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Am I A Bulimic Or Not?

Question:

I’m nineteen years old and have once been on diet about 2 years ago. I took a very mild way of doing it, having three meals a day of normal quantities and exercising very frequently. Though at the time I successfully lost 6 kilos without experiencing hunger, since then I had developed a terrible crave for food. I couldn’t stop gobbling even on the verge of throwing up. It is always with rigid self-control that I don’t take in excessive amount of food, though from time to time I loose control completely, consume enormous amount of food and feel the overwhelming guilt afterward. And I often turn to food while I’m depressed. Once or twice I attempted to vomit but failed. And within a year I gave up the diet I gained 7 kilos. I looked up the symptoms of a bulimic and found I had nearly all of them except that I never take stuffs like enemas and couldn’t vomit. Does that make me a bulimic? Worse still, people around are always scoffing at my attempt to eat less. How do I stop that crave for food without having to go to therapy?

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Answer:

As you have a few questions here, we’ll deal with each in turn.

First of all, you are likely to be in the ballpark of what has been called “binge eating disorder”, rather than bulimia (although Bulimia is a very good guess!). Binge eating disorder is not formally recognized in the latest DSM, but I suspect it will be included in the next revision. Binge eating disorder is similar to Bulimia in that both conditions involve binge eating, which occurs when people quickly consume mass quantities of “forbidden” foods (e.g., that they have been trying to avoid but nevertheless crave). Binging activity usually occurs in cycles along with food restrictions. What happens is that people try to restrict their food intake rather tightly in the manner of a dam holding back a river. The food restriction regime works for a time, but ultimately gives way during moments of stress. What occurs next is a binge; a comparative orgy of food consumption, usually concentrating on sweet, starchy or fatty foods (e.g., fattening food that taste really good). Following a binge, people tend to feel very guilty or ashamed of what has occurred and they vow to do better next time. Typically, another round of food restriction occurs followed by another binge and so on in a repetitive cycle of dysfunctional eating. Binge eaters can be separated from bulimic eaters by purge activity that bulimics undertake in the wake of a binge to try to get rid of the calories they have just consumed. The prototypical purge activity is induced vomiting, but creative bulimics may also take laxatives or exercise like crazy in an attempt to shed the calories.

As is hopefully clear, just because binge eating disorder is not yet formally recognized doesn’t mean it is not a serious condition. It is indeed an eating disorder, and can have serious medical and emotional consequences for an affected person, among them rather substantial weight gain. This much you know.

Short of addicting yourself to stimulant drugs (which I most emphatically DO NOT RECOMMEND), I’m not aware of any easy way for you to curb your hunger. The safest approach tends to be behavioral in nature. Weight Watchers and similar weight loss programs typically advise people to eat multiple small meals throughout the day so as to avoid any build up of hunger feelings. You might try that approach safely enough, but there again, it only works when you are disciplined about how much you are eating at any given moment. If you eat too little, you will be hungry and more vulnerable to binges; if you eat too much you will gain weight.

Eating disorders are often about people who feel out of control trying very valiantly to regain control. And, indeed, your second question has to do with how you might better control your hunger “without having to go to to therapy”. A flag goes up when I hear you phrase the question like that, because it strikes me that you are trying to go it alone. You may be carrying around an unspoken assumption that if you need help to deal with this issue, that you will have failed. But it is not failure to ask for and accept help when that help will be in the greater service of your life. In fact, to my way of seeing things, not asking for help when you are really stuck is a failure of personal flexibility and creativity.

A serious problem that many eating disordered people tend to have is that their beliefs and judgments about what is a reasonable weight to be at, and how much is a reasonable meal to eat tend to be off. If this is the case for you (and neither I nor you are in the proper position to judge this), you will be handicapped in your self-help efforts. It might perhaps really benefit you to be able to interact with a therapist who could help you do some reality testing, and with a weight loss and/or exercise coach who could help you plan out a diet and exercise plan that you’ll be able to stick with more easily than what you were doing before. You appear to be stuck in a shame and depression-driven cycle of binge eating; you would benefit from learning ways to manage your moods that do not involve binging, and a therapist is the best sort of professional teacher from which to learn this material.

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Comments
  • Anonymous-1

    "In fact, to my way of seeing things, not asking for help when you are really stuck is a failure of personal flexibility and creativity."--This strikes me as rather harsh. It probably came out so more than intended, but as somebody who is having a very difficult time acknowledging my eating disorder and telling friends or even a therapist about it, I cannot see it as a 'failure'. This is underestimating how emotionally difficult it can be to overcome an eating disorder. Perhaps the doctor would choose his words more wisely next time.

  • Anonymous-2

    I had a stomach problem after an accident and it got fixed after a year but before it was fixed, I was unable to eat. I lived with it so long that I mentally cannot eat anymore. i can't mentally get passed it because i lost a lot of weight an now I am afraid to gain weight. Im happy with how I look but its unhealthy, i am always told that i need to eat more but when I do, I want to throw it up. What should I do?!!

  • kelly

    im really paroined about my weight, and shape. i eat but not much, but then theres days where i could eat for england and eat load's. after i vomit, and if i dont i make my slf sick beacuse i feel sick. after i eat alot, i also make myself do loads of exericse. i also feel faint quite alot, and feel dizzy am i or not ?

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