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Problems

Eating disorders - Bulimia

What is bulimia nervosa?

If you suffer from bulimia, you will eat large amounts of food, often thousands of calories, in a short space of time. You may begin by eating sensibly but then find you are unable to stop and continue to eat everything available. You may subsequently experience guilt or panic and purge by vomiting, taking laxatives or starving yourself. These binge and purge cycles vary in frequency and degree from person to person.

Exactly why a person binges depends on the individual but it tends to be triggered by situations that she or he finds difficult or distressing. Focusing on food and eating is a way of avoiding other painful issues. Bulimia becomes a way of coping, yet often by the time help is sought, they usually feel that the binge and purge cycle is beyond their control.

What triggers a binge?

Keeping a diary can be very helpful when trying to identify the triggers that cause someone to binge. You could note down your thoughts as well as situations, to help you work out how you can try to bring your bingeing under control.

For instance, you may find that you are more likely to binge…

  • At certain times of the day, maybe when you are at home alone in the evenings
  • At certain times of the month. If a woman has bulimia, there may be certain times during the menstrual cycle when a binge if more likely
  • During a particular season, maybe the winter months
  • Under stress at work, or home, or before exams
  • When snack foods are around, like crisps, biscuits or chocolate
  • When you have skipped lunch or not eaten for a long time
  • In response to something disturbing that you see or read about, such as child abuse

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Ways of coping

It may be difficult to cope with uncomfortable feelings without bingeing. If so, you should seek help and a support group is often beneficial. Here are some ways to help control the urge to binge:

  • If being home alone is a trigger, you should try and leave the house, go for a walk, telephone a friend to at least delay the binge, do something you enjoy that is not associated with bingeing
  • Be kind to yourself with a treat such as massage or a favourite film
  • You should allow yourself to experience these feelings. Writing about your experiences, or drawing them will be helpful to your counsellor in interpreting your expressions
  • Seek inspiration in other peoples writings, paintings and sayings
  • Take up a new interest, enrol in an evening class or become a volunteer.
  • Ensure you get regular exercise, walking once a day is good.
  • Re-educate yourself to eat healthily - low fat products, snack on fruit, vegetables etc. Have treats maybe only at weekends.

Recovery

Recovery from bulimia takes time. It may have taken years to develop the illness and, therefore, it is not easy to break established eating habits, particularly if they have become your way of coping with emotional difficulties. The first step to recovery is to acknowledge that you have bulimia.

You need to re-establish a structured eating pattern and to try and resolve the underlying emotional problem. You are more likely to binge if you deprive yourself entirely of food. The body needs to be reassured that regular meals are available that satisfy physical hunger, as distinct from the emotional hunger that might trigger a binge. Re-educating the body is not easy and if you relapse, it should be regarded as a set back, not a failure.

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Planning meals

Bulimia tends to throw eating patterns into chaos, so planning meals will help. You should:

  • Take it gradually. Begin by planning breakfast each day for a week, then breakfast and lunch, and so on
  • Eat regularly - little and often. Six small meals a day may be suitable. This will help to avoid feeling hungry at a time when you are training yourself in proper eating patterns
  • Try and keep to regular meals, even if you binge and vomit
  • Write out meal plans for the week, it will help to not worry about what to eat and when. You can then allow yourself some flexibility, you must make sure your nutrition is balanced
  • Eat slowly to enjoy the different flavours and textures. Meals should be a pleasure. Relaxation afterwards will allow you to feel satisfied.

Food for health

Food from the following groups will ensure that you are eating a balanced meal and taking in the nourishment the body needs.

  • Bread, cereals, potatoes rice and pasta are carbohydrates; not only are they necessary but they are satisfying and will make you less likely to binge

  • Fruit and vegetables provide many of the vitamins and minerals needed, as well as fibre to combat constipation

  • Meat, fish, eggs, pulses and nuts are proteins essential for renewing the body's cells, including muscle

  • Dairy products - milk, cheese and yoghurt provide calcium for strong bones as well as protein

  • Some fat is essential for the body to function so fat must not be cut out completely

  • Plenty of fluids, especially water, should be drunk although too much at meal times will make you feel bloated. (Drinking to avoid dehydration after purging may appear to increase weight. Do not panic - allow the body to adjust itself).

