Expert: Dawn McNamara - 1/29/2011

Question
Allo Dawn,

I am currently in recovery from anorexia. I have also struggled with bulimia in the past. I cant currently afford a dietician- all I have is  GP and a therapist. I am 5'2", low weight 70lbs, current 100-ish. Right now I have a very disturbing problem...Ive been in recovery for over 4 months and still have terrible binge eating and night eating. Its so humiliating and I dont tell anyone... sometimes I restrict to compensate but lately I stopped doing that to see if it would help. However, it seems like even when I eat enough for meals and snacks, I still end up going crazy when I'm NOT eating. Either Im thinking about food, or Im so overcome with hunger that I let myself eat only to find I cant stop! My binges are terrible- somtimes up to 3000 cals plus in a 2 hour span! I try everything to stave it off, distract myself, etc but nothing has worked. How do I get this insane hunger to go away and get control of myself? Is this really normal for someone who's at this point in recovery? How is that possible? I cant purge either- my gag reflex is totally shot from my bulimic days. I hate myself for doing this...I just want so desperately to be NORMAL and not feel like such a freak about food. Ive tried planning balanced meals and snacks, getting out more, etc but all that does is cause more anxiety when I get struck by ravenous hunger and Im somewhere without food. Its not emotional either- it really seems to tke that much food for me to be comfortably full for a few hours! What is wrong with me?

Answer
Hi There,
I'm happy to hear from you, and proud of the progress you are currently making.
Its incredibly difficult to deal with this on your own. This is very common in others ive talked to in recovery. I hope you are able to recruit the help of your family and friends they have been indispensable to me. Im by no means "recovered" but Gaining strength to resist purging all the time. Your weight is a little low but not too low.
 The trouble your having sounds a lot like what I have been dealing with too.But You Will stabilize in your cravings. The first thing is that when you eat/ or purge you release endorphins. These feel good hormones are addicting. Your body will crave them and drive you to eat in order to release them. Its the same as when a person gets addicted to exercise, and when they cant they are drivin to distraction, and depressed. eating has the same effect. Also there are additives in alot of foods that actually increase appetite like diet soda, sugars, fast foods and processed foods.
  Another thing to consider is fluids. Most people are dehydrated wich will also increase "hungry" feelings. Try drinking a tall glass of unfiltered apple juice when you feel hungry, but you know you've eaten recently. also get your blood sugar checked..early symptoms of diabetes will make you feel hungry. Remember that your body has been conditioned to slow digestion, your body is used to not being allowed to "keep" much of what it gets. Therefore is is still in "starvation" mode even though you're trying to get better. And because of this it will drive you to eat. Leptin is a hormone released to give you the feeling of bieng satisfied. It is usually released as your intestine gets its first food, passed from the stomach. This is what tells your brain to stop eating because your satisfied. In us bulimics this is slower therefore we eat larger quantities to stretch our stomachs and thats how we feel full. This should come from your intestine, in the form of leptin. You can help this by eating a large apple or orange 20 minutes before a meal. Or by starting a meal with a medium sized salad with extra veggies on it, and waiting 15 minutes before the main course. this will help your body feel more satisfied. Try to eat small amounts throughout the day and glasses of juice in between. Stay away from white foods (White bread, white rice, sugar, and white pasta) substitute with whole grain, is is absorbed slower and will stay with you longer.
Remember it takes a year or more to "normalize" our bodies and even then, we still have to deal
with the disorder from an emotional level too. Its hard work but you can do this. I hope this is a help.
Yours, Dawn