Bulimia is an eating disorder, but it has little to do with eating. In reality, bulimia has more to do with low self-esteem, perfectionism, unrealistic expectations, anxiety, fear of losing control, depression and other psychological barriers.
Unfortunately, parents, spouses and others who become aware of a bulimic's problem have a tendency to focus on eating and weight, just as the bulimic does.
The symptoms of bulimia include:
• Recurring episodes of binge eating. Binge eating is characterized by eating large amounts of food in a short period of time. While the exact amount of food eaten may vary, it's not unusual for someone with bulimia to consume whole cartons of ice cream, a whole pizza or an entire bag of chips or cookies in one sitting.
• Lack of control over eating during a binge. Someone with bulimia may feel they cannot stop eating during a binge until either all the food is gone, they literally can't fit more food into their body or someone walks in and disrupts what they consider their shameful behavior.
• Compensatory behavior. Bulimics are extremely afraid of gaining weight. Therefore, they try to compensate for the binge by misusing laxatives or diuretics, fasting or extreme dieting, excessive exercising and self-induced vomiting. Many people think that all bulimics vomit after eating. But that's not every bulimic's chosen "purge." For example, a former patient would ingest more than 50 laxatives per day. Another would fast for three days after a binge, while another would exercise five hours straight to compensate for a single binge.
TV and movie comedies sometimes poke fun at bulimic behavior, but it's no laughing matter. Medical complications that can accompany bulimia include dental problems, stomach rupturing, heart problems, inflamed esophagus, swelling of the glands behind the cheeks that can become chronic, irregular menstrual periods and death.
In addition, bulimics often lead lives filled with anxiety, fear, depression, addictions, obsessive-compulsive disorders and feeling helpless and out of control.
Bulimia usually is not obvious. The typical sufferer is neither emaciated nor overweight (although they think they're fat). This leads other people either to assume that they don't have a problem or to inadvertently reinforce their behavior by praising them for their thinness and apparent self-discipline with food.
Bulimics are ashamed, so they hide their bingeing and purging. Shameful as it may be, they feel purging is the only way they can keep in control.
For many, bulimia began simply with attempts to lose weight that became more rigid over time, leading to the first binge. The desire to regain control and erase the apparent failure then led to compensating for the huge number of calories consumed. The cycle of bingeing and purging quickly takes over.
Not realizing the connection between the rigid, depriving behavior and the loss of control, the bulimic continues the same behavior.
Bulimics think they just need to stop bingeing. But as long as purging is an option, the next binge isn't far away.
To recover, the individual must acknowledge and accept that food and eating are not the problem. Fears must be confronted, usually with the help of an expert guide. And the bulimic must accept that recovery is a process that requires dedication and hard work. The person must want to be free of the disorder, seek professional help and put recovery first.
Fortunately, recovery is possible and can be complete. It may go just as unnoticed by most of the world as the bulimia did, but those who have taken the journey say it was well worthwhile.
As one recovered patient once said, "I feel like I was stuck in hell for many years. Now I feel I'm finally really living."
Lavinia Rodriguez, Ph.D., is a Tampa psychologist and expert in weight management. She is the author of "Mind Over Fat Matters: Psychological Barriers to Weight Management." She can be reached through her website: FatMatters.com.