brothers are, or have been, seriously ill. This is affecting him emotionally, and also highlights our mortality. It is likely he is struggling to process his emotional response. Displays of emotion are considered a weakness in his family of origin **
(** these are recognised as potential causes of EDs - refer to professionals or professional literature for advice)
So yes, an emotional eater using food for comfort, a control issue where he needs to control food to feel in control, and a body image issue are all a part of this complicated picture.
If I tell him that I, or other women, don't find excessively thin men to be attractive, he tells me that he is not excessively thin - even the doctor has said that as his BMI is within the normal range and I just have to get used to how thin he is and having bones sticking out where you don't expect them to be. (Apparently BMI used to be considered the marker for EDs prior to more extensive research.) If that was all it was, perhaps I could just get used to it, but the ED is so much more than what he looks like. Women within his family of origin, and others who idolise thinness have told him he looks great, which doesn't help. So buying into a cultural notion of an ideal male body and feeling worth more or loved more if his body is thin as opposed to bigger is also definitely part of the issue.
No, he doesn't play any sport for fun. It's all about the ED. He continues exercising when seriously injured and in inclement weather, and in favour of socialising even with us as his family. All activities other than dieting and exercising have to be fitted into or around his diet and exercise regimen, which is laid out and logged on a spreadsheet. He is stressed to the max if this is interfered with, unless he has had prior warning and can adjust and compensate, which highlights his need for control.
You asked about Hypothyroidism. Firstly I don't believe he has told the doctor that he is feeling the cold, or revealed all his injuries. He recently had a week-long bout of what he thought was gastro while he was interstate - he sought out a doctor after the fourth day - and might not tell the family doctor that back here. This was followed by a cold so bad that he had to stop exercising and stay in bed. He is not over that yet, but is back up and into his regimen regardless, and in the rain !! I don't know what tests he has had, but nothing is showing on standard blood tests. If there are health issues developing under the medical radar, they probably require specialised testing, but I can only see that happening if the doctor becomes convinced they ought to be undertaken. I am unlikely to be told either way, unless something dire emerges. My concerns have been represented as sour grapes about his successful and impressive weight loss, so effectively I have been locked out of the information loop, for now.
It's all so complicated. I really think he needs professional intervention, but I can't make it happen.
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