Bulimia is the attempt by those of us with eating disorders to have our cake, eat it and then avoid the consequences. We do this by bingeing and then getting rid of the food we have eaten (purging) through vomiting or purging with laxatives or through exercising excessively to burn off the calorie content of the food. Our intention is to maintain our body weight at a particular level so that we can disguise from other people – and even ourselves – what we are doing.
However, there are three physical signs that may be difficult to disguise. Callosities may form on the back of the knuckles as a result of putting fingers down the throat to induce vomiting and catching them on the teeth. The front teeth may become transparent as a result of stomach acid dissolving the enamel. The heart rhythm may become irregular – and even stop – as a result of loss of potassium from the stomach in the vomit.
Psychologically, the initial pride in beating the system becomes anxiety, guilt and then shame in the awareness of dependency. There is no such thing as responsible bulimia, any more than there is sensible drinking for an alcoholic or well-managed drug addiction.
Addiction of any kind is always progressive and destructive. The damaging consequences mount up until the pain of continuing becomes greater than the pain of staying as we are. Only in that state do we finally ask for help. Otherwise we try to convince ourselves that we are really not too bad and there are a lot of people far worse than we are. These justifications – often referred to as ‘not yet’s – keep us stuck in our addictive behaviour.
Paradoxically, we get better only after we have despaired. Utter hopelessness is the necessary starting point on the path to recovery. Firm resolutions don’t last.
We see doctors who give us sensible advice and dire warnings. That doesn’t stop us – we simply believe, irrespective of our various skills and achievements, that we are inadequate human beings.
We consult psychologists who are both clever and kind but their advice is still ineffective, telling us things we knew already or that showed little insight into our own distorted perspectives. We are left feeling inadequate and stupid.
We see psychiatrists who prescribe drugs for us – most commonly antidepressants. Irrespective of all the learned papers on the effectiveness of antidepressants, they don’t work for us and they can be dangerous in keeping us away from more effective treatments and in leading to a psychological and even physical dependency that can be fearfully difficult to treat.
We find one nutritionist or health adviser after another and finish up with cupboards full of magical pills and potions – that don’t help and which can lead to obsessions.
We try healthy pursuits, such as exercise, but for us they become unhealthy retreats from reality.
The truth is that we are addicts, in exactly the same way as alcoholics and drug addicts are hooked on their various mood-altering substances and behaviours.
We are able to receive help only when we finally run out of steam. Our best efforts get us nowhere. Our willpower and determination dig us further into the lonely pit of spiritual emptiness.
Help comes from the most unexpected source: other people who have experienced the same spiritual wretchedness that we have endured in our eating disorders. At the age of 47, I got really helpful understanding and support from young girls in their twenties. I thought we had little or nothing in common. As a doctor, I reckoned our roles should have been reversed. I was the health professional; they were merely… merely… umm… people who knew instinctively where I was in my addled mind – because they themselves had been there.
And so began my journey back to sanity – as near as I can ever achieve that goal. I no longer eat sugar or white flour – these substances make me crave for more. In their absence, I no longer crave for anything. I have three regular meals each day, with nothing in between. I do not add spices or ketchup. They distort the natural function of my palate. I eat normal portion sizes. This is difficult because my head sometimes tells me lies – and the difficulty in that is the ‘sometimes’. I therefore judge by what other people are eating provided, of course, that I do not surround myself with other foodies – which is exactly what I used to do in order to feel ‘normal’.
Also I have to look at all my other addictive behaviour. Commonly sufferers from eating disorders cross-addict into compulsive shopping, spending, work and exercise. I have had to learn that I have a faulty ‘stop button’ in these activities.
Nowadays I work the Twelve Step programme of Overeaters Anonymous on a daily basis. This enables me to be free from all the crazy things I used to do previously. My body and mind are my own. They are not in hoc to mood-altering substances. My feelings are positive. I am creative, spontaneous and enthusiastic. I have happy and mutually rewarding relationships. I’ve got the life I want and I work to help others to achieve the same results.