Perspectives - Vol. 5, No. 3 - Eating Disorders: The Obsessive-Compulsive Link

How do I even begin to describe my experiences with my eating disorders throughout the last fifteen years - over half my lifetime? I say eating disorders because I have, at different periods of my life, resorted to manipulating my use of food in different ways and with different purpose. First, I was anorexic; then, bulimic; then, an anorexic who practiced bulimia. At times, I have exhibited behavior that is more characteristic of a compulsive overeater. The reason why I decided to write this article, in fact, is because I feel like these are distinctions an outsider will not necessarily be able to discern for him- or herself. While I was recently looking over various graduate programs in psychology, for instance, I noticed that, almost invariably, eating disorders were linked with "body image" topics. It seems to me that what is lacking is an understanding that, in addition to self-esteem and self-image concerns, in addition to the trait of perfectionism that is usually associated with anorexia and the control issues associated with bulimia, the misuse of food can also be yet another manifestation of obsessive-compulsive disorder.

At this point, it is important to distinguish between the person who suffers from an eating disorder and a person who has disordered habits. One is a way of thinking; the other a way of behavior. Whenever I hear someone who says, "Oh, I was a bulimic for the first semester of college, or "I was anorexic for a while when I was in high school," I am immediately suspect. In fact, I would wager that most girls at some time during their adolescence have gone on at least one radical diet, and many have tried at least once the trick of sticking the finger down the throat. Many people, celebrities and unknowns alike, admit to excessive dieting or exercising in order to achieve and maintain a certain image. These people, however, not only are aware that their methods are questionable, but they also manage to keep things in perspective. By this, I mean that their behavior is simply a routine that they adhere to, in order to attain a particular, definite end. The person with the eating disorder, however, never achieves an end goal; the process itself takes over her/his life - all mental and physical energy. Furthermore, the process turns into the end itself, because it is often a way of coping (more aptly, not coping) with other issues.

Long before I started dieting with unbelievable rigor, I displayed signs of obsessive-compulsive behavior. What makes obsessive-compulsive behavior problematic is that, in many ways, it is something that our society rewards. Often at the expense of our sanity, we work with a ferocity and speed that others marvel at; and, as one would expect in any competitive and progressive society, we are rewarded according to what we produce. As a young child I would finish schoolbooks months in advance, turn simple book reports into lavish presentations, win awards in academics as well as in sports. Obsessive behavior, frequently seen simply as dedication, is fed by recognition and praise. But there is a fine line between a healthy work ethic and obsession/compulsion.

For me, my first step into the eating- disordered universe was in the form of calorie-counting. I was twelve years old and the slimmest (and fittest) girl in my dance classes. I had no hang-ups about my body whatsoever; yet, I can identify four main factors that made calorie-counting appealing to my personality. First, as my other adolescent friends began to diet, it was a way of chiming in (not exactly peer pressure, since everyone else was always asking me my "secret" to being so thin; nevertheless, a means of feeling like I belonged). Second, I perceived dieting as being something grown-ups did; being a precocious child, I was always emulating adults - including the focus on dieting. Third, my obsessive-compulsive nature was easily manifest in a preoccupation with numbers (I still revert to counting and working through complicated math problems when I have reached my stress threshold). Finally, calorie-counting went right along with my tendency toward extreme ritualistic behavior. My reliance on structure and repetition made the anorexic world a safe, more comfortable place for me. But as with any other relationship, my relationship with my disorder evolved as I grew and my needs changed. I became bulimic.

There are two very separate experiences with bulimia I can relate. First, as an anorexic, I would make myself throw up when I had given in and eaten something. This was by no means the binge/purge cycle most often associated with bulimics by people who have had no immediate experience with eating disorders. Rather, I can remember one night kneeling on the floor and sobbing because I had eaten a half of nectarine. I had to get rid of it. In this case, it was a tool to aid the predominant anorexia frame of mind. Then there is the side of my bulimia that has little to do with the anorexic mind-set. It is wholly different -- what triggers it and what effect it has on me. My "binges" were never out-of-control gorging. The foods I ate and the order in which I ate them were exact, the calculated combining of foods in a way that would make them easier to regurgitate. If the only food available was something I knew would be difficult to throw back up, I would leave it. Or, when there was nothing around, or I did not have the money for an all-out binge (they can get very expensive), I would throw up water by the gallons. For me, it was all about the throwing up. I have called it "my silent scream," a phrase that other bulimics I know have latched onto. When I was feeling complete frustration or anger, this was my way of yelling out to the world in protest. Because I didn't even have to use my fingers, there was no gagging, no choking experience - just a letting it all out. In addition, throwing up produced a rush of sorts, a boost of energy; or, I could count on the exhaustion that would come shortly afterwards to help me during periods of insomnia. For me, throwing up had absolutely nothing to do with losing weight - I didn't need it for that. What it offered me was a sensation of release, and a way to have a "voice" when I felt I had none.

And how does the anorexic/bulimic also share traits of the compulsive overeater? I remember when I was nearing the end of individual sessions with one of my therapists, she suggested I look into Overeaters Anonymous meetings as a source of continued support. This, however, seemed a stretch for me. The only form of compulsive eating I could identify in myself was the habit of consuming foods solely because I associated them with specific people or times of my life. For example, I would eat a certain flavor of ice cream -- even though I personally didn't like it -- because it was the favorite of someone I was, at that moment, missing. But as far as overeaters were concerned, naturally I thought I would have nothing in common with such people. It was only once the therapist told me that they had meetings specially geared towards anorexics and bulimics that I agreed to go. However, within those rooms I discovered that we do, in fact, have a great deal in common. We all use food as a means of expression, and sometimes as a way not to feel; also, unlike addicts of narcotics and alcohol, we all are challenged with using our drug of choice on a daily basis, since there's no giving up food altogether. And no matter how much we starve, vomit, or gorge ourselves, there is always something gnawing away at us, the underlying issue(s).

Eating disorders are a matter of the mind. How my body looks or feels is not necessarily a tell-tale sign about my emotional well-being, because the disease is much more than just the behavior. It is a way of thinking. This is what I would like to tell people when I see them looking at me as if they are trying to assess my present state by my appearance. And, while it is possible to re-train the way we think, there is a lot more to it than just stopping. Even when I'm not practicing my disease, it is there; my obsessive-compulsive thinking and behavior are aspects of myself that I am careful to keep in check, to counter with meditation, positive thinking, and other coping strategies. Truly, not practicing my disease is more work than letting it run its course.

Reference
Discorfano, Sharon (2000). Eating Disorders: The Obsessive-Compulsive Link. [Online]. Perspectives. [2000, July 1].

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