Bulimia
Bulimia was only named in the middle eighties, as I was finishing my internship at the University of California, Irvine Counseling Center. I discovered that, suddenly, without any seeming reason at the time, the counseling center was flooded with students who needed to be seen as soon as possible. The intake counselor asked all of us if we knew about eating disorders. No one on the staff at the time had ever heard of the word “bulimia” but I just said of course I’d be glad to see them. I heard time and time again the exact same story - precisely the same scenario. I had no resources to turn to that could assist me in the process of helping them. There was no literature at all on the subject, none. No research had been done, no one had ever even talked about it in any journal anywhere. I was on my own.
Eventually I discovered how come so many students were coming into the center all within a month of each other. An article had come out in Glamour magazine that was called “Full Stomachs, Empty Lives.” Once I found the article, I began to understand the influx of students. This article described what I had been hearing over and over. It, though, had said that, though these girls had thought they had found the perfect way to lose weight, they actually had a disorder that could be very dangerous, which is true. That was thus the reason I was treating so many in a short time. They had gotten scared from reading about something they had no idea was a “disorder.“ They had convinced themselves that they had the best-kept secret for losing weight and they were indulging in it several times a day.
Many horrible consequences can occur from binging and purging plus using laxatives. Deaths occur that are the direct result of electrolytes becoming so unbalanced that the body can’t sustain life. I have witnessed 22 year olds losing their teeth and, even if they haven’t yet lost any teeth, certainly the enamel has been permanently damaged due to the vomiting. Many other serious effects can occur from having this disorder.
Yet, it continues to be epidemic. In fact, the statistics show that younger and younger girls are starting to become bulimic (I have had several men over the years in my practice, but 94% of the people I see are girls/women). Also, I must point out that many women into their 40’s are coming into therapy, having had the disorder for over 20 years. In fact, I was in the Los Angeles Times several years ago, for they were doing a comprehensive article about a bulimic I was treating when I was on the medical school faculty at UCI, appointed as the chief psychologist for their in-patient eating disorder program. She had had the disorder for almost 20 years and was in the program because of how much her life revolved around binging and purging - it was her life. She said my working with her felt like I was trying to remove her arm or her leg. She was that attached to her daily ritual of the bulimic pattern.
Early on, certain activities that young girls get into can start the process of binging and purging, such as dance, gymnastics, swimming - any sport that focuses on being a particular weight and keeping it there to be eligible or at least considered for professional participation in it. It, though, can also begin due to family dynamics. I will be discussing that in a later column.
What are some of the other signs that someone has bulimia? Not eating at meal times, finding food that is hidden under the mattress in their rooms, in drawers, under furniture, hording food that is even still in the family kitchen, being very possessive about food so that overreactions of anger occur if “someone,” anyone really, tries to take any of the food that they have designated as their own.
Finding that someone goes to the bathroom right after a meal may be an obvious sign that someone has bulimia. Another is that they stay up late or disappear at times during the day and no one seems to know where they are. They often hide food in their car or eat in their car to avoid being caught so they are out of the house an unusually large amount of time.
Unexplained outbursts of rage, very little tolerance for anything, excess exercise, weighing at least once a day if not more, disgust with their clothes and how they look, withdrawn, secretive, hiding out in their room if they are home, and other changes in behaviors and emotional tones are still more signs of bulimia.
When they do come home with food, notice the kinds of food that end up in the refrigerator - things like gallons of ice cream, lots of milk and other easy to vomit soft foods such as cakes and yogart. Bulimics are experts in what foods will “come up” easily, so they buy what they can easily get rid of. Eventually though, as one 44 year old bulimic told me last week, they can eat anything and easily vomit it. The body gets used to getting over-full and then vomiting comes almost naturally. She said she no longer has to be careful about what she eats, it will all be “gotten rid of” almost instantaneously. In fact, she will do this behavior several times within an hour or so, binging, vomiting, binging once more immediately and then vomiting again.
Bulimics can become very adept at covering what they do. They are often in positions where they can either stay up late at night or do it when people aren’t home or, if they are, are paying attention to other things. One other way that bulimics can get rid of the food they have just over-indulged in is to get into the shower and vomit there.
Before I turn to anorexia, it is important to note that bulimics become quite addicted to the cycle and are terrified to stop. They believe they will get fat (one of their major fears, obviously) and also they think they must do all of the behavior in order to get the kind of emotional relief that, for a moment, they feel.
