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I was the girl who thought bulimia sounded like a great idea.

Caperton

[Trigger warning for eating disorders]

Background: I battled bulimia for ten years. Or, more accurately, I embraced it for three years, battled it for one, reveled in it for another one, struggled with it for another one, partied with it for two more, and fought it for another two before winning(ish). It’s been five and a half years since I last purged and four years since I last wanted to. I’d ask for a chip or something, but chips are kind of a sore subject with me. (Rimshot.)

For most of my youth, my exposure to eating disorders had been pretty much limited to Lifetime-style movies where the pretty young woman desperately wants to join the cheerleading squad and starts exercising all the time and throwing up her food, and everyone compliments her on losing weight, except for her abandoned former best friend, who is the only one who can tell that Something Is Very Wrong, and eventually she collapses at school, and then there’s inpatient treatment and a roommate who’s been Doing This For Years, blah blah blah meaningful self-discovery, blah blah happy ending, blah blah ED hotline blah. A serious and not-uncommon story, of course, but about about as relatable to me in my sheltered life as the Very Special Episode of a sitcom where a heretofore unknown uncle shows up, drinks from the liquor cabinet at night, drives drunk, gets in an accident, teaches us all a Valuable Lesson, goes home, and is never mentioned again.

It hit a little closer to home my junior year of high school when my chorus teacher was voice-coaching an aspiring Miss Georgia. They’d decided that a captive audience of 18 high-school-age girls would be a great chance for rehearsal, so AMG stopped by to sing a few songs and practice her platform–eating disorder awareness. It was, from what I recall, a good presentation. Formerly anorexic and bulimic herself, she had pictures of her Before and After and Since, accurate statistics and medical information, and honest commentary on her own experience. It was meaningful stuff. And while the girls in the class were cringing at the idea of someone sticking her fingers down her own throat, I’m pretty sure I was the only one thinking, “Hold on, that’s a thing you can do?”

At least one meta-analysis indicates that my reaction is the exception rather than the rule and that most girls do receive the intended benefits of eating disorder education programs. I was, arguably, already broken at the time–the only person in the room (to my knowledge) who heard AMG’s awful stories and managed to tune out everything but “I started sticking my finger down my throat” and “I started losing weight.” I saw her skeletally thin photos from inpatient treatment, and while I didn’t admire them “thinspirationally,” I thought, “Well, I can stop before I get that skinny.” (I can quit whenever I want.)

AMG had no way of knowing, when she walked into that chorus room, that one of the girls there would end up taking the diametrically wrong message from her presentation. And even if her talk did give me brilliant ideas for starting my very own eating disorder, it certainly wasn’t the cause of the stress, depression, perfectionism, poor self-image, and body hatred that would have manifested somehow eventually, if not the wrong way up my esophagus. And yet the part of me that, 15 years ago, was grateful for the diet tips now feels just a little bit betrayed. I was 16 years old. I was stupid. Why would you put that in front of me? As if I wouldn’t have stumbled across it sooner or later anyway.

Even now, I’m still in no place to look back on that time objectively and identify the factors that got the whole thing started. Was there something she said (or didn’t say) that set me off? Some analysis suggests that “survivor testimonials” like the one I got may be more likely to have adverse effects. Did I show any kind of warning sign that I personally would be better off not hearing that particular message in that particular way? I don’t even have the comfort of saying, “We need to protect girls from the fate I suffered,” because the research seems to indicate that most other girls don’t suffer it. But whenever I’m given the opportunity to talk about my own history with bulimia (and I’ve got some stories), I’m afraid to–because I’m afraid that in the audience of girls cringing about vomiting, there will be one girl taking notes.

97 thoughts on I was the girl who thought bulimia sounded like a great idea.

  1. Woah, this happened to me (it was the Calista Flockhart movie, “Secret Life of Mary Margaret” btw, in high school.) and I’m still dealing with it. I want to stop, but it’s just…easier not to. And I hate it. What helped you break the cycle?

  2. Yeah, I was anorexic, and I have a whole slew of diet tips that I try to keep to myself. Do warning lectures for anything ever work? I don’t remember much positive impact from the anti-alcohol speaker hired by my high school. If the best case scenario is a net zero, and the worst case is atrocious, then the scare our kids straight strategy needs to go.

    1. warning lessons are pretty much just “teach kids how to do X” classes. I never realized that most people considered marijuana far less harmful, for instance, than other drugs, until some police officer came to our school for an anti-drug lecture and spent the majority of the time insisting that pot was just as bad as heroin.

  3. I’m an anorexia survivor (in the sense of, I almost died) and have done several ED awareness panel-type events. It always frustrates me when other survivor panelists concentrate on how little they were eating (or how much they were bingeing/how long they were exercising/whatever). Hell, it gets *my* competitive sense going, and I “know better.” I try to walk a line between “here is what I was feeling” and “here are the things I was *doing* to ‘help’ me be anorexic.” I try to concentrate on the isolation and cold of deep anorexia, and usually don’t even mention weight loss, much less behaviors (or, dear heavens, what I ate).

    As I understand it, though, a lot of times those events are mostly useful for people who are *not* susceptible to ED-type thoughts/behaviors, who are concerned about friends and want to understand what they’re going through and maybe how to help. The group I work with has gotten *very* positive feedback when we frame our presentations like that, rather than “just don’t do it.”

