For more than a decade I had bulimia nervosa. It is a serious eating disorder characterised by cycles of binge-eating followed by purging to offset the calories consumed. If you’re in its grip, it can feel as though there isn’t an end in sight.
The good news is that a full recovery from bulimia is possible. There is not a quick fix and it can be a long recovery process, but with the right treatment plan and therapy, you can live your life without obsessing over your eating habits and food intake all the time.
‘An eating disorder characterised by regular, often secretive bouts of overeating followed by self-induced vomiting or purging, strict dieting, or extreme exercise, associated with persistent and excessive concern about body weight’ – definition of bulimia nervosa in Oxford Dictionary
It’s not something I talk about at all and very few people would know this about me. I find it hard to speak about as there are lots of feelings of guilt and shame. It also feels worlds away from who I am now.
The first few years were the worst for me. I had episodes where the binge-purge cycle was frequent. When at times it seemed to take over my life and I couldn’t focus on anything else. It was something that was always there, a constant. But I also had periods of time where it ceased. Times in my life where I must have been happy, and didn’t need to use food as a way of control, a coping mechanism.
How it began for me
I started binging and then purging food around 16 years old. I had been signed to a modelling agency after being spotted out and about in London, and spent the first summer holidays after my exams travelling around London with an A-Z book of maps (yes, I’m that old!). It wasn’t something that I had thought about, but decided I should give it a try and see what happened.
I was put with a group of girls, the ‘new faces’ of the agency and sent out to meet with photographers, stylists and magazine editors. I found it completely overwhelming. Rather than make me more confident, it hammered home how shy I was and how uncomfortable I was meeting new people.
My heart wasn’t in it, but I felt I had to give it a try and see if anything came of it. I was surrounded by beautiful, thin, stylish people and I just felt very plain and ordinary.
After a while I became sick and lost a lot of weight. Upon arrival at the agency one summer I was marched off to the toilets, measured and weighed, to which my agent exclaimed she was delighted with the results and that I must keep the weight off. I vowed to myself that I would try my hardest and started to more or less starve myself to ensure those extra pounds didn’t go back on.
Starving myself to be thin
My parents and teachers at school noticed that I had lost a lot of weight. I became more and more withdrawn, spending most of my free time in my room.
My dad caught me weighing my cereal one morning and started questioning me. I would walk for miles and miles every day and hide most of the food that I was given.
I constantly checked my stomach in the mirror, delighted that I could see my ribs more and more.
I became thoroughly depressed. I was obsessed with a song by the Manic Street Preachers – 14st 7lb (widely considered to be the weight below which death is said to be medically unavoidable for an anorexia nervosa sufferer).
The song depicts the thoughts and feelings of someone suffering from anorexia (believed to be about the band’s guitarist’s personal struggle with the disease). It says a lot about the state of my mental health at the time.
“I’ve finally come to understand life through staring blankly at my navel” – Manic Street Preachers, 4st 7Ib
I was hungry and miserable all the time. One day I had a real lightbulb moment. There was a realisation that I could eat the food I wanted, but this time I could just bring it up afterwards. I could get all the enjoyment of eating, without the negative effects of putting on weight
I don’t think I even knew there was such a thing as bulimia. There was no internet or social media in those days. Nowhere for me to find out weight loss tips and tricks like there are now.
The binge-purge cycle
I found it hard to be sick at first, annoyed that I couldn’t bring everything up, until I discovered a few tricks that helped. The binge-purge cycle became increasingly more frequent until I was not only bringing up my usual meals, but actively going out of my way to binge on copious amounts of food so that I could then go through the process of being sick. It brought a sense of relief after, if only because the physical act made me tired.
I would use marker foods to try and ascertain how much I had left to bring up. Usually something bright like a red apple whereby I could see the skin, and thereby know I had got rid of all the food I’d eaten.
This wasn’t a foolproof method though as your stomach doesn’t layer the food in order of consumption and it gets mixed up together. Especially if the purge session takes place a while after the binge session.
Drinking something hot in between mouthfuls would help the food come out easier, mixing with what I ate. I went through copious amounts of hot chocolate, which now I can’t bear to taste.
Accepting that I needed help
This went on for quite some time until one day I was watching TV with my mum and a lady came on to talk about her eating disorder. I broke down and told my mum (who I knew had her suspicions). I was promptly marched to the doctors to tell them what I had been doing.
