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As with anorexia, the person with bulimia will measure everything by one object - their bodies. Their body and their weight will commonly measure whether the day will be good or bad, and whether they are allowed to eat. Often times someone with bulimia will completely avoid food during the day, but usually by nightfall the person ends up binging, or otherwise eating anyways, and then purging. A cycle of trying to starve and/or diet during the day but then eating and purging at night is not uncommon. The person with bulimia then feels even more of a failure as they believe that they can't even get "dieting" right.
why.it.goes.untreated
Because bulimia does not cause someone to lose an extraordinary amount of weight it is generally an easy disorder to hide. The person with bulimia will often only purge at night or when they take showers so that no one can hear them vomiting or see them binge. With anorexia there tends to be more extreme deteriorations of the body on the outside, whereas with bulimia much of the physical damage is done on the inside. As a result it isn't uncommon for someone to live with this disorder for many years before being caught or finally going to someone for help. This also increases the amount of denial that someone with bulimia has. Since medical problems from the bulimia don't surface as quickly or as readily apparent as with anorexia, the person with this disorder often is unable to believe that it is "that bad."
Another one of the many reasons people who suffer from bulimia don't go for help is because they feel ashamed. Let's face it - in this society people with anorexia are almost put on pedestals. Sure we are shocked at how emaciated someone could get, but at the same time we have a morbid fascination with their extreme self control and destruction. People regard purging as utterly gross (which it is, but that does not make the person suffering is gross) and believe that people with bulimia just have a lack of self-control, and that's it. So, to keep people from thinking less of them, someone suffering will hide their problem. They also fear the threat of weight gain. I wont lie and not say that stopping purging right away will bring some weight gain, but the person suffering won't wait long enough for their metabolisms to straighten out, and will continue the behaviors without speaking to anyone. Then, just as with anorexia, if the family of someone with bulimia is not supportive when the person does ask for help, then that makes it next to impossible for them to get treatment to stop the vicious cycle. Yet another problem those with bulimia face is being unable to see themselves correctly. Just as those battling anorexia, someone with bulimia cannot see themselves as they are in reality when they look in the mirror. They only see someone who is too fat, full of flaws, and a failure.
when.the.time.comes...
You or the person you know with this problem must be willing to work together with a therapist in order to get better. When trying to stop alone the person with bulimia often believes that the binging is the only problem, so they solely work on restrictive eating. Inevitably they get too hungry and binge anyways, which leads to a trip to the bathroom. The key to treating bulimia is not self-control. This sounds like a problem that is basically just a fight with food, when in reality it is a battle with the self and self-esteem inside of a person. You must deal with the issues that are triggering you to eat and purge for comfort, and you must be willing to put up a fight. Remember that eating disorders are addictions, and it will require a lot of TEAMWORK between you and a therapist to finally win this battle.
When you or someone you know is ready to come forward for help, usually group therapy is the first place to go. Because so many people with bulimia feel incredibly guilty and ashamed, it is usually a helpful experience to talk with others that also suffer, just to know that you or the other person is not alone and has nothing to feel bad about. Overeaters Anonymous tends to show promising results for compulsive overeaters and people with bulimia, but if you are not a Christian you might have trouble following the 12 step program. Individual therapy is key to fully recovering. It is tough to deal with the issues that someone with bulimia has locked away inside all these years, but they must be dealt with so that you or the person does not have to constantly go back to binging and purging as a way to comfort and bring relief to internal pain. As with anorexia, usually family therapy is suggested for those patients who are under 16 or 18 years of age and have bulimia.
I should make a note here that those suffering from bulimia tend to have problems with substance abuse more so than people with anorexia. It is estimated that as many as 50-60% of those with bulimia are also addicted to alcohol and need treatment for alcohol abuse along with the purging. If this is the case with you or someone you know, you must get treatment for the drug/alcohol addiction ALONG WITH the purging. You can not treat one problem and not treat the other. What will happen if you treat one addiction is the person will just replace the treated addiction with the non-treated one (i.e. - the person goes into treatment for bulimia, so they drink to make up for not purging, or, they go into treatment for cocaine, so they eat and purge to make up for the loss of the drug).
To see a listing of treatment options, go to here: Treatment
next: Warning signs of eating disorders
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