    1. I’m not what I’d consider “susceptible” to an eating disorder — never have had one, haven’t even dieted aside from skipping dessert — but even I occasionally see the “too”-skinny pictures as… inspirational. And then I’m like “BACK THE FUCK UP, BAGELSAN” and eat a normal lunch, but it’s still a scary mental sensation. The control sounds very appealing to me.

      1. I, too, have quietly collected some ED or body hatred images as inspiration. It is what it is. I’m unlikely to engage in ED behaviors because my crazy doesn’t roll like that.

      2. I feel the same way and it really bothers me. I’ve never been on a diet (well, except for one day of the master cleanse that ended in scarfing down two pizzas with my roommate) but… ehhhhh. It’s awful how IN THERE those ideas can get.

    2. Yes. The sense of competition is HUGE, I feel. My sister has an ED and is recovering from bulimia and she has always said this is a really big deal for her. Hearing, “I was only ___ lbs” is like a challenge to her. And when I’m around her she is forever minding what I eat and don’t eat. I know that a lot of her most helpful counselors have been individuals with disordered eating as well, but I have always wondered how they walk that fine line. I feel like there have been times for sure when she’s been like, “She’s looking a little skinny…and yet she tells ME I have to do x, y, and z??” And WOW when she was in-patient…that was a flipping disaster. The women were straight up teaching each other tips. It was out of control.

  4. The most vivid depiction that I have seen of an eating disorder was a student film made by a fellow student when I was at art school years ago. She filmed her skeletal body, panning over it slowly like a landscape of protruding ribs. One of the things I remember from the film was exactly what you describe. She said that she had heard someone talking about eating disorders as a warning, and she had thought: “That’s what I want: an eating disorder.” Perhaps this reaction is not as uncommon as one would hope.

  5. Maybe this is a more common reaction than people think? I suffered from anorexia for several years after reading survivors experiences and seeing their photographs. I thought (like you) that I’d be smart enough to stop before it got to that stage. It made me want a ‘controllable’ eating disorder. It’s only once you’re in the middle of the anorexic mindset that you realize that you can never be too thin.

  6. I am hoping we can get some good tech to deal with this soon. Although what with the FDA I kind of doubt it….

    It’s something a little bit scary to me. I am trying to make a small correction downward from an acceptable weight and if my apetitte can be this uncontrolled (in no particular direction) in the best of times, I tremble to think of how it might direct if I accidentally broke it.

  7. I started cutting after an “awareness” presentation at school that discussed eating disorders, self injury, depression, etc. I was already floundering around looking for tools to tackle the self-loathing and desperation I was feeling, and when I heard about cutting, my reaction was “that… sounds like it might work for me”. There was one phrase I remember especially- that cutters “seek relief from their emotional pain by converting it to physical pain”. That was, at the time, an incredibly attractive possibility to me.
    Honestly in my case I don’t think cutting really made my life any worse. It was certainly less harmful to me, in the long run, than many other coping behaviors I could have taken up, like drug abuse. As I matured and developed healthier ways of dealing with things, I was able to gradually stop cutting. I haven’t intentionally cut myself in about three years now.
    I do wonder if it would be more helpful and less risky to have a presentation that describes healthy ways to deal with emotional problems and resources to access more help if needed, rather than going into the specifics of various disordered behaviors like eating disorders and self harm.
    Hope this comment wasn’t a derail; it’s my understanding that there are some similarities in the experiences of people who suffer from EDs and those who self injure, so I thought my experience might be relevant to this discussion also.

    1. Same. I didn’t start cutting until after I learned that my friends were doing it. For the first few months (age 14), we would compare; it was the only way we knew how to communicate to each other that we were so unhappy.

      And to the OP, I also studied what makes an eating disorder “clinical” and thought I could control my eating disorder by ensuring my weight never dropped below the number that flagged people as underweight in school physicals. I wrote about this in a zine on self injury, disordered eating, and patriarchy, Ladders and Hips.

      1. “it was the only way we knew how to communicate to each other that we were so unhappy.”

        I think you totally hit the nail on the head there! And for this reason, I think teaching skills to communicate needs would maybe be more useful than talking about the target behaviors (something people avoid in therapy, even, so as not to trigger someone who’s already “broken” — using the language of the OP here, and not meant to be offensive.)

        1. Agreed with all the commenters that teaching communication, coping skills, self-care, and how to access resources for survivors of abuse of all kinds would probably be a much more effective strategy than focusing on symptoms.

        2. something people avoid in therapy, even, so as not to trigger someone who’s already “broken”

          Thats bad therapy. The job of a therapist isn’t to treat someone like a china doll and let a patient feel that their symptoms are so terrible and dangerous that even the therapist fears them. The job of the therapist (in my view) is to contain a patients distress, to guide them through it, and to interpret aspects of a patient’s maladaptive coping skills that the patient might not be aware of. I’d never avoid something like cutting or ED for fear of trigger a patient. They’re in my office to gain power over their triggers, not bringing a patient to those places would mean not doing my damned job.

          Sorry, its a sore spot. I’ve had way too many patients show up in my office who’ve been in pain for far longer than they ought to have been because their previous providers flinched.

