Bulimia

What is bulimia?

Bulimia is a mental illness that makes sufferers obsessed with food, their weight, and counting calories. It’s often linked with low self-esteem, emotional problems and stress. People with bulimia can be a healthy weight, or even overweight, but the behaviour is unhealthy; they’re usually stuck in a purge cycle of binge-eating, and then ‘purging’ themselves of the calories by making themselves sick or using laxatives.

Why do people get bulimia?

Despite being called an ‘eating disorder’ the underlying causes of bulimia have little to do with food – there’s almost always something else that’s making sufferers unhappy. Similar to anorexia, people control food as a way of feeling more in control of their lives. However, people with bulimia tend to have a more impulsive personality than those suffering with anorexia, which makes them more likely to binge or purge.

What are the symptoms of bulimia?

Bulimia has physical, psychological and behavioural symptoms.

Behavioural symptoms

• Episodes of binge eating a large amount of food, usually until you feel uncomfortable
• Making yourself sick after binges
• Taking laxatives or diet pills
• Being secretive and lying about your eating habits
• Spending lots of money on food

Physical symptoms

• Bad breath and recurring mouth infections
• Constipation and stomach pains
• Puffy cheeks and dry or poor skin
• Sore throat
• Girls can have irregular periods
• Problems sleeping
• Fainting

Psychological symptoms

• Obsessive thoughts about body image, body shape and dieting
• Feeling emotional, depressed or guilty after binges
• Feeling out of control of your life
• Mood swings

Help with bulimia

Realising you need help – and being open to getting it – is the important first step. It is best to seek help early on, as soon as you first notice any symptoms. Try talking to someone you trust about what’s going on. We know this may be scary, but you deserve help and support for what you’re going through. If you’re not ready to talk to a close friend or family member, we recommend you speak to your GP as soon as you feel able so they can refer you to the best person to help. There are also plenty of online support groups that offer advice via email and over the phone – Beat (beating eating disorders) has a helpline: 0345 634 7650, Monday to Wednesday, 1pm – 4pm.

Bulimia control and treatment

Once you’ve made the first step by starting to look for help you’ll most likely be taught several techniques for bulimia control as part of your treatment. Whilst it may be daunting at first, remember that it is possible to successfully treat bulimia and regain a healthy relationship with food. Here’s what to expect.

Bulimia treatment tends to focus on some type of behavioural therapy to help you understand where your behaviour comes from and how to control it. This includes learning about how to monitor what you’re eating to help you spot any changes, planning your meals and watching out for patterns in your behaviour and things that act as triggers. You may be offered cognitive behavioural therapy (CBT), which is a type of talking therapy that can be really helpful for all sorts of things.

What are the risks of having bulimia?

Lots of people recover from bulimia and go on to have a healthy life and a healthy relationship with food.

However, there are some health implications to bingeing and purging if you do it for a long time. Persistent vomiting can erode your teeth enamel causing tooth decay. If you’re female, bulimia can affect your periods and potentially affect your fertility. It also causes stomach problems, for example, using laxatives regularly can give you permanent constipation.

If your bulimia is severe, vomiting and taking laxatives can result in kidney damage, an abnormal heartbeat, fits and muscle spasms which can be potentially life threatening. Given these are long-term risks it is really important to get help as soon as you notice any symptoms. The first step is looking for help and beginning to talk about it.

Lucy had been hiding her eating disorder for years, but when the pain became unbearable she realised she needed help. She tells us about the ups and downs of her recovery from bulimia, and how she’s much happier now she’s regained control of her life.

I’d been in hospital for almost a week when I finally muttered: ‘Mum, ‘I think I have an eating disorder’. They were the scariest eight words I’d ever said. The burden I’d been carrying for over five years felt lifted. But saying them was only the beginning of my recovery.

Bulimia and laxative abuse

For years, my GP and local hospital were totally baffled by my stomach problems. They diagnosed inflammatory bowel disease, but couldn’t figure out the cause. What I wasn’t telling them was I was secretly abusing laxatives.

One day, at work, my stomach hurt so much I got sent home. My mum took me to hospital to get the usual prescription of steroids, but this time I was sent to a specialist gastro ward.

It sounds silly, but at the time I honestly had no clue why I felt so sick. But then I read my diary… I hadn’t eaten a thing in eight days and I’d been deliberately overdosing on laxatives. I refused the steroids because I thought they’d make me fat, and refused to eat too. It was then I broke down and admitted to my mum I had a problem. She arranged a psychiatric assessment and I was diagnosed with anorexia.

Knowing when it’s time to get help with bulimia

On my 12th day in hospital something didn’t feel right. I reached for the call button, but was too weak to get to it. So I tried to attract the attention of the patient across from me. Then I lost consciousness. When I woke up I was linked to an EGC and oxygen and heard a nurse say the words ‘heart attack’. I remember thinking ‘if I’m going to die I wish it would happen soon’.

It sounds dramatic, but I was incredibly depressed and weak, and knew I was going to have a tough time ahead of me. After that the decision to eat was taken out of my hands and they started to tube-feed me (I only consented so I wouldn’t get sectioned). They removed the tube once I promised I would eat, and I was finally discharged with a daily eating plan.

Having a relapse

This should’ve been the start of my recovery. But it wasn’t. Once I had a taste of food again I couldn’t get enough. I started binging on excessive amounts, then compensating by over-exercising and taking laxatives. I started to worry the laxatives weren’t working, so I made myself sick. I was soon taking over 40 laxatives as well as vomiting over 60 times a day.

My diagnosis was changed to bulimia and I was told I had to attend a specialised centre, five days a week, starting the next day.

The highs and lows of bulimia treatment

My first day was terrifying. I was given food as soon as I arrived at 10am and quickly learned that if you went to the toilet after a meal you would be followed. I lost my dignity completely. But I did start to understand that I needed to recover.

The next 11 weeks were a massive mixture of highs and lows. Undoubtedly the hardest day was my first ever ‘Snack Out’, where you have to eat an afternoon snack in the cafe in front of everyone. I hadn’t eaten publically for so long and cried the whole way through. But that was the first step towards conquering my fear of public eating.

One of the highest points was overcoming a challenge to eat pudding with my new friends. None of us wanted to eat it, but we decided to do the opposite of what our heads were telling us. We ate a toffee sundae and a Krispy Creme and laughed hysterically. We actually enjoyed the food, and for those 20 minutes didn’t have any guilt. It was incredible!

Hope for the future

Thinking of where I’ve come from this past year makes me want to share my story with others. I want people to know that recovery is possible. I’m now healthier than I’ve ever been and I feel at peace with myself.

My advice to anyone with any type of mental health issues is to tell someone you trust. It will be terrifying, but muttering those words to my mother was less scary than the prospect of living with this horrible illness. You could even write it all down and give it to someone if that feels less scary.

Ignore the stereotypes of bulimia

I also wanted to write this article to dispel the stereotype attached with eating disorders – that sufferers are emaciated, and that you have to be severely underweight to get help. But there’s no weight limit to eating disorders, and no matter how long you’ve been struggling, or how ‘sick’ you are, YOU DESERVE HELP.

I read an amazing quote that helped me: ‘It’s time to get angry at the eating disorder’. So try not to get angry with yourself. If you have slip-ups in recovery, pick yourself up and carry on. Mistakes are proof that you’re trying.

How to find support for eating disorders

Coping with an eating disorder can be really difficult, but you’re not alone and there are plenty of organisations you can turn to for help. If you want to speak to someone, The Mix’s support services are completely free and confidential.