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Bulimia

Meaning ‘great hunger’, bulimia is marked by episodes of excessive eating and or bingeing. After a binge, in an attempt to avoid putting on weight or as a punishment for eating in the first place, the sufferer will often induce vomiting or purge with laxatives. Binge foods are often high in starches and fat, such as sweet biscuits, ice cream, chips, cake and diet soda, but vary from person to person. Bulimia is often a hidden condition, where your family and/or partner are unaware you are driven by such torment. The shame, guilt and despair can be overwhelming. No one on the outside would suspect a bulimic has an eating disorder as their body shape often appears normal, unlike anorexia and exercise addiction, conditions with which bulimia shares similarities. All three disorders may coexist or alternate. It’s a miserable and lonely existence. Often weekends revolve around a planned eating and purging alone, and an invitation out to a restaurant with friends can be fraught with foreboding because such an event, however innocuous to non-sufferers, can be a potential trigger.

Symptoms

  • Frequent induced vomiting causes inflammation and eventually may result in ulceration of the oesophagus.
  • The lining of the stomach will possibly be inflamed.
  • Hydrochloric acid from the stomach contents can damage tooth enamel.
  • If laxatives are overused, the bowel may ultimately become reliant on them, resulting in a lazy bowel.
  • Frequent diarrhoea means the loss of nutrients.
  • Longer term side-effects of bulimia (and anorexia) often result in bowel conditions such as Irritable Bowel Syndrome.
  • Due to the coinciding psychological aspect of this condition, anxiety and or depression is often present.
  • Vomiting will disrupt blood sugar levels. The erratic blood sugar levels may in turn trigger another binge/purge cycle.
  • Excessive eating, vomiting and purging affect neurotransmitters including serotonin (the calming chemical). In turn this exacerbates mood disturbances.
  • Low potassium (hypokalaemia) and other micronutrient deficiencies can result from frequent vomiting and purging. This can affect the heart, and in extreme cases may be fatal.
  • Vomiting and diarrhoea often result in dehydration.
  • Fatigue and exhaustion as the binges can go on for hours.

What causes it?

  • The issues underlying bulimia are often similar to those of Anorexia nervosa, and involve a host of emotional and psychological issues, sometimes relating to body image, sometimes not.
  • An emotional shock in adolescence.
  • Not feeling understood by emotionally remote and or controlling parents.
  • A radical change in diet during childhood, such as a food allergy diet or converting to vegetarianism, may predispose you to bulimia later in life.

Bombarded by media images of botoxed celebrities and perfect models, it’s not surprising those of us not blessed with such comeliness may feel inadequate. For some, this may lead to a disordered view of their body shape (body dysmorphia) and confusion about what food to eat – disordered eating. When does this disordered way of thinking morph into an eating disorder? When it takes over a large percentage of your thoughts and affects you on a day-to-day basis; colouring what you eat, wear and exercise, which can change your perception of who you really are.

What To Do

Although it sounds counter-intuitive, it is more helpful not to focus on the bingeing. Bulimia is merely a symptom, overeating is the manifestation of an underlying cause. So, don’t shoot the messenger. If you suffer from bulimia, the most important lesson you can learn is compassion. Compassion for yourself. When a binge happens, instead of beating up on yourself, and promising to be even stricter, try to forgive yourself. Knowing that you are doing what you can to get better, it is a slow journey, with many ups and downs along the way. If it’s hard to show compassion to yourself, try to imagine how you would respond to your best friend or someone you love if they were in a similar situation. While the journey towards wellness may take some time, the following advice is to help your body recover so that you can enjoy years of good health and well deserved happiness. Interestingly, for many people, their eating disorder develops alongside a passion for cooking and feeding others.

Diet

Bulimia often feels like an addiction, but unlike those with an alcohol or drug addiction, the person with an eating disorder cannot avoid their drug of choice… food.

  • Try to avoid becoming excessively hungry.
  • It is wisest to avoid foods that you associate with overeating such as chips or chocolate. This varies from person to person.
  • Now is not the time to become a gourmet chef. Stick to simple meals that contain some protein, for example, fish, egg, legumes, meat, with vegetables and carbohydrate such as rice, bread, pasta.
  • If you have had an eating disorder for some time, your appetite control mechanism will be out of kilter, and you will need to relearn how and when to eat. Learn what a ‘normal’ portion of food looks like. Some people have never acquired these skills from their family of origin.
  • An eating plan that involves eating several small simple meals throughout the day may be the best model to follow because it will not make you feel deprived, your blood sugar levels will remain constant, reducing a tendency for craving. However, the road to recovery is all about learning what suits your body. If three meals a day is more appropriate, then go with that. However, once you have decided, you need to maintain your chosen routine.
  • Don’t judge yourself harshly if you do slip. You are not perfect. No one is. Forgive yourself and hop back in the saddle straight away… don’t wait until tomorrow.
  • Eat plain yoghurt made with acidophilus or bifidus daily to help re-establish your intestinal microflora.
  • If you are vomiting and using laxatives, make sure you drink plenty of water or you risk becoming dehydrated.