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Agencies which offer support and information for eating disorders

  • SupportLine Telephone Helpline: 01708 765200, email info@supportline.org.uk - Confidential emotional support to children, young people and adults. Also keeps details of agencies, counsellors and support groups throughout UK.

  • Anorexia and Bulimia Care: 01462 423351, www.anorexiabulimiacare.co.uk - Support, information, advice, befriending to sufferers and families. Can put parents in contact with other parents of sufferers. Christian organisation run by Christians for sufferers, families and carers.

  • beat - beat eating disorders (formerly the Eating Disorders Association) Helpline: 0845 6341414, email help@b-eat.co.uk; b-eat Youthline 0845 634 7650, email fyp@b-eat.co.uk, www.b-eat.co.uk

  • British Nutrition Foundation: 020 7404 6504 - Provides information and advice on nutrition and related health matters. Produce a wide range of leaflets and books.

  • Caraline: 01582 457474, email info@caraline.com, www.caraline.com - Helpline providing counselling and support for people experiencing anorexia, bulimia, compulsive overeaters. Monthly self help group and individual counselling, specialised programmes. Helpline covers UK, local services to Bedfordshire.

  • DABS Mail-Order Book Catalogue: 01709 860023 - Books relating to Eating Disorders, Child Abuse, Self Esteem, Assertiveness, Self Harm etc.

  • Eating Disorders Research Unit, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF.

  • Gemini: www.gemini.selfhelp.btinternet.co.uk - Site aimed at eating disorder sufferers – also run self help and support group for sufferers in Beckenham, Kent. Site includes chat room and forum.

  • Independence: 01223 566130 - Publishes book Coping With Eating Disorders price approx. £5.95.

  • The International Eating Disorders Centre: 01296 330557, www.eatingdisorderscentre.co.uk - Information, advice, support to sufferers and their families. Run short residential combined out patient programmes and inpatient programmes for sufferers.

  • Maisner Centre for Eating Disorders: 01273 729818 - Deals with bulimia and compulsive eating. Offers personal consultations.

  • The National Centre for Eating Disorders: 0845 838 20 40, www.eating-disorders.org.uk - Details of therapists who specialise in the treatment of eating disorders. Also provide low cost online self help for bulimia and binge eating.

  • Northern Initiative on Women and Eating: 0191 261 7010 - Helpline and information service for anyone experiencing problems with food and for their families and professionals. The agency provides support across the whole spectrum of eating problems including anorexia, bulimia, compulsive eating, binge eating and other associated problems.

  • National Institute for Health & Clinical Excellence: 020 7067 5800 - Publish guidelines relating to Treatment of Anorexia.

  • Office of Health Economics: 020 7930 9203 - Publishes a useful book called Eating Disorders: Anorexia Nervosa and Bulimia Nervosa 1994 by Richard West. Cost £5.

  • Overeaters Anonymous: 07000 784985 - 24hr information line on a/machine. Works to relieve our compulsion to overeat/undereat or an obsession of food and dieting by living by spiritual principles based on the 12 steps of Alcoholics Anonymous.

  • Young Minds: 0800 018 2138 - email enquiries@youngminds.org.uk, www.youngminds.org.uk - Helpline and other support services for parents concerned about the mental health of a baby, child or young person. Produces a range of leaflets, reports etc.

Useful websites

Resources: EDA, SupportLine, Independence

Useful book

Bulimia Nervosa & Binge Eating: A Guide to Recovery by Peter Cooper, Christopher Fairburn - Publishers Constable & Robinson: ISBN 1854871714
Click here to read more or buy this book

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