Expert: Katie - 12/11/2007

Question
I've been bulimic for a long time but over the past year I have become completly obsessed with it. It controls every part of my day. I start by going as long as possible without food.. the when I finally give in or 'fail' i will binge for hours. I havent been able to just eat something and keep it down for months. I have lost about 40 pounds and often feel very dizzy and have muscle twitches.. especially in my legs. I also think my heart also beats irregular sometimes..hard.. randomly. I also haven't had my period in about 8 months. Even my brin seems to be slowing down.. its even hard sometimes to hold a normal conversation because i dont have the enery to think of anything. my family lives far away and I don't have many close friends where I live now thats really been around to notice my transformation. Also I'm a model so being slim is normal, i'm surrounded by it everyday. basically what I'm saying is i kind of have everyone fooled.. everyone thinks i'm fine. when I'm around people i act strong, often drink alot of alechol. i find it takes my mind off food and also gives me energy (is that possible?) but I'm worried that I might die. ..besides being slim i dont look like i'm going to die. but from what i've told you... what do you think?? and do you have any advise? I DONT want to be like this.. but i dont know how to make it go away. I feel guilty and horrible when i binge but almost just as bad when i eat. there seems to be no way to go

Answer
Megan, thank you for your question. First and foremost, the thing that I would most like to express to you is- things will be okay, that is if you want them to be, and are willing to work hard enough for them to end up that way, which, by the tone set in your email, I can see that you are.
It is astounding as to how many levels on which we relate and connect. I was you at one time, basically. I have been you at the level you are at now, and I have also been on levels which are far more progressed than the one you are currently on, and our aim is to get you off of this current level, and onto a much healthier and happier path. Also, I am in the entertainment industry and am an actress, so I definitely understand the tension and the emphasis put on being thin that must surround you. I am 20 years old (began my eating disorder at age 11, and am still in recovery) and so I am assuming that we may be around the same age, as well.
I want you to understand that this is a very pivotal time for you to seek help. At this point, seeking help and/or treatment is no longer optional, it is necessary in order to live a normal, happy, healthy life, and in order to prevent yourself from ultimately dying. I understand that you do feel trapped in your current situation, but if you do not seek help and let your eating disorder escalate (which it will, no matter what, if you don't get help) you will feel even more stuck, and ultimately lose the ability (both in physical ability as well as in mental soundness) to live a life that has any sort of semblance of normality. Please, please just take my word for this, and get yourself the help that you deserve. Life without eating disorders is a wonderful life, and you deserve that wonderful life!

Let me address the physical side effects that seem to be manifesting themselves within your body. You have these mucsle twitches in your legs because your circulation is becoming very poor due to lack of food. Poor circulation leads to heart disease, heart attack, etc. and even in its most severe cases, limb amputation. I had an irregular heartbeat myself as a result of my eating disorder, and I now have a heart murmur because of it. You could end up the same way, or even worse, with your heart shutting down at any given moment. Your lethargy is caused by your eating disorder as well, as I'm sure you know. Your brain "seems" to be slowing down, only because it is, in fact, doing just that. Brains need nutrients in order to function properly, and you are starving yourself down a path of memory loss and possible brain damage. Yes, drinking alcohol will give you energy (due to the residual sugar that alcohol contains), but I would not suggest drinking it. There are many reasons for this- a.) Drinking alcohol on an empty stomach is very unhealthy, and if you're throwing it up, it may lead to an earlier onset of esophogeal ulcers, due to the high acidity. b.) in some cases, girls with eating disorders have a predisposition to "addictive behavior" and you would not want your casual drinking to spiral into alcoholism (which it can), as that coupled with an eating disorder will just make things more difficult. c.) There are better things to ingest than alcohol when your body is already malnourished. Alcohol is highly caloric, and high in sugar (just like soda) and alcohol is one of the biggest contributors to belly fat. You could be receiving these calories in more nutritional forms that this. During my eating disorder, I also could not contribute to conversations well, couldn't interpret regular information like everyone else, and I even lost my ability to perform everyday tasks (I didn't understand how to put a can of diet coke into a refrigerator, nor could I figure out how to turn on a shower head). It became where I could no longer drive, and I would even drool on myself, because my body did not have the ability to control these functions (such as not drooling on one's self) that we don't even think about. Things will not get better without help, they will only get worse, and I can't let that happen to you. You do not deserve to have to go down that road. I am not telling you these things in order to frighten you into getting yourself help, I am telling you this because these things are inevitable if you do not seek help. These side effects of bulimia and anorexia are not anything that one would choose for themselves voluntarily, so why would you allow yourself to ultimately be subjected to them?
I understand that that isn't the way that your brain is currently operating (when I say that I mean that you're mind is most likely entirely focused on your eating disorder right now, and that you have very little "peripherel" vison dedicated to other things.)
getting help now is a must, this is nothing that can be placed on a to-do list or be done when most convenient. For the benefit of you and your health, it is important that you seek help now.

It is not an easy process, but it is done using baby steps, so that it is not completely overwhelming (as I'm sure it seems now, which is entirely normal). I guarantee you that once you reach recovery (which you will, I am confident in saying that) you're going to look back at the recovery process with so much pride, and a new sense of self-esteem, as well as a better understanding of who you are. I have found it to be one of my life's greatest learning processes and I cherish it completely.

If your family lives far away, then I think it would be best to relocate to them, even if temporarily, as you will need their support. Call somebody (although face to face is best) that you trust, and tell them about your current eating disorder battle. It sounds intimidating, but if they are a true and loving friend/family member, they will understand. Afterwards, you'll be amazed at how liberating it is to share this with someone, it feels as though an enormous weight has been lifted off of your shoulders (it has, in a sense). You've told me, and although I may be an exception, it goes to show you that people will not judge you, they will be eager to help you and to see you end up healthy, happy, and sound.
See a doctor, and they will not only run some standard tests on you (nothing too scary, I promise) to see what shape your body is in, if you are completely honest with he/she about your condition and about the worries of your future, a good doctor will also help to guide you to a good nutritionist and a good psychotherapist (not a "shrink", someone to talk to). Those three are what make up a good recovery plan: a good physician, a nutritionist, and a good therapist. The support of (trusted) family and friends is also essential. You don't need to tell everyone, only those who you trust, and think have a right to know. They will support you, and you will be okay if you get help soon, I can promise you that.

I hope this helped! If you have anymore questions or concerns, feel free to ask me. Best of luck to you in your recovery, and happy holidays.