If a child starts talking about going on a diet or begins to eat less at meals but you find food you have bought missing, begin talking to them instantly about what they are feeling - not necessarily about food, about pressure at school, discontent at home, other things that you may have noticed when you stop to think about it.
[PREVIOUS] [NEXT]
Eventually I discovered how come so many students were coming into the center all within a month of each other. An article had come out in Glamour magazine that was called “Full Stomachs, Empty Lives.” Once I found the article, I began to understand the influx of students. This article described what I had been hearing over and over. It, though, had said that, though these girls had thought they had found the perfect way to lose weight, they actually had a disorder that could be very dangerous, which is true. That was thus the reason I was treating so many in a short time. They had gotten scared from reading about something they had no idea was a “disorder.“ They had convinced themselves that they had the best-kept secret for losing weight and they were indulging in it several times a day.
Many horrible consequences can occur from binging and purging plus using laxatives. Deaths occur that are the direct result of electrolytes becoming so unbalanced that the body can’t sustain life. I have witnessed 22 year olds losing their teeth and, even if they haven’t yet lost any teeth, certainly the enamel has been permanently damaged due to the vomiting. Many other serious effects can occur from having this disorder.
Yet, it continues to be epidemic. In fact, the statistics show that younger and younger girls are starting to become bulimic (I have had several men over the years in my practice, but 94% of the people I see are girls/women). Also, I must point out that many women into their 40’s are coming into therapy, having had the disorder for over 20 years. In fact, I was in the Los Angeles Times several years ago, for they were doing a comprehensive article about a bulimic I was treating when I was on the medical school faculty at UCI, appointed as the chief psychologist for their in-patient eating disorder program. She had had the disorder for almost 20 years and was in the program because of how much her life revolved around binging and purging - it was her life. She said my working with her felt like I was trying to remove her arm or her leg. She was that attached to her daily ritual of the bulimic pattern.
Early on, certain activities that young girls get into can start the process of binging and purging, such as dance, gymnastics, swimming - any sport that focuses on being a particular weight and keeping it there to be eligible or at least considered for professional participation in it. It, though, can also begin due to family dynamics. I will be discussing that in a later column.
What are some of the other signs that someone has bulimia? Not eating at meal times, finding food that is hidden under the mattress in their rooms, in drawers, under furniture, hording food that is even still in the family kitchen, being very possessive about food so that overreactions of anger occur if “someone,” anyone really, tries to take any of the food that they have designated as their own.
Finding that someone goes to the bathroom right after a meal may be an obvious sign that someone has bulimia. Another is that they stay up late or disappear at times during the day and no one seems to know where they are. They often hide food in their car or eat in their car to avoid being caught so they are out of the house an unusually large amount of time.
Unexplained outbursts of rage, very little tolerance for anything, excess exercise, weighing at least once a day if not more, disgust with their clothes and how they look, withdrawn, secretive, hiding out in their room if they are home, and other changes in behaviors and emotional tones are still more signs of bulimia.
When they do come home with food, notice the kinds of food that end up in the refrigerator - things like gallons of ice cream, lots of milk and other easy to vomit soft foods such as cakes and yogart. Bulimics are experts in what foods will “come up” easily, so they buy what they can easily get rid of. Eventually though, as one 44 year old bulimic told me last week, they can eat anything and easily vomit it. The body gets used to getting over-full and then vomiting comes almost naturally. She said she no longer has to be careful about what she eats, it will all be “gotten rid of” almost instantaneously. In fact, she will do this behavior several times within an hour or so, binging, vomiting, binging once more immediately and then vomiting again.
Bulimics can become very adept at covering what they do. They are often in positions where they can either stay up late at night or do it when people aren’t home or, if they are, are paying attention to other things. One other way that bulimics can get rid of the food they have just over-indulged in is to get into the shower and vomit there.
Before I turn to anorexia, it is important to note that bulimics become quite addicted to the cycle and are terrified to stop. They believe they will get fat (one of their major fears, obviously) and also they think they must do all of the behavior in order to get the kind of emotional relief that, for a moment, they feel.
If a child starts talking about going on a diet or begins to eat less at meals but you find food you have bought missing, begin talking to them instantly about what they are feeling - not necessarily about food, about pressure at school, discontent at home, other things that you may have noticed when you stop to think about it.
[PREVIOUS] [NEXT]
0 Comments:
Post a Comment
<< Home