Understanding Bulimia Nervosa

Understanding Bulimia Nervosa

The eating disorder termed bulimia is at least two or three times more prevalent than anorexia nervosa. In fact, recent surveys report that about 1 percent of the general population and 4 percent of women aged 18–30 suffer from this troublesome disease. People with bulimia have repeated episodes of binge eating—rapidly consuming large quantities of food and then ridding their bodies of the excess calories by vomiting, abusing laxatives or diuretics, and/or exercising obsessively. In most cases, this binge/purge syndrome is an outlet for anxiety, frustration, depression, loneliness, boredom, or sadness. Because most bulimics are typically normal weight, they can keep this a secret and go undetected for years. Although some researchers think the problem is getting worse, others believe that people are just more willing to seek help, and therefore, it's noticed and treated more often. Here are some of the warning signs of bulimia:

• Dissatisfaction with body shape and constant preoccupation with becoming thin.
• Recurrent mood swings and depression.
• Frequent episodes of rapidly consuming large amounts of food (binge eating), followed by attempts to purge (get rid of food) through self-induced vomiting, use of laxatives or diuretics, prolonged exercise, or by following severe low-calorie diets between binges.
• Serious physical complications from chronic vomiting, including the erosion of dental enamel from acidic vomit, scars on the hands from sticking fingers down the throat, swollen glands, sore throat, irritation of the esophagus, and poor digestion (heartburn, gas, diarrhea, constipation, bloating). The more serious physical dangers include severe dehydration, loss of potassium (because potassium controls the heartbeat), and rupture of the esophagus.
• Awareness that their eating pattern is abnormal.
• Fear of not being able to control eating voluntarily.
• Light-headedness and dizziness or fainting.
• Frequent weight fluctuations of 10 pounds in either direction from the constant bingeing and purging.

“My Vicious Cycle of Starving-Stuffing”

It all started when I was preparing to go off to college. My anxiety stemmed from separating from my family and manifested itself in a body-image and eating problem. Up until this time, I was a “normal” eater, eating when I was hungry, stopping when I was full, and occasionally overeating during special occasions. I ate chocolate bars, pizza, and movie popcorn without as much as a blink. What was it like then?

Suddenly, it was as if my body wasn't mine anymore. It became this “thing” separate from myself. I became hyper-aware and mentally obsessed with how to control my shape through obsessive exercise and restrictive eating patterns. Skipping two meals in a row and exercising two hours a day became normal to me. I used to stand in front of my dorm room mirror naked, poking and scrutinizing myself out loud. My self-esteem was so low that I actually needed someone to validate all of my insecurities. My overweight roommate would look on in disgust, reassuring me that I wasn't fat. A lot of people in my life got tired of reassuring me of this.

I did not allow myself to enjoy “forbidden foods” for a long time through college. I felt proud of this control but ironically continued with my dissatisfaction over my “chunky body” (which has always been very thin, so I'm told). But after a while of rigid restriction, my body rebelled and my disordered eating took on a new twist: a few days of restricting (sometimes as low as 500 calories a day) and then bam—I would “sabotage” all of my efforts by stuffing myself until I was uncomfortably full! Feeling disgusted, depressed, and ENORMOUS, I would get rid of the calories by making myself vomit, and then struggle back to my extremely low-cal, restrictive diet, and the vicious cycle continued. My weight could fluctuate 10 pounds depending upon the day of the week, but to the outside world, I still remained a “normal” little person.

I also developed strange idiosyncrasies. Certain colors had to be eaten together, and certain foods had to “match” each other, for no particular reason except that they made sense to me. I would also weigh myself up to 25 times each day. There was no room for error, spontaneity, or change.

Finally, coming to terms with the fact that this obsession with food and exercise was ruining my life, I started to see a psychotherapist. For the first time, I realized that my “food thing” was only a symptom of unlimited emotions that I had bottled up inside. I needed to work hard to break free from my extremist attitudes and my belief that being less than perfect was not worth being. (What is “perfect” anyway?)

Today, I allow myself to feel entitled to my words and actions and realize that a middle ground is healthier in relation to feeling, thinking, and eating. I've also worked with a nutritionist for the past year. She has taught me that restricting inevitably leads to bingeing, and I'm desperately trying to do away with black/white days (restricting or bingeing) and instead focusing on the “gray.”

I no longer let one M&M dictate my self-esteem, and I have learned that normal eating is flexible and always changing. It's okay to eat a big piece of cake on my birthday, chocolate when I have PMS, and movie popcorn once in a while. “Normal eating” means eating healthy most of the time, while allowing yourself to indulge when you feel like it. It's feeding yourself when you're hungry and sometimes when you're not—even just for the fun of it! It's feeding your mind as well as your body and realizing that weight fluctuations are normal. It is seeing life as more than what you put in your mouth and enjoying social situations for the conversation and laughter. It is learning to accept our bodies, our strengths, and our limitations as well. I admit, every day is a struggle right now, but at least I finally believe that I am worth it.

—A 27-year-old recovering bulimic