I was prescribed Prozac which is a selective serotonin reuptake inhibitor (SSRI) commonly used to treat bulimia by increasing the amount of serotonin in the brain, reducing the urge to engage in negative behaviours. The doctor told me they would be in touch about some counselling.
I didn’t feel too hopeful that they could help me (I’m not even sure want to be helped at this stage if I’m honest). This was the late 90s and doctors believed that they could get rid of the disorder by telling patients to just eat differently and avoid the foods that trigger a binge-episode.
Arguments with my parents started at home, in particular around the dinner table. Initially, they tried to be understanding, telling me that I didn’t need to eat everything on my plate. Everyone at the table feeling awkward, watching me like a hawk.
I would run a bath every night straight after dinner so they couldn’t hear me being sick, but they woke up to this and would bang on the door, shouting for me to come out. After a while I ended up being sick in the sink so it wouldn’t make so much noise and they wouldn’t hear the toilet flush.
When they eventually told me that I had to wait until later on in the evening for a bath (their way of stopping me), I would be sick in a carrier bag in my room or the garden,
CBT sessions for bulimia
I was booked into see a counsellor for a series of sessions of CBT, which although didn’t stop what I was doing, it put me on a path to seeing what I was doing wasn’t good for me and gave me some methods to recognise things that may trigger me.
After the sessions I went travelling and then moved out of the family home to live with friends in London. I carried on binging and then purging, though not as excessively like I had done previously,
I still regularly purged food after I had eaten, especially if I was particularly worried or stressed. I would go for months without doing it and revert back when I was struggling.
As per what I had been taught in the CBT sessions, I avoided certain foods that I knew would trigger me vomiting – ice cream, hot drinks, yoghurt, anything that I considered a food that was easy to eat quickly and ‘mixed well’ in the stomach.
How exercise became my main recovery tool
Exercise has been a cornerstone in my journey to recovery from bulimia.
I always liked running, but never took it that seriously. I’d go out for the odd run in the evening, or at the weekend to run off a hangover. I began running more frequently and the distance became longer, and eventually I entered into a marathon.
I didn’t know it at the time, but looking back I realise that I began to think about food differently. It wasn’t something that made me feel better or gave me back the control that I felt was missing, it was now fuel for my body, something that would get me through the long, arduous training runs.
I no longer actively sought out food with the intent of binge-eating and gradually it became less frequent until it wasn’t something I thought about.
I had a few relapses at points in my life that were stressful and occasionally I would find myself eating a lot of food, very quickly, without being conscious of what I was doing, my sub-conscious taking over in that moment of worry or stress.
Not only has exercise helped me rebuild a healthy relationship with my body, but it has also provided a positive outlet for managing stress and anxiety.
Through regular physical activity, I have found a sense of accomplishment and has a positive effect on my mental health, which reduces the urge to engage in disordered eating behaviors. It’s a means to maintaining a healthy weight, but also one of the most important steps for me in reducing negative self-talk and negative emotions.
Signs of bulimia
As defined in the Oxford Dictionary; ‘An eating disorder characterised by regular, often secretive bouts of overeating followed by self-induced vomiting or purging, strict dieting, or extreme exercise, associated with persistent and excessive concern about body weight‘. Here are the common signs and symptoms to watch out for:
Binge-eating
People with bulimia often consume large amounts of food in a short time, often in an out-of-control way. Personally, I would eat in a totally mindless way. Eating at speed to ensure the food I consumed didn’t have time to be digested. I would never savour the food, just shove it in quickly. Getting as much down as possible until I ate so much I felt physically sick.
I still eat my food really quickly, unaware a lot of the time of what I’m eating. I think my brain is wired to eat that way now.
Purging behaviors
There are various methods of purging – not only vomiting, which most people would associate with bulimia. The tactics below were all part of how I tried to undo the damage of binging and overeating. These include:
- Self-induced vomiting: Forcing themselves to vomit after binge-eating
- Laxative or diuretic use: Abusing these substances to eliminate calories
- Excessive exercise: Compensating for food intake through intense workouts
- Fasting: Avoiding food altogether after a binge
Fear of weight gain
Some people with bulimia have an intense fear of gaining weight or becoming overweight.