      2. Wow, I did the same thing, but for sort of different reasons. My closest friends and I were all a giant pile of varying kinds of emotionally fucked up in high school, and they had a variety of different eating disorders. I didn’t know how else to express mine (I honestly tried to make myself throw up and couldn’t do it), and cutting was the way I chose to do it for a while. I didn’t do it long, but it’s very interesting to me how easy it was to fall into patterns like that — like we all almost wanted to, whether it was to lose weight or to simply have a way to express whatever pain we felt. None of the “warnings” from various PSAs or presentations in school (or TV, or magazines, or elsewhere) had any lasting impact on me to stop me from “trying out” EDs or cutting. I don’t know… scary stuff.

    2. I have a teenage relative who cuts and I’m concerned that bringing this to her mother’s attention will result in “therapy” that makes it worse. She has refused to go to a therapist (for other reasons) so she’d have to be committed, and I really doubt that would be helpful. I’m not sure what to do.

  8. Its informal and anecdotal, sure, but the vast majority of kids on my caseload with ED and self injury histories eventually end up talking about where they learned their symptoms. Sometimes its a movie, sometimes its a newstory, or a forum online, or a friend with a similar problem, but people learn. Thats actually one of the big reasons I’m not a fan of dedicated in-patient treatment programs: patients get together, compare notes, and (as one of my current patients put it) “get better at being bad.” We tend to forget that even the healthiest of adolescents follow their friends. Why would their madness be any different?

    1. Absolutely!! This was the experience in my family–that in patient experiences worsened the behaviors! They taught each other how to ‘sneak vomit’ and where to hide it…when my sib came home (because she was kicked out of the program, mind you) it felt like a whole new level of disorder.

  9. I can’t even tell you how timely this is for me! I’m also someone who struggles with disordered eating and I’m about to start a unit on body image, health, etc., with my middle school students. While they are aware of my struggles in a VERY vague way, I was unsure about how much to touch on this. I know, for instance, that dramatizing a situation can be VERY attractive to teenagers (and maybe sometimes girls in particular for whatever reasons), so I knew there was a line to walk. I wanted to focus more on fostering anger about the system that’s created destructive desires in us than the destructive desires themselves. Anyhow, thanks so much for this food for thought (awful metaphor at the moment.)

  10. I was introduced to self-harm by a book about something else. “You can do that?” hit me and I did it for a couple of years before peaking with a still-present footlong scar on the inside of my arm.

    I wonder if those of us with depression, bipolar, anxiety, or other mental differences are more susceptible to seeing these things as a ‘logical’ option.

    1. There is an attempted suicide scene in a particular movie that means that I have to be careful being around certain household objects when I’m depressed because their use in it just seemed so sensible to me in the case that I try to kill me self.

  11. Not only from the comments on this post, but also the link Caperton shared, it seems that eating-disorder programming in high schools is a bad idea. Meta analyses find positive effects on lesser stuff like promoting nutrition knowledge but on their major task–that would be preventing disordered eating–these efforts achieve very little. On the down side they take up time, cost money, and sometimes generate the consequence we’re talking about here.

    I don’t have direct knowledge of eating disorder programs but I do know a bit about suicide prevention programming in a U.S. middle school. Oh man. Crock. O. Shit. Programmers don’t have to know anything and their interventions don’t have to be validated before they get sprung on captive kids.

    1. Programmers don’t have to know anything and their interventions don’t have to be validated before they get sprung on captive kids.

      I agree with the general thrust of your comment that suicide prevention programs in schools in the US tend to be crap, but I’m a little uncomfortable about the “validated” part. A lot of political forces weigh on clinical psychology and the battle over what constitutes a validated intervention can lead to some pretty monstrous treatment models (like manualized CBT with hard session limits being performed by psych techs) and often means that poor people who can’t afford better end up with whatever the hot new treatment of the week is instead of an experienced therapist.

    2. I’m uncomfortable with the argument that kids should be shielded from knowledge for their own good. That kind of argument has been used to deny children sex education in the past, since telling kids about safe sex is obviously just going to give them ideas.

      1. I think there’s a significant difference between saying “kids shouldn’t know about eating disorders” and saying “eating disorder programming in schools as it currently stands is ineffective and may be actively harmful.”

        1. You’re right, of course. I wonder what the right way to do it is, though?

          I mean, it seems like it would be a good idea to have someone who’s actually had an eating disorder talk about their experiences. That isn’t preachy or fake like having some nutritionist talk to the kids might be.

          But apparently that has drawbacks too.

        2. Honestly, I don’t know. In general, I’m not fan of special “break-out” programming/assemblies–I don’t have any expertise on this, it’s just my personal experience that as as student I experienced those as one-shot deals that didn’t really deserve my full time and attention and taking seriously. My gut feeling is that incorporating discussion of eating disorders into a general class on physical/mental health, nutrition, etc. would be a better way to go, but perhaps that’s only because that’s the way my high school did it.

        3. I wonder what the right way to do it is, though?

          I’m not sure theres a lot you can do to prevent eating disorders. We’ve got a fucked up society that sends messages about body image that do a lot of damage coupled with a kyriarchy that exposes children to an enormous amount of abuse and leaves people feeling ashamed and out of control. Thats a recipe for an epidemic of eating disorders. I think we’d be better off spending resources on mental health access and targeted interventions than on preventative measures.

