Expert: Ryan Hale - 5/19/2010

Question
QUESTION: I have been a bulimic for over 30 years,not the type that binges big time. I usually eat well, but if I eat something I think I should not have eaten,or have eaten too much I will purge it.My stomach will hurt if I eat a large meal. I usually eat my meals on a dessert plate. I have been through therapy and all that, and as much as I have tried, I can't seem to beat it. One time I went almost one year without purging, but I could not keep it up. I am 5'21/2 and weigh 123. I am 56 years old. I know it is a control issue, something I have control over in my life. It is like I want the freedom of eating what I want, and not gain weight. I was an anorexic prior to becoming bulimic, I was in my 20's at that time, so this has controlled me for many years. I am beginning to wonder if there is any hope for me. I know I am not helping my body by doing this, I know it is the wrong thing to do, but like an addict, I can't seem to stop it, even though I want to.

ANSWER: Dana-it sounds like you have a pretty good handle on what you are doing and why.  You definatly understand your condition, however, I'd like to challenge you to look at it a different way.  Perhaps you could see it as a continum rather than an "I'm getting better orI'm getting worse" sort of way.  Like addiction, you have been unable to make the choice to discontinue these behaviors, and like addiction, your condition has changed over time.  It sounds pretty typical so you're certainly not alone.  Change and even relapse are part of what you are goping through... just steps along the way.  If it has been awhile since you've been to counseling you may want to go again and do some maintainance.  It is an ongoing condition and often people quit therapy once they start feeling better.  Maybe check back in with your therapist?

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QUESTION: It seems like I know and understand everything the therapist is saying,and I know it is a step by step process that only I can do. I knew when I lasted almost a year that it seemed like I could never conquer it, only be able to manage the compulsion as best that I could. I have this fear that if I did eat reasonably and in moderation I would gain weight and be in that vicious circle again. I can't enjoy life for fearing I will get fat. I was a fat child and was made fun of at school. My mother put me on diets to lose weight. I gained weight when my kids were born, and was diagnosed as an anorexic way before it was a known problem, so these thoughts have haunted me a long time. The way they treated me was to put me in a Psyche ward and monitored every thing I ate,take medications, as well as giving me shock therapy. This was the 70's.  I can still hear that shock cart coming down the halls. Such things I have been through. I just wish I could relax enough to be able to enjoy food. Sometimes I just want to eat what I want and not care about how I look or what I think, but I know I would be just as miserable if I did that as I am now. I have read the things that could happen when someone is bulimic, and it is like I am waiting for something terrible to happen as a result of this compulsion. I feel so stupid for allowing it to start and I feel like a prisoner in my own body.

ANSWER: It sounds like your treatment when you were younger was an aweful experience... I think the field of mental health did more harm than good. I wish therapists would just treat people with the respect and understanding that people are just doing the best they can and copeing in whatever ways they know how.  If they could just treat people as being ok and worthy of positive regard instead of damaged and broken and in need of fixing it would go a long way.  It's no wonder with all you've been through that you feel the way you do.  I see you as very capable and am impressed with the successes you've had.  

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QUESTION: Thank you. It is not easy to talk to someone about this. Most people think you can just get over it, but it is not that easy. I do ok if I don't eat out, then it is like I just lose it. Everything is always all or nothing with me, in everything I do, no moderation, and when I fail it is like an embarrassment to me. I try to eat healthy, it is tough to stay away from desserts and stuff, but that is what sets me off, if I could just live with a sliver of cake or pie, without beating myself up over it,that is what I want to learn how to do.

Answer
Dana- you are what is known as an informed bulimic.  That means you know all the stats and the psych-language about your condition, but have yet to take action.  The good news is that the next step is very close... taking action.  It means making the decision to work on this with your therapist.  Good luck... you're really very close!