Feeling Out of Control over Food, Weight and Life
Anorexia and bulimia appear to be quite different disorders. People with anorexia practice self-starvation. People with bulimia tend to alternate between bingeing or overeating and getting rid of the food or its effects (the purge).
What they have in common is that they are both the outcome of attempts to control eating and weight—attempts that have become extreme, damaging, and entrenched habits.
If you tell a person with anorexia that she must start eating more to restore her body weight, she will often comply with your demand but then cross over into bulimia as a way to maintain a feeling of control.
If you tell a person with bulimia that he is not allowed to make up for overeating, he may just decide to adopt a rigid, restrictive diet to make sure that he does not gain weight.
In other words, you cannot force a person to give up a severe eating disorder. Like it or not, this is the situation, so we must find a way to help people without just converting their eating disorder into another form.
How to Identify Anorexia and Bulimia
Severe eating disorders are the most lethal mental illness. Even if a person does not eventually die, he or she can suffer from terrible health, emotional, and lifestyle problems as a result. A person in therapy for a severe eating disorder is in a race with time to recover.
Here are some of the symptoms and consequences of these disorders:
- expressed fear of weight gain
- evidence of secret binging – missing food, hidden food wrappers
- frequent or severe dieting & fasting
- excessive exercising
- use of vomiting (ipecac), diet pills, laxatives, diuretics, enemas to promote weight loss
- frequent trips to the bathroom, especially after meals
- food rituals
- preparing food for others & not oneself
- avoidance of events where food is present
- preoccupation & talking about food & weight
- isolating oneself socially
- critical of self: perfectionistic attitudes
- mood swings
- strong need for approval
- dressing in bulky clothes to hide weight loss
- Note: Many people who have eating disorders have no weight-related symptoms
- weight loss or gain
- no weight gain, despite frequent binges
- feeling cold
- fainting or dizzy spells
- swollen glands
- puffy cheeks
- broken blood vessels under eyes
- tooth decay
Don’t delay treatment!
Anorexia and bulimia are serious eating disorders that begin with dieting and exercise and progress to a physically damaging or even fatal mental illness. It is important to identify and address these disorders as soon as you suspect they are present. As your therapist, I can help you understand the complex nature of the problem, and how your eating and weight control efforts also serve important purposes in your emotional life.
I will not pressure you to change your behavior as this rarely works. Instead, we will work together to find ways for you to cope with feelings and situations that are difficult for you. As your therapist, I will suggest ways to get your eating under control and improve your body image.
As you recover, your self-destructive eating behaviors will subside, because you will no longer need them.
Recovery is possible, but it takes time.
This is the most important thing to keep in mind as we work together.