        4. I don’t entirely agree. I think there’s room for preventative measures, but ones that are focused on the culture around eating and weight (which would mean taking on a lot of powerful cultural myths not to mention lucrative industries), but not on avoiding the symptoms that might appear in individuals as a result, which I agree is best treated by an actual intervention. More like the environmental movement – it would be silly to try to lecture the ice cap on melting or the ozone for thinning. Just as silly to try to superficially reason someone out of an eating disorder without addressing the actual causes.

          Not likely to happen, I know… But maybe in relatively more self-contained environments, like schools.

        5. Not likely to happen, I know… But maybe in relatively more self-contained environments, like schools.

          I think the challenge I would have for that would be drug abuse or sex ed programs: you might reduce the incidence of some behaviors in relatively healthy kids but the kids at the margins who are really at risk aren’t going to be much swayed. Someone doesn’t accidentally become a drug addict because no one ever told them not to smoke pot, a kid who is serially promiscuous and engage in unsafe sex probably isn’t doing it because sex feels good, and someone who is going to look at an airbrushed model and think “I need to vomit until I feel empty” or “I should cut myself prove I have the will to be thin” probably isn’t going to be saved by even the best body-positive program.

          We’re talking about disorders that are about so much more than not only the behaviors that disturb us but than what patients themselves say. I’ve never had a patient with an Eating Disorder who just wanted to be skinny. Sure, they all say that, but most depressed people will tell you that they really are worthless. ED behaviors are, in my experience, symptoms of something thats a lot more complicated than the kinds of body-image concerns that prevention campaigns are going to work.

  12. i was also vomiting for 2 years..now,after 6 years of psycotherapy…i still have some moments i eat more than i need,but i put my awareness in that moment and it has a different quality,you do what u do in consiousness.i do gestalt therapy,so acceptance is the key to change something about u…not because u dont like it,but beacuse u dont need it anymore…
    i totally agree that talking to teenagers about ‘mental diseases’or whatever we can call it its not helpfull..teaching how to love,respect and accept ourselfs and the others is all we need…

  13. There isnt just skinny and bulemic, there are positive rolemodels, such as women whom got their figure through working out, with an healthy weight and muscle tone to show for it.

    Bulemic can get you in the hospital fast, overweight kills you more slowly.

    1. How do you reconcile that point of view with the studies suggesting that in fact, mildly overweight people are generally healthier?

      I didn’t get my figure through working out. I got it through sitting around reading books and occasionally walking places. So far, my health seems relatively fine, with exceptions made for certain hereditary conditions.

      1. What about the fact that fitter people can move faster, have more stamina when running, and are able to lift heavier objects?

        1. Being fit /= not being fat.

          You can be fit and fat. Plenty of fit, athletic fat people would be happy to demonstrate that to you.

        2. That’s…the definition of fit. That’s how it’s measured. And that’s nice. But I am fortunate in living in a technologically advanced society wherein I can take trains in order to move fast, and do not have a job wherein I have to lift heavy objects. So I don’t care.

          And what does that have to do with health? I didn’t realize we measured health by lifting things.

        3. Being fit /= not being fat.

          I found it funny that doberman’s comment referenced being able to “lift heavier objects”. Strong weight lifters tend to have quite a bit of body fat…

        4. What about the fact that fitter people can move faster, have more stamina when running, and are able to lift heavier objects?

          Take a good look at a football team. Sure, you’ve got running backs and defensive backs who are full of stamina and probably have beautiful abs, but then you’ve got the linemen who aren’t going to run very fast, aren’t going to have a lot of stamina, but are going to be able to hold a 300+ pound man at bay through sheer physical strength. Or go take a look at a rugby team. Yeah, some of those people will be conventionally fit, some will be tubby, all will be more fit and athletic than the vast majority of the population.

          Even within your cultural context you’re demonstrably wrong.

      2. I am not aware of those studies and even if thats true, its MILDLY overweight. And the extra weight could be muscles due to work related physical activity, genetics or performing sports.

        2. The study just refers to diabetes. So all the doctors whom said being overweight is bad for you are wrong?

        3. The study just refers to diabetes. So all the doctors whom said being overweight is bad for you are wrong?

          No, it doesn’t. Read it again until you understand it. Also, you mean “who” not “whom”.

        4. This discussion is somewhat off-topic from the OP. (Except to the extent that the current societal fixation on obesity rather than health contributes to women’s desperation to be thin by any means.)

        5. The study just refers to diabetes. So all the doctors whom said being overweight is bad for you are wrong?

          No, it doesn’t. It controls for diabetes, and it singles out mortality by diabetes for special attention, but it looks at mortality figures overall.

          If you’re having trouble understanding the study, try this article.

        6. @EG: Yes, being underweight seems to cause health issues also. But aren’t you just quibbling over details – ie exactly which amount of body fat is the optimum health-wise?

          And having at least some regular exercise seems to be good for you regardless of weight.

          OTOH, considering the original discussion, it might be worthwhile to point out that being slightly overweight seems to cause at most only very small health issues. So as long as you do not have a clear problem with your weight (in either direction) you should not stress too much about it.

