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Bulimia: More than 'Ox Hunger'

bulimia: more than "ox hunger"

People who develop bulimia have a bad body image, distorted eating patterns, are involved in laxative abuse and are erratic with their emotions.It is estimated that one in four women in college have bulimia. One in four. It has become so common that some schools have been reported to have posted signs in the girls' bathrooms that say something along the lines of - "Please stop throwing up - you are destroying our piping system and backing things up!" (The acid that comes up from purging was eroding the schools' pipes.) I've also noticed that among the complaints of having to share a room on campus with someone, that one of them was dealing with a roommate who hogged the bathroom because he/she was throwing up or on the toilet constantly from laxative abuse.

Once a problem that was "too gross" to imagine has practically the whole country affected. When did throwing up "here and there" become so acceptable? When is this ever going to end?

words.of. experience: amanda

    Since the age of six I've had bad body image. I was always NOT RIGHT. Something was always fucked up with me. Either it was my hair or my feet or my nose, or my weight. I figured that if I could just be thinner, things would be better. If I could just lose some weight, I would be a different person with different friends and some different glamorous life. And so it started.

    I didn't become immediately immersed in the idea of throwing up. Around that time I had gone off and on diets from the age of about 7 to 11, even though at that age you consider a diet really just telling people you are on one while never really changing your eating patterns. But one day I overheard some people talking about how they vomited what they ate just to keep their weight steady, and I figured that was a good idea. If food never fully went "in," I couldn't put anymore weight on. It was disgusting for me to imagine making myself vomit, but... I put my whole life into being the best, the thinnest, the winner, and if this made me drop some weight...

    I hardly ever did it in the beginning. Just once in awhile, like once a month, but it gradually got worse. My parents always fought a lot and used me as a pawn to decide who was liked more, and I hated that. I found myself eating more and more around those times, and having to heave over a toilet just as many times to keep away the guilt. I stopped eating just three meals a day and instead skipped everything and only ate when I was upset. I then purged to "wash" the sins away and to help find some peace in myself. It didn't matter what I was upset over - food was there to help out, and so was purging.

    About two years after starting, I was flipping between ten pound weight gains and losses just about daily. My face was constantly bloated along with my hands and feet. It was really hard for me to sleep, too. I was so moody that I turned a lot of people off, but I didn't really notice the changes. I still thought that throwing up daily or weekly was "fine." I didn't realize that what was going on was bulimia until my freshman year of college when a friend of mine brought it up. She helped me go and see a counselor, even though I then denied everything. That helped a little...

    I'm now a senior and still fighting. People don't understand that this is an addiction. In the beginning you think you are fine, that there is no problem, and that you have control or that you only need to lose a "few more," but it bites you in the ass eventually. I'm going to group therapy and stuff, but I haven't found one on one therapist that I really like, so I just kind of try to fight the urges on my own. Some days are good, some days are really bad, but never in the middle. I hope that I can beat this one day, but it doesn't look like that'll happen anytime soon.

overview

Bulimia is Latin, meaning "ox hunger." There has been research done showing that bulimia first began in the middle ages when people in celebration gorged on food and then induced vomiting so that they could go back to the party and eat more with their friends. However, bulimia is not about purging for the sake of having to go back to a celebration. It's about emotional pain more than anything. Frighteningly, 2-4% of the population suffers from this, including 20% of high school girls. These statistics don't include the large amount of people who don't go for treatment, either.

who.it.strikes

The typical person vulnerable to developing bulimia hides what they feel inside frequently and is a people pleaser. More so than with cases of anorexia those vulnerable to bulimia care deeply about what others think about them. A past history of on and off dieting is common, as well as problems controlling their impulses. Often people vulnerable to bulimia tend to experience more irrational and erratic emotions than those with anorexia, which leads to the problem of controlling the impulses of dieting, and binging and purging.

why.it.happens

Just as with anorexia, society gives the impression that to be liked (something the person vulnerable craves) you have to be thin. To be thin equals power and respect and money and love and attention. That alone can trigger bulimia, and because those vulnerable to developing this eating disorder veer from one extreme to another in every aspect of life, they eventually plunge head into the problem.

Something so powerful and deadly as bulimia is not based around mere society, however. In the family of someone vulnerable there is usually chaos. Emotions are erratic and scattered and the person isn't taught how to deal with things very well. It is often noted in bulimia cases that the mother has been the type to diet constantly herself, and more so than anorexia there tends to be a past history of sexual abuse.

Somewhere the feelings of unworthiness and failure build and erode the person's self-esteem, whether that be the person feeling inadequate in the eyes of their parents or perhaps even the eyes of a significant other. Food brings comfort at first, but then eventually guilt over having eaten the food hits the person, and purging brings relief into the person's body and mind. Purging also creates a false sense of control, as well. Knowing that they can basically eat what they want and just bring it all up later helps the person feel better and in control of what they allow their bodies to have and digest.


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).

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APA Reference
Staff, H. (2008, December 16). Bulimia: More than 'Ox Hunger', HealthyPlace. Retrieved on 2020, February 24 from https://www.healthyplace.com/eating-disorders/articles/bulimia-more-than-ox-hunger

Last Updated: January 14, 2014

Medically reviewed by Harry Croft, MD

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