Expert: Joanna Lhulier, Psy.D. - 8/8/2008

Question
I am 18 and have been bulimic for two and a half years. It started when I
transferred high schools--even though I transferred from a strenuous school
to a more laid back and easy school, I somehow developed bulimia.
A perfectionist, I have been a part of varsity cross country, varsity soccer,
varsity track and have been presidents of numerous clubs, the editor-in-chief
of the school paper, honored in Sacramento by Gov. Schwarzenegger for
academics, Girl of the Year of my school, etc. Yet, nothing ever seems to be
enough. My mom is always pushing me for more, more, more. Very skinny
herself, she often used to tell me, "Kylie, you're getting fat...like your
sister...what happened? My friends and I always thought you were going to
be so skinny..." And she doesn't let me go out with my friends as often as I
want AT ALL despite my honors and achievements. It gets so bad that I sneak
out at night just to see my boyfriend, whom I have been dating for more than
three years--secretly for two and a half years, as she forbade me to see him
since she "didn't like" him.
At one point, my mom knew about my bulimia, since my sister caught on and
told her. But this was very, very early on, and my mom kind of swiped the
concept of mental illness aside and told me not to be so "stupid." My dad, an
alcoholic himself, told me that if he ever caught me doing it again, he would
"send [me] away." They never discovered that I continued to throw up. It has
been years now, and despite efforts to stop, I can not stop completely. Even if
I last six days without the cycle, by eating fruits and vegetables, frozen
yogurt--basically anything but breads or meat--I revert back to my
disgusting habit. Once I start eating something, like bread or meat, I can't
seem to stop. After one bite, I feel like hope is lost, and that I might as well
eat and purge because I have already taken a bite.
I have so much to live for. I don't want to be like this ANY MORE. I want to
marry this man that I love, have kids, and live a long, healthy, and fit life with
him. I am moving to the other side of the country next year to attend an Ivy
League university, and I am so scared that my condition will worsen--though
I vow to get treatment from their eating disorder program and hope to attend
individual and group therapy, also.
I have this vision of myself in less than a year, with an irregular heartbeat,
chronic stomach aches, and nothing to live for except this cycle. It is so
depressing.
And then I see the life I could have, a life with my naturally skinny body (I
have always been fairly skinny! Another reason why I can't believe I am doing
this!), a life with a loving, silly, worthwhile man, and with a few healthy,
happy, giggling kids--certainly a successful job to boot. I have so much to
live for.
And yet...
I am bulimic.
Today I went on a walk with my family. On the way back home, I jumped on
my Dad's back and after a few seconds, he let go. Granted, he was drunk, but
his words truly affected me: "Ugh! Too heavy. Ugh! How come you are so
much heavier than your mom?" he said. I was so angry and frustrated and
upset and I walked all the way home singularly, in a diva-esque tantrum
state.
I want to know what is triggering my behavior. It can't be that I eat for
comfort, at least I don't think so because when I am really sad I can't
stomach food. Please help, I am so so desperate.
It may sound like I know what I am talking about in this elaborate explanation
of my illness without any definite question, but truly, I am so lost and fearful
of failure by succumbing to my weakness for bulimia. Please help me by
telling me how I can get over this illness. Please.

Thank you so much for your time, truly <3

Answer
Wow.  I am glad that that you wrote the part at the end about being scared and feeling like you may succumb, because I was beginning to think that you did have it all figured out.  This, meaning your intelligence, must be something you use to keep people from seeing the real you.  

Well, I am afraid you know what I am going to say, which is that you need structured, professional help to get you out of this cycle.  You know that you have a lot to live for and that is true, but it does not mean much if you do not allow yourself to live it and enjoy it.  

I am glad that you are getting away from home to go to school.  I think being away from the house will help you separate from your family's problems so that you can focus on your problems.  

When you get to school, do not delay.  Go to the counseling center and start making use of the services.  I wish you the best of luck.
Dr. Joanna Lhulier