        8. And the extra weight could be muscles due to work related physical activity, genetics or performing sports.

          But it is very, very difficult to control for the difference between fat and muscle when you’re talking about obesity. One of my good friends is a power lifter. He’s 5’9″, about 190 pounds, and regularly lifts better than twice his body weight. He sprints, he jogs, he eats healthily, and he has very little fat on him. Still, his BMI is very close to “obese,” and he’ll be obese by BMI standards once he hits his target weight.

          Me, I’m fat AND muscular. I’m 6’1″, I have shoulders wide enough that I generally can’t buy jackets in normal stores and, on the off chance that I find something that fits my shoulders, I have to get things tailored to fit my waist. If I drop down to under 10% body fat I’ll still be in the “obese” range. If I got down to 0% body fat I’d still need to shed 30 pounds to be in the “normal weight” range rather than overweight. Its ridiculous.

          The way we think about weight is fucked up and doesn’t fit actual human experience.

        9. William as long as your bodyfat is normal your actual weight is secondary. However most people are average and drifting too far in either way from their BMI is a hint they should at least get checked out.

        10. William as long as your bodyfat is normal your actual weight is secondary. However most people are average and drifting too far in either way from their BMI is a hint they should at least get checked out.

          Not to break out the postmodernism, Stella, but please define “normal.” I can tell you’re not using “normal” to refer to the mean or the middle half of the bell curve because talking about how “most people are average and drifting” tends to suggest you’re looking at more than a mathematical concept of normal. Maybe what you meant to say was “as long as your bodyfat is healthy” but that tends to be undercut by how hard you fought against the idea that mild obesity was healthy. That brings us to the boring, and obscenity-worthy, kind of “normal” that means “meets my subjective values and is subject to the coercive power of shame and ridicule.” If what you mean to say is “as long as you’re not a fatty that I don’t want to look at your weight is secondary” just say it so we can tell you to go fuck yourself and move on with our day.

    2. Ever heard of exercise bulimia? Plus, most bulimics aren’t skinny…

      Also, people with disordered eating, and disordered attitudes to food are just as likely to go for overeating. We should be working on the underlying cause of the disordered attitudes, the warped food culture in this country, overemphasis of weight over other signs of good heath, and enormous pressure to be skinny.

      2. Most bulimics are very skinny. They dont lift weights and dont eat to put on muscle.

        People who go for an athletic look make sure to eat enough protein. Sadly while many girls embrace an athletic look there are still too many women whom feel any size in their legs or hint of muscle on them is a no go.

        2. Actually, most bulimics aren’t skinny. It doesn’t lend itself to extreme thinness the way anorexia does. It’s one of the reasons bulimia frequently goes unaddressed for so long before anyone notices.

        4. And one of the reasons that people with anorexia diagnoses are skinny is because among the mandatory criteria for the diagnosis are:

          A. A refusal to maintain body weight at or above a minimally normal weight for age and height (e.g. weight loss leading to a maintenance of body weight less than 85% of that expected, or failure to make expected weight gain during period of growth, leading to body weight less than 85% of that expected).

          B. Intense fear of gaining weight or becoming fat, even though underweight.

          So “overweight” people have a much higher threshold for being diagnosed. It literally doesn’t count until you are “underweight”, and I suspect there is a substantial population of people with anorexia out there who are unlikely to be recognized as such because they are still “too fat” for doctors to care. They’re just “dieting” at that point. Never mind that all of the mentally disordered aspects and health risks are present long before the “ideal” anorexic weight is actually achieved.

          /bitterness

        5. My sister is exercise bulimic, and my aunt is exorcise anorexic. The underlying anxiety and pain that causes them to be both somehow isn’t magically less in my sister, who has more meat on her than my aunt, and their disordered self image isn’t magically healthier because they exercise. In stead of panicking over people maybe being fat, OMG! we should try to stop putting the kind of emotional pressure to be skinny on people, especially women? Maybe?

          Bulimia is characterized by a binge/purge cycle, where the bulimic usually eats as much as or much more than a person with their body would need, and then purges through vomiting, fasting, laxative use, or, yes, exercise. Because of the binge part of the cycle most people with bulimia are not skinny, and many of them are even obese. Anorexics, who don’t binge like people with bulimia do, are the ones who are usually very skinny. But you can also have a fat anorexic, usually because they only recently became anorexic, but also for other reasons.

          Bulimia, even excluding exorcise bulimia, in men is especially common among athletes, so stop acting like exorcise is a magic way to cure disordered eating.

        6. I literally hear the first time about exercise bulemia. What is that about, athletes whom look fit and at a healthy weight, but go pukies every time they cheat on their eating schedule?

        7. Not all people with bulimia vomit to purge. Exercise bulimics binge, and then “pay” for the calories they consume by exercising. Instead of exercising because it helps them build and maintain muscle, improves their stamina, they like it, whatever, they do it to punish themselves for eating and burn off the calories they feel guilty for, and to regain a sense of control that they lost when they ate. Exercise anorexia is when you don’t binge. You just starve yourself and exercise a lot.

          to complicate the picture, our society sees as normal and even encourages small scale versions of the same psychological pathology. We’re all taught to “pay” for the food we eat through exercise or later self denial, to feel guilty or shamed about eating. THAT ISN’T HEALTHY. Just because it has been normalized within this culture doesn’t make it in anyway a good thing. So if you’re looking at my discription of exercise bulimia and thinking “but that’s normal”, this is why. Society teaches us this mindset. people with what we would consider full blown eating disorders are just engaging in more extreme versions of what society teaches.

