People with this problem can’t control their eating any more than an alcoholic can control his drinking. Binge-eating episodes alternate with frantic efforts to off-load calories – paying for the binges by vomiting, using laxatives, fasting, or constant exercising. The dilemma arises from the contradiction that you can’t control your calories intake, but want to control your weight. If you didn’t care about your body shape, your unrestrained binge eating would lead to obesity. But you do care very much and are engaged in a desperate attempt to neutralize the effect of the binges in order to avoid gaining weight. This leads to its own vicious cycle.
Bulimia Nervosa is an all too common problem, especially for young women between puberty and the early twenties. It often starts with dieting efforts to get off the baby fat. Dedicated fasting triggers breakthrough pig-outs, which in turn increase the motivation for even more fasting. Before long you discover vomiting or laxatives, or both, as another compensation and punishment for the binge episodes. The cycles of bingeing and “antibingeing” come to completely dominate your life.
You are remarkably ashamed both of the binges and of the things you do to counteract them. You are filled with disgust when you think about sneaking into the bathroom, making yourself vomit, flushing the toilet, and having to do everything possible to hide the smell. You try to keep this a secret from everyone, even the people who love you, and will admit to the problem only if questioned directly. New relationships are avoided for fear your dirty secret will be discovered.
According to the diagnostic manual, you have Bulimia Nervosa if :
- – You have episodes of binge eating during which your eating is out of control and you consume an amount of food that is definitely larger than what most people would eat in a similar period of time and under similar circumstances.
- – To offset the caloric intake and to keep from gaining weight, you do inappropriate things such as making yourself vomit; abusing laxatives, diuretics, or enemas; fasting for extended periods; or exercising excessively.
- – You frequently engage in the bingeing and compensatory behaviors (e.g., on average, at least twice a week for three months).
- – As in Anorexia, your feelings about yourself are excessively influenced by your body shape and weight.