I’ve been bulimic for about 3 years now. there have been periods where I’ve stopped a few weeks at a time, and either way, I’ve always remained a normal weight. I’m 5’4” 136 lbs, but terrified of gaining weight. All my life people have called me perfect and i think subconsciously, I’m trying to prove that I’m not in a secret way. I went to therapy for 6 weeks to deal with the bulimia as well as a cocaine addiction a few months ago, and it helped tremendously, but I can’t completely stop the binging and purging. Also, I’m studying Nutrition for various reasons, and know all the consequences of having an eating disorder but block them out. why? why do I do this to myself? i have a boyfriend who loves me and I’m ashamed to talk about my problem. I want to stop and be a normal healthy person. I know I need to exercise more and stop binging, but i feel like I’ve lost control. One thing my therapist told me was that I have control issues.. What is your advice? I’m desperate.

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The ‘control’ and ‘perfection’ issues you describe are pretty classic for people who deal with eating disorders. It is part and parcel of the whole psychological dynamic that drives people to binge and purge or starve themselves to have unrealistically high standards for their own eating behavior, to have bought into an unrealistically high and unattainable standard of beauty, to have a distorted body image (view of self as fat when in reality this is not the case), and to attempt to cope with the tensions that this food fixation and beauty fixation stuff generates through restriction of eating or through binge eating, and then to deal with the ‘failure’ associated with having binged by self-punishing with a purge and self-recrimination – all of which generates fresh motivation to be perfect and never let eating get out of control again (which perpetuates the cycle). You know this, I’ll bet. But keep in mind that knowing something intellectually is not the same as grasping it emotionally, and that even when you have grasped something emotionally once, that doesn’t mean that this emotional knowledge will always be available to you at all times in the future. People backslide for a variety of reasons, some of which are not particularly under their control. The solution is to have ongoing support from a community of people with whom you can honestly share what is happening for you, and who can positively guide you towards a more healthy ways of managing your relationship with food, sobriety from substances like cocaine, and your inner emotional turmoil. I think it would be a good idea for you to consider going back to therapy – perhaps on an ongoing basis. Make sure that you feel comfortable with the therapist and that he or she has experience with eating disorders and addictions, and is problem-solving oriented rather than merely caring and kind. I’m a biased source, but I recommend cognitive behaviorally oriented psychotherapists when you can find them, as they will have scientifically validated ‘tools’ to offer you which can help you better manage your eating disorder. I also think it would be a good idea if you sought out an eating disorders support group, either to attend in person (a good eating disorders therapist will know if there are any in your area), or an online one such as is available at http://www.somethingfishy.org/. Good luck!

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