        8. I would like to add that by the time clinicians are willing to consider someone bulimic an using exercise to purge, that person has to be exercising hours upon ours a day. Thus the more extreme I mentioned in the previous comment.

        9. My understanding is that you are less likely to die from bulemia than anorexia, but otherwise they’re both a nasty situation to deal with.

        10. Stella, can you not see how inappropriate and triggering this line of discussion is on a thread about eating disorders? Stop it, or you’ll be banned.

        11. I literally hear the first time about exercise bulemia.

          So, this, combined with what you’ve said above and below regarding obesity, lead me to believe you’re talking out of your hat. Maybe, before you make such absolute declarations, you should do a bit of research? Or even listen to the other people talking here?

      3. Exercise is like anything else – dangerous in the wrong proportions. Often people will exercise themselves (or participate in sport) to the point of severe injury, the effects of which become worse as they age. Which, hey, doesn’t mean that it’s wrong to try to push yourself to your physical limits. But it’s still pushing yourself to your physical limits, and that can have consequences. Good training and a knowledgeable coach should minimize injury or long-lasting negative effects, but not everyone gets good training or a good coach (and accidents still happen). And, yes, some people use exercise to self-harm.

        The whole “eat well and exercise” spiel glosses over a hell of a lot.

        Exercise anorexia is when you don’t binge. You just starve yourself and exercise a lot.

        And, given how weak the heart is after prolonged starvation, exercise can be what actually finally kills.

        1. Every extreme is bad. Thats why I dont see how people whom warn against anorexia and bulemia can say the other extreme, being mildly obese or even obese, is just hunkydory.

        3. Stella, I said the “wrong proportion”. Our understanding of what the actual proportion of obesity is dangerous to any given person is pretty fucking limited, as the discussion above should have clued you into.

          Ugh, I’m so sick of having this conversation over and over again. And on a fucking BULIMIA thread already. Yay for eating disorder triggers. Can we just ban Stella and be done with it?

        4. Thats why I dont see how people whom warn against anorexia and bulemia can say the other extreme, being mildly obese or even obese, is just hunkydory.

          Mildly obese is an extreme? Can I suggest looking in a dictionary under ‘M’? You may find that mild means something completely different than you think.

      4. Plus, most bulimics aren’t skinny…

        I myself suffered from a form of bulimia which wasn’t at all related to weight loss. I got into this phase where I was comfort (over-) eating (generally preceded by smoking very strong cannabis.) I would just eat so much that I’d have to make myself throw up in the middle of a meal. Because of my pre-conceived notions, I didn’t even realize that counted as ‘bulimia’ until I told my doctor about it.

  14. Actually, bulimia and anorexia are similarly dangerous for your body. Studies on this are kind of hard to interpret b/c most people who die from ED die from heart failure, organ failure, suicide…but the mortality rates are very similar (3.9 vs 4 % are the rates I have seen).

    @AttackFish, sounds like we had similar experiences in that I have ED in my family, as well (aunt and sister, just as you mentioned). Both of them have gone back and forth between anorexia and bulimia, as well as compulsive exercise. I totally agree with this:

    Our society sees as normal and even encourages small scale versions of the same psychological pathology. We’re all taught to “pay” for the food we eat through exercise or later self denial, to feel guilty or shamed about eating. THAT ISN’T HEALTHY.

    The only difference between the behavior I witnessed in some friends in college and my sister’s behavior is that she took it to the extreme. I know that is pretty much the definition of mental illness, but to me its ridiculous that we praise a person who starves themselves and exercises to the point of losing that “extra 50 lbs” and getting to a “healthy weight” (whatever the fuck that means) and then shake our heads when someone “takes it too far.” We focus far too much on weight and we call that “healthy” and then we expect people to know when to quit, even though our excessively competitive society rewards people who never quit and who strive to be the “best.” What happens when a person feels “the best” is the skinniest? Its easy, for me, to see how a person with a perfectionist type personality gets to this mindset. I seriously live in fear of my daughter have an eating disorder and I just have no idea how to teach her healthy eating habits and behaviors in a society that is just so fucked up when it comes to food. AGHHHHHHH!

    1. Unless you use steroids there is only so much weight that can be attribuited to muscle gain through exercise. Neither extreme should be encouraged obesity or anorexia. There is such a thing as a healthy weight range and with our lifestyles of sitting during work/school and sitting in the car or bus on the way to work/school few people run the risk of exercising too much.

      Not everybody has the genetics to be slim, but even if you tend towards retaining fat you need to add overeating to the mix, to become more than mildly overweight.

      1. Neither extreme should be encouraged obesity or anorexia.

        Can you name a single mainstream example of obesity being encouraged? This is a fascinating boogeyman to me.

      2. Anorexia is a type of disordered eating. Obesity is a state of someone’s body. One of these things is not like the other one.

        Also, what’s even wrong with “overeating” anyway? Food is fucking delicious and pleasure isn’t actually morally wrong.

