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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 Good luck!

More "Ask Dr. Dombeck" View Columnists

  • Heather

    After recovering from 16 years of bulimia, I feel like there is definitely a mind-body-spirit connection to getting well. One of the areas I've often seen neglected in medical and therapeutic help for bulimia is nutrition. Not just any old nutrition, but nutrition to heal the body. I tried every nutritious eating plan under the sun and finally healed by following The Body Ecology Diet, by Donna Gates. After visiting an Environmental MD, I learned I was low in important B vitamins and not metabolizing fats. I also learned I was sugar sensitive and had candida. All of the medical aspects of these issues seved to keep me in the vicious cycle of bulimia. Controversial or not, it's the only thing that allowed me to fully recover. The Body Ecology Diet is not a diet -- it's a way of eating to repair the inner ecosystem. Since my digestive issues started well before I had bulimia (at least 8 years before), I feel that I had been lucky enough to find a doctor who understood the human body as a system -- instead of a mind, a colon, a stomach or whateve their specialty -- it could have been of great help to me. Now that I am recovered, I am sharing everything that worked for healing my mind, body & spirit in my blog: Recovery is possible -- it takes work, but it's worth it!

  • Eric M.

    I don't know who to talk to about my eating disorder. I have told my girlfriend about it and she told me to tell her when I feel I need to throw up or after I do. I said I would but I throw my food up so much that I didn't want to be a burden on her. I don't want to draw attention to my problem because It's embarrassing. I'm 35 and I've been bulimic for 7 years. I don't have money for insurance or help that i need. I'm not gay,I'm not a teenager, I'm not a girl, I don't work out hardly at all either, but I would like to. I'm 5'8,165 pounds and i do think I should be about 10 pounds lighter. I enjoy food allot. I don't always vomit, but I do feel guilty after eating things I love, or just about anything. Sometimes I will vomit when ever I have the opportunity to. I never stick my finger down my throat, my body just kind of let's me know I can throw it up and I just push it out. My teeth still have all the enamel on them. I love social situations, I don't mind conflict, or expressing my opinion to people. I am very friendly. I don't want to die because of an eating disorder. I am not a perfectionist at everything I do. I will go out and eat some mexican food or whatever and I love every bite. I will walk out of the restaurant and vomit in the parking lot or whenever I feel my body wants to let it out and people are not watching. I feel guilty when I eat to much. I seem to be really gassy too and I'm not trying to make any kind of joke about this, but I think it's from vomiting so much? I don't know what to do and I have tried to stop, but I think I'm gonna be to fat if I do. I don't really like my body, but I think I'm good looking for a 35 year old man compared to allot of people who look 35 when there 25. There is more to tell and this is the first time I have written about this. Sorry if it's not perfect, but I'm just typing what I feel. I have trouble finding facts about other people (men) with bulimia and relating to there stories. I do feel more alone with this everyday. Can anyone help me? Eric M.


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