It is a misconception that all people with bulimia are underweight though, as they can, in fact, be of a normal and healthy weight. Being bulimic can actually make you gain weight due to the huge amount of calories consumed in binge-eating. Even though you believe you have purged all of the food, many calories still remain in the body.
At the height of my illness, my weight and appearance weren’t my main concerns. Instead, dieting, bingeing, and purging felt like a way of gaining some control over my life.
Mood swings and emotional distress
Anxiety, depression, and obsessive-compulsive behaviors are often associated with bulimia.
Bulimia and anxiety are closely linked, and while there are many factors that contribute to the development of the eating disorder, anxiety can be a contributing factor.
For as long as I can remember I have been an anxious person and struggled with negative thoughts. I have recently given up alcohol due to the negative effects that I experience afterwards – the anxiety and shame.
Bulimia can affect your physical appearance
Bulimia can result in severe medical complications. Here are some of the key issues associated with bulimia:
- Oral health problems – A common side effect of self-induced vomiting is bulimia teeth. Bulimia teeth describes a variety of oral health problems. Frequent vomiting exposes teeth to stomach acids, which erode the enamel, the protective outer layer of teeth. Dentists are usually the first to spot erosion to teeth enamel and mine had asked me if I eat a highly acidic foods such as citrus fruit due to my enamel wearing away. He painted fluoride varnish on the surface to give them more protection.
- Gum disease – Acid exposure can irritate and inflame the gums, leading to gum disease. Symptoms include gum sensitivity, recession, and ulcers. I suffered from ulcers all the time, some of them really painful
- Swollen salivary glands – acid can irritate the salivary glands, causing swelling and reducing saliva production
- Nutrient deficiencies – Bulimia disrupts normal eating patterns, leading to deficiencies in vitamins, minerals, and essential nutrients
- Sore Throat – From frequent vomiting
- Bloodshot Eyes – Irritation from acid exposure
- Kidney damage – Dehydration and electrolyte imbalances strain the kidneys, potentially leading to kidney failure
- Bloating or Tummy Pain – Digestive discomfort
- Tiredness – Due to physical strain and nutritional deficiencies
- Menstrual Irregularity – Girls and women may experience irregular periods or even amenorrhea (absence of menstruation)
Bulimia treatment– effective therapies and interventions
The main treatments for bulimia typically involve a combination of the following approaches:
Guided self-help programmes
As a first step, you might be offered a guided self-help programme. This can often involve working through a self-help book or online programme, combined with sessions with an eating disorder therapist.
Cognitive-behavioral therapy (CBT)
This is a well-established treatment for bulimia usually involving up to 20 sessions across 20 weeks. These are talk therapies to gain skills to deal with underlying psychological problems that drive eating disorder symptoms
Dialectical Behavior Therapy (DBT)
This therapy is useful for individuals with bulimia, especially those who struggle with emotional regulation. DBT teaches skills to manage emotions, tolerate distress, and improve relationships.
Family therapy
Particularly effective for younger individuals, family therapy involves working with family members to improve communication, address family dynamics that may contribute to the disorder, and provide support for the recovery process.
Medication (antidepressants)
Antidepressants should not be the sole treatment and should be offered in combination with therapy or self-help treatment. Prozac is commonly prescribed to help reduce the frequency of binge-purge cycles and improve mood.
Hospitalisation or residential treatment
In severe cases, where a person is at risk of serious physical harm, or if outpatient treatment is not effective, hospitalisation or residential treatment may be necessary. These programmes offer intensive care and support in a structured environment.
The recovery journey from bulimia can look different for each individual. It is possible with the right support and strategies, although it can be a long process and I know first-hand how hard it is to rewire thoughts and behaviours around self-image and negative thoughts. Recovery for me wasn’t something that happened straight away, and as I mentioned above, it took me a long time to get to the point where I didn’t see binge-eating and purging as a way of feeling some kind of relief.
Having been through this disorder myself, I can tell you that while the road to recovery is challenging, it’s also incredibly rewarding. I’ve emerged on the other side living a life that is no longer controlled by the constant thoughts of food or the relentless cycle of bingeing and purging. Through therapy and support, I reclaimed my health and my self-esteem.
Today, I enjoy food as it was meant to be enjoyed—without guilt, without fear. If I can do it, so can you. Healing is possible, and with the right support and determination, you too can find peace and happiness beyond bulimia.