      3. Unless you use steroids there is only so much weight that can be attribuited to muscle gain through exercise.

        Again thats just not anatomically accurate. More importantly, if you’re eating healthily and building a significant amount of muscle mass there is a very good chance you’re going to end up storing more fat because of the sheer amount of calories your body is demanding and the proportion of those calories that will need to come in the form of protein. Go watch a strongman competition on ESPN and look at the kind of body type that comes from aggressive weight training for power.

        Neither extreme should be encouraged obesity or anorexia.

        Except those two things don’t exist as part of a spectrum. As Li pointed out, obesity is having a body which weighs more than a coercive norm says it ought to while anorexia is a disease. Yes, there can be health problems that come from being fat but they have a lot more to do with individual bodies than with how far one strays from a socially constructed ideal.

        There is such a thing as a healthy weight range

        Not at the level you’re talking about when you’ve got the incredible diversity of body types and metabolism seen in the human race.

        and with our lifestyles of sitting during work/school and sitting in the car or bus on the way to work/school few people run the risk of exercising too much.

        Again you’re making broad statements about a diverse society with neither citation nor nuance. Do you have any idea how many joggers and dedicated cyclists there are? How many treadmills and stationary bikes are owned in the US? How many diet books and exercise programs are sold? P90X is a current fad thats basically built around the “eat very little and work out like a fiend” model. Its incredibly easy to work out too much and our society encourages it. If you want some evidence you can take a look at the ways in which people who run marathons are lionized.

        Not everybody has the genetics to be slim, but even if you tend towards retaining fat you need to add overeating to the mix, to become more than mildly overweight.

        Unless you have a metabolic problem. Or your body isn’t genetically suited to refined grains and sugars. Or you don’t have access to healthy food options. Or you’ve got the kind of body that needs 2500-3000 calories a day for 20 years and then changes to needing only 1800 because of a medication. Or you’re on atypical antipsychotics. Or, or, or…

    2. I didn’t realize just how screwed up our society’s views on weight were until I hit a very rough patch with my immune disease in high school, and my weight plummeted. I was vomiting all the time, not absorbing food, desperately doing everything I could with advice from my doctor to maintain my weight, and I dropped 30 pounds. I was 4’11” and slender to start with. Dropping thirty pounds left me weak, boney, and sick. Several of my teachers were convinced I was lying about being sick and really had an eating disorder. And at the same time, other teachers, students, and my sister all told me how good I was doing losing all of that weight, and I shouldn’t eat like that, or I was going to gain it all back, and oh, I must feel so much healthier now. My doctor was talking about hospitalization because my weight was so low. And when I got my body back on an even keel and started gaining the wight back, everybody kept saying “What if you become fat?” Tell me that’s healthy.

  15. I think the reason I talk about patterns of obsessive behavior rather than the causes of eating disorders is because its easier. I can talk about compulsive exercise in polite company, but I can’t talk about the soul crushing depression and self loathing that caused it without making people uncomfortable. Eating disorders are acceptable. Mental illness is not.

    And for me, there is an element of pride or maybe self satisfaction with how committed I was to my eating disorder. Its sick, but its one reason that its easier to talk about what I did rather than what I felt.

  16. I had a similar experience when I was exposed to BASE jumping. I watched an hour long documentary called “The men who jump off buildings”

    My take home message was, “You can jump off cliffs and it feels awesome!!” However most of the documentary covered the hideous injuries and failed relationships sustained by the men involved. I went off and learned how to BASE jump.

    Now I am in a very different place emotionally, and the same film scares the crap out of me.

    I think the question is; why don’t some people engage emotionally with the side effects of these addictions? I was consciously aware of the risks; 1 in 6 jumpers die because of the sport, all jumpers spend a few months in hospital, I even bought health insurance that covered BASE. I just had no emotional reaction to the risks, so they didn’t feel real.

    I think that in my case it was due to the advanced and effective child abuse coping strategies that I had developed growing up. I was used to thinking that when bad things happened to me it was ok. I was used to walking into situations that were very dangerous and abusive. At least BASE was fun, and I was in control of the level of danger.

    It might be interesting to try to identify young people who are predisposed to ignore risks, then see how this subgroup respond to material designed to educate them about; bulimia / anorexia / self harm / extreme sports / becoming a soldier ect …

    I would predict that the subgroup would only see the positives in these experiences. This might then lead to the counter intuitive message that the best way to prevent bulimia might be to not talk about it, as the kids who respond to the horror are not the ones who will do it.

    1. When I started reading this comment, I was all ready to get pissed off about it–“Right, bulimia is exactly like BASE jumping. Sure”–and then it just clicked. There would be times right after I’d purge when my heart would stutter and then start up again, and even though it should have been terrifying, I found it exhilarating. I felt like I’d beaten death. I don’t remember if anyone mentioned “Also, your heart might stop while you’re vomiting and then you die” during any ED-prevention program I’ve seen, and I don’t know if it would have been a deterrent or if I’d just have ignored it entirely.

  17. What you accurately describe is because there is an “up” to bulimia (the weight loss) and the “testimonials” are based on the 12-step model, where there really is no “up”… for instance, driving drunk has no “up” side, and you die, period.

