Expert: Saffron - 6/19/2009

Question
Hello, I’m 20 years old and I've struggled with disordered eating for the last 4 years in varying degrees. It started out as the textbook anorexia case, beginning with a diet and bit by bit channeling all of my problems into food and trying to rectify them by that extra pound lost. It seems like such a long time ago now and I really can’t remember how but it stemmed into bulimia where initially I would try to fast for 3-5 days and then inevitably binge all weekend. That is when I discovered purging which went on for a good few years, managing to maintain and healthy weight but with extremely unhealthy habits. Then last summer the anorexia returned and I would fast and exercise with any food that was consumed would be purged. I dropped 3 ½ stone in 4 months and was admitted to a unit as an emergency admission with cardiac problems and kidney failure at a bmi of 13.9.    I did really well in hospital, normalizing my eating, I never once purged and I got to a bmi of 14.7 when I was discharged and although I found it incredibly tough I managed to gain weight slowly and not purge at all. However a few months into my outpatient recovery my appetite returned in a big way and I felt so totally out of control and was compelled to eat and not stop. Although initially I managed to stay strong there were inevitable times where I would binge in an almost unconscious state and then purge. Now I am at a much healthier bmi of 17 and feeling a whole lot less out of control with food but I have still carried on what I can only describe as a habit of purging because I am not overwhelmed to overeat anymore and nor am I doing it to silence painful emotions, it is purely a sort of love of food and the only way that I can enjoy it. I don’t know what the best way is to stop this behavior? I eat a really normal diet now and so it is not through restricting either. I have read a lot about self-help for bulimia but none of it is at all helpful as it focuses on the emotions behind the binge when I know that this is not an emotional problem but obviously a physical effect of the starvation I put my body through.   I am so desperate to stop this but I most definitely can’t talk to my parents about it as my Mum just can’t handle the idea of purging. I also can’t really talk to my recovery team about the severity of the purging as it is in their hands whether or not they allow me to return to uni and if I don’t go in the next few months I lose my place there which I know would destroy me and I am entirely sure the anorexia would surface again. I am very worried that I will never be rid of this behavior and do not want this to go on any longer but am at a loss as to what to do? It happens roughly 2-3 times a week and I don’t know whether the best way is to try and reduce it gradually or go cold turkey. Please help me; I’m so ready for this behavior to stop.   Thank-you so much.   xxx

Answer
Hi Emily:

So sorry about the delay in replying.  It is very normal for many anorexics to turn into bulimics.  It takes the most unbelievable amount of will power to keep starving yourself.  Truly superhuman.  The binge purge cycle is incredibly difficult to break.  I am surprised you still feel the urge to purge even though you say you are not overeating.  Are you eating the wrong kinds of foods?  I think it takes a while no matter what when you've been purging to get used to the idea -even on a subconscious level - that you can eat and retail the food and everything is going or be alright!  I think if you weren't ready to get better you wouldn't be writing this note and you wouldn't be saying the things you are saying.  Most eating disordered people who are still consumed by the disease can't speak as honestly and openly as you. Please tell me more specifically how you are eating.  Your body is still underweight and so you will still have a stronger urge to eat then someone who is not underweight and malnourished so bear that in mind.

Look forward to hearing more and take care,

Saffron