Remedies

  • Slippery elm powder helps to line the stomach, helpful after vomiting, and soothes the bowel after diarrhoea caused by laxatives. Take one teaspoon of slippery elm powder in yoghurt, banana or warm water morning and night.
  • Take a multivitamin supplement. Powdered or liquid supplements may be better absorbed. Depending on frequency of vomiting and purging, you are quite likely deficient in a variety of micronutrients, in particular zinc and potassium. If vomiting is very frequent, an extra potassium supplement is recommended.
  • The Bach flower remedy crab apple is recommended for those who have moments of self-loathing and disgust.
  • The herbs meadowsweet, chamomile, lemon balm, ginger and peppermint are kind to the digestive system. Have them in tincture or tea form daily.
  • Glutamine is an amino acid that helps repair damaged gut cells. Take regularly. Often glutamine is found in supplements combined with other healing substances including aloe vera, gotu cola and zinc.
  • Neurotransmitters, including the calming serotonin, are disrupted by binging and purging. Various herbs including St John’s wort, passionflower, zizyphus and magnolia will help to regulate this.
  • The microflora in your digestive system will be traumatised by all the commotion going on with vomiting and or frequent bowel movements. Take a teaspoon or 3 capsules of a good mixed probiotic each morning.
  • Stomach acid is harsh on tooth enamel. After vomiting, rinse out your mouth with a teaspoon of soda bicarbonate in water to buffer the acid, spit out the soda bicarbonate after rinsing so as not to disrupt the normal pH of the stomach.
  • If your tummy bloats after eating a normal meal, take a digestive enzyme/hydrochloric acid tablet with every meal.

Other

  • Seek counselling. The therapist you choose does not necessarily need to specialise in eating disorders, the eating disorder is merely a symptom of underlying issues. Make sure you feel understood by your counsellor. You might need to kiss a few frogs before you find your therapist prince/princess. Once you feel understood, connected and safe, stick with them.
  • Binging may be an attempt to stuff down bad feelings. When you feel likely to binge, sit quietly for a moment and try to identify what you are feeling, you don’t necessarily have to understand why. Write down these feelings, or draw them, or describe them to a good friend.
  • There are support groups for eating disorders. Bulimia is an isolating condition, so it is good to connect with others who share similar experiences. All states in Australia have a foundation for eating disorders that can provide valuable resources and information.
  • If neurotransmitters are out of whack, it is much harder to gain equilibrium. If natural methods are not working for you, it may prove fruitful to talk to your doctor about taking a course of antidepressant medication, just until the chemical imbalance is sorted. Once you feel better, and the binging behaviour has receded, the medication can be reduced.
  • Find the courage to confide in your dentist. They will be able to place a protective covering on your teeth each visit and suggest the right kind of toothpaste.
  • Do something you love every day. As many people with eating disorders also happen to be perfectionists, this something should be a simple activity with no level of skill. For instance, lying on the grass in the sunshine, listening to a piece of music, patting a purring pussy-cat.

At a glance

Diet

  • Avoid known binge trigger foods. These may include biscuits, ice-cream or chips. It will vary with each person.
  • Find which eating plan suits you; either small meals five times a day or three meals a day.
  • Each meal needs to contain some protein and carbohydrate.

Remedies

  • Take 1 teaspoon of slippery elm powder twice daily to protect stomach and oesophagus lining from excessive vomiting.
  • After vomiting, rinse the mouth with soda bicarbonate in water to minimise damage to teeth enamel.
  • Take a multivitamin daily as you are most likely deficient in nutrients.
  • The Bach flower remedy crab apple will help if you have moments of self loathing, a common feeling with this condition.
  • If you are bloated after meals, take a digestive enzyme and hydrochloric acid tablet with food.
  • Lemon balm, meadowsweet, chamomile, ginger and peppermint are all good calming herbs for the digestive system. Take them in tea or tincture form daily.
  • St John’s wort, passionflower and zizyphus will help restore nervous system equilibrium.

Other

  • Find a good therapist. The journey to recovery can be hastened with good friends and wise counsel.
  • Every day do something simple you enjoy such as listening to birdsong, walking your dog in the park.
  • Join a support group. Bulimia is an isolating condition and you are not alone.
  • As the wise Taoist philosopher Lao Tse (600BC) wrote, ‘The snow goose need not bathe to make itself white, Neither need you do anything but be yourself.’
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