Expert: Ginger M. - 11/17/2008

Question
I have a rather extensive history with disordered eating patterns. From the age of 6 until I was about 12, I was a compulsive overeater. When I was 12, I started dieting and that got stricter and stricter until I was 16, when I was eating 6 oz of nonfat yogurt at lunch and a salad at dinner. My mother started paying attention and got me some help, but when I started gaining weight, I started purging.

In college I was diagnosed ED-NOS, since I didn't binge/purge more than once a week. The past few years I've gone 4-6 months eating normally, then I'll have a day or a week when I binge and purge. I just thought this was as recovered as I would get.

Three months ago, I started taking anti-depressants, and my doctor suggested I lose some of the weight I put on during my depression. I was fine the first two months, and lost ten pounds in a healthy fashion, but the last month I've been binging and purging on average once a week. I've also become much more aware of my own low self-esteem.

It seems like whenever I try to eat healthy and lose some of my excess weight (and I am overweight), I start the binge/purge cycle again.

Does this warrant seeking out a therapist? Or should I just speak with my medical doctor about increasing my dosage of anti-depressants? Since this has been a pretty normal cycle for me, I'm having a hard time getting a clear grasp on it.

Answer
Hi Lauren,
Yes, I think you should definitely seek a therapist. Did you see one before when you were dealing with the ED/NOS? The binge/purge cycle (and restricting behaviour) is really, really hard to break. I was in your situation once, and that's how the anorexia resurfaced- I weighed 178 pounds and wanted to lose some weight before my wedding. I had every intention of doing it in a healthy way, because I didn't want to get to where I was before, and I lost the first 10 pounds by eating healthy and exercising. Then the weight loss got addicting, and the ED came back. I ended up at 100 pounds (I'm 5'8") and very, very sick. Seeing a therapist or counsellor now will have a lot of benefit for you, I think- you can get a hold of your bingeing and purging, and you can deal with other issues, too. Do you still feel depressed? Once your feelings of depression and low self-esteem are dealt with and you're feeling better, it's possible that you'll naturally lost some of the weight you gained, anyway.

Does your medical doctor know about the ED? Some anti-depressants are actually prescribed for bulimia- maybe this is something you can talk to her/him about. You doctor can also point you in the direction of a therapist or counsellor who could help you. You are really smart and very strong for recognizing your disordered eating patterns again now and wanting to get a handle on it!

I'm here if you need me.

Ginger