    This reflects the dilemma in comparing eating disorders to chemical-dependency, since they are not analogous. We NEED to eat to survive, but we do not need to drink or take drugs to survive. Thus, the model won’t work in the same way. (e.g. the way to “stop” compulsive overeating would therefore be to stop eating; and that is anorexia.) This is the whole problem with the concept and why a different approach than 12-step models (and the accompanying testimonials) is necessary.

    Great post.

    1. we do not need to drink or take drugs to survive.

      Speak for yourself. Quite a few people do indeed need to take drugs to survive, and many people use alcohol and illegal drugs to self-medicate for ailments that are not being treated.

      1. Please bring a little “assuming the best intent” to the table. It’s obvious the commenter did not mean “medications.”

        1. The idea that street drugs and medications are entirely different with no overlapping features and that people who need one have no need of the other is one of the pernicious myths of the US’s puritanical anti-drug hysteria. Plenty of medications are addictive, and plenty of people use them illegally.

      2. Ah, I finally figured out the comment system. Sorry for my recent errors.

        EG –my major point was the shortcomings of the 12 step model and why it is not so easily applied to anorexia/bulimia. It was not invented for that, and does not “translate” well.

        I understand your point, and have written about it at length on my own blog.

        If my exact wording was somehow lacking, my apologies.

        1. EG –my major point was the shortcomings of the 12 step model and why it is not so easily applied to anorexia/bulimia. It was not invented for that, and does not “translate” well.

          A strong argument could be made that the reason the 12 step model doesn’t work well with ED is because the 12 step model doesn’t work well. I mean, sure, taking someone with already low self esteem and demanding that they accept that they’re helpless and need to accept Jesus sounds good and all but from a clinical perspective its kind of a crap shoot.

        2. No problem. I think that my problem is that I’m suspicious of the twelve-step model, period. I’ve heard that its success rate isn’t actually very good, and, like William, I’m suspicious of any supposedly therapeutic program that demands religious belief. I also am suspicious that the twelve-step demand for complete abstention is part of the US “all or nothing” mentality. I don’t know, I’m just dubious about the whole thing. That doesn’t mean that it hasn’t worked for people–obviously it has. But its underlying philosophy leaves a bad taste in my mouth.

        3. My experience with the 12-step model (which may not be typical) is of it going beyond complete abstention into vilification. I have no experience with eating disorders, but I am a recovering sex addict. I had had a very sharp rebound into “all sex is evil”, and I realize that is probably brought about by my overcompensation, but therapy did nothing to discourage this, and even tacitly encouraged it.

  18. Millicent, I take drugs to survive, so I know that.

    I did not, however, need alcohol to survive and nearly died from it, so cut me some slack. EG, thanks for understanding me.

  20. Sorry to backtrack, but bulimia can in fact be highly lethal. When one purges, one loses huge numbers of electrolytes – especially sodium and potassium – that perform vital functions such as keeping one’s heart beating. When I was in inpatient tx for anorexia, I remember the psychiatrist who was the director of the program telling me that the most lethal ED is probably ED-NOS, in which there’s usually a combination of anorexic and bulimic behaviours. Furthermore, bulimics can be any weight; it’s just that when one reaches a certain low BMI, one’s diagnosis changes to anorexia: binge/purge type.

    On the original topic – a number of years ago, a local celebrity who’d been anorexic in her teens wanted to go around talking to groups of school students about the evils of anorexia. The involved professionals talked her out of it, as they were concerned that it would have results opposite to the intended ones, and function to encourage ED’d behaviours. This was definitely good, as the local celebrity committed suicide several years later, and I think that would have been a real head-fuck to at least some students she might have addressed. It was certainly a head-fuck for me…

  21. But whenever I’m given the opportunity to talk about my own history with bulimia (and I’ve got some stories), I’m afraid to–because I’m afraid that in the audience of girls cringing about vomiting, there will be one girl taking notes.

    I am the same way. I feel a moral and social responsibility to not share those details. I realize that if people want a how-to guide, they will be able to find it one way or another but I don’t want to be one of those ways.

    – Jen @ Skinned Knees

  22. I’ve struggled with this for ten years. I forget how I even found out; a movie or an article or something…I went to Catholic school so we didn’t get much of the scared straight stuff…the priests and nuns were scary enough…but I digress. I still have a hard time thinking of it as a disease or an addiction…it just seems like a…thing. I thing I do when I get worried or scared about what I’ve eaten. A thing to distract me from other fears and worries. A fear of not being able to eat later because I’ve eaten too much for lunch or for breakfast…but this doesn’t happen often. I’m sorry if this triggers anybody. As a Marxist feminist, I am deeply, deeply ashamed of my eating issues. I feel like a political fraud, like something dirty, like a privileged hypocrite even though I work two jobs, and have medical assistance, so it isn’t like I’m Ann Romney or something, but I just feel like intellectually I. Should. Know. Better. I. Should. Be. Better. Luckily I’ve managed to keep the purging down to once or twice a month, only under stress, I’m managing. I’ve switched back and forth between opiates and purging, LSD and purging, MDMA and purging and it just seems like purging is the mainstay of my bad habitude. I’ll gladly rattle off my history of drug use but it kills me to admit the purging. Maybe it’s because drug abuse is considered to be a masculine thing, I don’t know, my head’s all fucked and I’ve probably offended half the commentariat by now. Blah. Off to bed before work. Thanks for letting be vocalize this.

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