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When abuse includes forced starvation and malnutrition
- Nov 29, 2017
One of the great things about being an adult versus a kid is we get to make our own choices. We can wear what we want, go where we want and—possibly most exciting—eat what we want. Don’t like cooked spinach? Great! Don’t eat it! Want a cupcake for lunch? Fantastic—you’re allowed to make that call!
Except … when you’re not. For some victims of domestic violence, their abusers have decided to use food as a way to assert power and control. An abusive partner might limit what their partner eats or shame them for their food choices. Over time, says Rachel A. Annunziato, Ph.D., assistant professor of clinical psychology at Fordham University in New York City, this abusive tactic often escalates into even more controlling measures. Victims have been known to become so malnourished, they can’t even get out of bed. Sometimes, these victims even include children, says Annunziato.
That was the case for survivor Stephanie.* Her partner began abusing her before her daughter was born, though he escalated the abuse during and after her pregnancy.
“I began noticing unsettling comments my abuser would use toward me when we were in the grocery store,” Stephanie recalls. “It could be me making a statement like, ‘I should get a pack of gum,’ or ‘That looks really good.’ He would say, ‘You don’t need that.’ At the time, I didn’t know what was going on. I was baffled. I didn’t notice the buildup until later.”
As his abuse escalated, his budget for groceries was very strict, and he would become angry if they spent more than he allowed. He bought the same foods again and again, filling the pantry with little more than canned tomatoes and beans. Stephanie searched for recipes that would work with the ingredients he approved, but he insisted she couldn’t be trusted with any responsibility.
Stephanie started suffering from malnutrition at the same time her abuser took over all of the grocery shopping. What he brought home, she says, wasn’t enough to feed them, their daughter and their dog. He could, however, afford “daddy’s food,” Stephanie remembers. He bought things like pizza and cookies for himself and would eat them in front of Stephanie and her daughter.
A Range of Abuse
Food control wasn’t the only abuse Stephanie faced. She had been raised with abuse in her childhood home, and her abuser convinced her to break contact with her family. “I saw his gestures as protective—he was going to take care of me,” she says, when what he was actually trying to do was isolate her.
He also pressured Stephanie to leave her job. She was trained as an EMT and he convinced her that taking shifts at odd hours would be destructive to their marriage. He took full control of the family’s finances.
As his abuse escalated he withheld affection and turned cruel if she showed signs of weakness. He became violent toward their dog. Then, he began physically abusing and raping Stephanie.
“He presented himself as my protector and provider, and he became my torturer. I thought I could make him a goodhearted person and he used that trust to abuse me more. His caretaking turned into extreme cruelty,” she says.
Yet, Stephanie's abuser would sometimes give her what she wanted, confusing Stephanie even more. “One week he’s not giving me any food, then the next he’s giving me nutritional shakes. There was a lot of cognitive dissonance. He told me he was going to take care of me, and I was still holding onto that narrative. When he went back to abusing me I was so confused. I thought maybe I wasn’t understanding correctly, or maybe it was my fault and I was giving him a reason to treat me this way,” Stephanie says.
“A pattern of coercion and punishment can be something that evolves over time. It gets worse and worse,” Annunziato points out.
When Abusers Shield Victims from Medical Care
After a couple of years, Stephanie was experiencing signs of malnutrition: rashes, bruises, and hair loss. “I went from 125 to 93 pounds. I stopped being able to digest food. I had to wear layers of pants because the smallest size did not fit me. My body was just a weeping sore,” she says. “He said since I couldn’t digest food anyway, why was I complaining? I was so sickly, I didn’t really question it.” Her abuser kept her from seeking out mainstream healthcare and had her change her doctors with the intention of hiding the pattern of abuse behind her symptoms.
“When an abuser cuts off things that a woman and child need to survive, things get worse and worse,” Annunziato says. Stephanie's body eventually gave out. She needed to be on strict bed rest to recover. “I was cut off from independence. It was incredibly frightening to be in such a critical health state,” she says. “I was trying to follow doctor’s orders. I had to have sufficient food and sleep and no stress or I wasn’t going to recover.”
Stephanie's abuser completely ignored the doctor’s orders. He began to bring home Lean Cuisines—frozen, low-calorie meals—for her to live off. “He wanted to keep me as weak as possible. He said because of all the medical bills and the stress of dealing with a sick person this is what I got,” she says.
The abuse continued as Stephanie got sicker. She tried to put together meals from canned tomatoes and beans but she could no longer manage. By the time her daughter was 7 years old, she weighed only 34 pounds. “Nobody told me this was serious. We were in an isolated rural town and he tried to keep us from mainstream care. He told me she was normal, and I didn’t know any other narrative. I knew she was in trouble but I didn’t know to what extent,” she says.
‘The Secret Was Finally Out’
Stephanie was able to escape one day when her body finally gave out. In February 2016, she fell and couldn’t get back up, so her daughter called 911. The EMT asked if there was something going on and she admitted she was trying to get away from her abuser. “I was bawling all the way to the hospital. The secret was finally out,” she says.
Her abuser showed up at the hospital, acting concerned for her. Stephanie had told the nurses she didn’t want to see him but he barged in. Her heart rate skyrocketed and she needed oxygen.
When she was released, the doctors cautioned Stephanie not to return home, so she and her daughter moved in with her mother. Her abuser insisted that Stephanie return home. “He would literally not leave me alone in the beginning,” she says. He cut off her access to the gas card and the bank card. With help from a shelter, she got a restraining order and her abuser was granted supervised visits with her daughter. But a later court decision awarded him joint custody, and to avoid leaving her daughter alone with her abuser, Stephanie and her daughter went into hiding for several months. Fearful of losing her case, she came out of hiding and allowed her daughter to have contact with her abuser.
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Her daughter is now awaiting surgery to place a tube in her stomach to help cure her serious medical conditions. Today, at 10 years old, she has bones the size of a 6-year-old. They are rebuilding their lives together but still awaiting trial in November to work out custody details. “I’m taking steps in my new life,” Stephanie says. “I’m focused on making new memories. Healing is not something I want to wait for, regardless of what the courts do.”
Annunziato acknowledges that women dealing with food control by their abusers can struggle to find a way out. Weakness and illness can compound the challenges of leaving. She encourages women in this situation to talk to their own physician or their child’s pediatrician.
“A lot of people in healthcare are prepared for these scenarios. They know how to help you safely navigate these situations. The healthcare system can be a good place to go,” she says. Victims should also consider reaching out to a trained domestic violence advocate near them who can help them develop a safety plan, secure an order of protection and find emergency shelter if needed.
*Her name has been changed to protect her privacy.
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