Bulimia
Diagnosis
Let’s start with something very important: There are a lot of misconceptions about eating disorders, including bulimia. Myth #1: Bulimia is a behavior (in other words, something you can control)—specifically vomiting and laxative abuse. Myth #2: People with bulimia are “healthy” again once they stop purging. In reality, bulimia is much, much more complicated than that. While it is an eating disorder—and many people who have bulimia have an unhealthy relationship with food and their bodies—it’s also a complex, potentially life-threatening mental disorder. First of all, not all people with bulimia purge. There are actually two subtypes: purging and non-purging. Similar to binge-eating disorder, those who have bulimia engage in cycles of excessive eating. Afterwards, they seek to undo it all, either by forced vomiting or other potentially dangerous behaviors, such as misusing laxatives or diuretics, starving themselves, or exercising excessively. Underlying all these symptoms of the disorder are emotional pain, shame, and stigma; nearly half of people with bulimia also deal with a mood disorder, more than half suffer from anxiety, and nearly 1 in 10 have a substance abuse problem. Bulimia takes a huge physical toll, depriving the body of necessary nutrients and putting someone with this eating disorder at risk for dehydration, dental problems, damage to the esophagus, and GI issues related to repeated exposure to stomach acid. In extreme cases, bulimia can lead to heart and other organ problems and even death. People with bulimia are better at hiding their condition than those with anorexia because they don’t always lose weight. As a result, it’s not always possible for family and friends to notice what’s going on or to intervene until the person is at risk for serious health problems. All of this information can feel scary and may be upsetting. But here’s the crucial thing to know: Bulimia is treatable. Many find permanent relief with professional help and nonjudgmental support from friends and family. (We’re serious about that nonjudgmental part—that’s really key!) As a first step, it may be helpful to find a local 12-step program like Anorexics and Bulimics Anonymous (ABA) or Eating Disorders Anonymous (EDA). Being part of a 12-step program that has helped others to recover is a hopeful act. Studies have found that both drug therapy, especially tricyclic antidepressants, and psychotherapy can help. If you have bulimia, there’s a lot you can do to take care of yourself as you strive for recovery. First, banish any social accounts or media that show underweight, objectified bodies—you don’t need that in your life (in fact, none of us do!). Avoid all weight-loss diets and commit to eating healthy, nutritious meals—meals that don’t trigger the urge to purge, but also don’t leave you hungry—on a regular schedule. Do your best to keep stress (which is a trigger) to a low simmer. If you’re coping with an addiction—to food, booze, or drugs—seek help for that too. Some people who have successfully recovered from bulimia say it helped to work with an integrative nutritionist and incorporate supplements, though there’s no actual research to say this approach works. Last thought: Lean on your WanaFam for advice and encouragement. Bulimia is an illness, and having people to lean on—people who get it—can make a huge difference in your recovery.
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