Living with Bulimia Nervosa can be a scary and long journey for both the individual diagnosed with the condition and their families / loved ones. Understanding the complex nature of bulimia can be difficult. It may be hard for people who haven’t experienced the disorder to grasp why people would engage in such behaviors. Learning about bulimia can be helpful for clients and their loved ones during the treatment and recovery process.
Bulimia is an obsession with food and weight that manifests itself through cycles of binging and purging. A binge can be difficult to diagnose, but the Diagnostic and Statistical Manual 5th Edition (DSM-5) describes the following two critical components: 1. Eating, in a discrete period of time (e.g. within any 2-hour period), an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances 2. A sense of lack of control over eating during the episode (e.g. a feeling that one cannot stop eating or control what or how much one is eating). Binges are typically followed by overwhelming feelings of guilt and shame. For those living with bulimia, this guilt and shame are temporarily relieved through some type of purging behavior. Purging can include vomiting, laxative use, diuretics, over-exercising, enemas and/or fasting.
While many people living with bulimia may engage in behaviors in order to manipulate weight and/or shape, behaviors typically begin as a way to escape, avoid, numb or weaken uncomfortable thoughts and/or emotions. There is usually some type of relief – albeit temporary – that performing disordered eating behaviors brings. Whether a person chooses to binge to numb emotional pain or distress or purges to relieve stress/anxiety, each of these behaviors has a purpose and are not necessarily about the food. One client that I worked with explained to me that she had a love and hate relationship with food and her body. With further exploration, she was able to describe that the binge-purge cycle helped her to gain control over her painful trauma history. She binged as a form of self-medication and purged to punish herself for the trauma that she believed was her fault.
In order to be formally diagnosed with bulimia, the binge-purge cycle must occur at least 3 times per week (please know that any amount of time spent on disordered eating behaviors deserve to be professionally addressed). The binge-purge cycle can be extremely vicious and can have severe psychological and medical complications if not properly treated. Some of these complications can include kidney failure, severe tooth decay and gum disease, acid reflux, esophageal tears, heart problems and even death.
No one deserves to fight alone. For those who are living with Bulimia Nervosa, specialized support is available.
Taryn Reynolds, MS is a clinician in Walden Behavioral Care’s Peabody clinic. She works with the adult population in the partial hospitalization and intensive outpatient programs. Taryn has been a part of the Walden family for almost ten years and has extensive experience helping individuals in their road to eating disorder recovery.