W2B-024 Bulimia - Nutrition-0.txt
Battle of the binge Mandy McAuley

BULIMIA NERVOSA

It will affect one in eight females. It can cause internal rupturing, infertility and tooth decay. Bulimia Nervosa may not be as visual as anorexia, but it's equally destructive. Mandy McAuley talks to Rebecca, survivor of the battle of the binge.

BULIMIA NERVOSA will affect one in eight females at some stage in their early adult life. Trapped in a self-destructive cycle of uncontrolled bingeing, forced vomiting, and laxative abuse more women are opting to deal with their emotional insecurities behind closed doors. Unlike anorexia nervosa, which triggers a range of highly visual and immediate side-affects, bulimia nervosa remains a secretly tolerated disorder. It is notoriously difficult to detect in its initial stages, and many sufferers receive no form of treatment until serious physical and <{> psychololical damage has occurred. To date medical research has linked prolonged binge-vomiting with internal rupturing, tooth decay, heart attacks, epileptic fits, infertility and severe mood swings.
Rebbecca's Story Rebecca is a 35 year old design specialist. Now in the recovery stages of the illness her impeccable appearance and confident manner belie a 15 year on-off battle against bulimia. A self-confessed perfectionist, her low, husky voice lends the only clue to years of self-induced vomiting: "It happened when I was 20. Up until then I was always on yo-yo diets but I was never anorexic. As far back as my early teens I regarded food as a primary source of comfort. One evening I was baby-sitting for college friends and I became so frustrated and depressed that I yearned to eat everything they had set out for me plus any food left in the cupboards. At that stage the overwhelming fear of obesity was the only factor holding me back. Suddenly the magic idea of being sick came to me and that's exactly what I did. It was a very painful and tearful experience but within the space of two years I was managing to make myself sick up to 12 times a day."
Unable to cope with emotions of any kind Rebecca freely admits convenient transition: "It was a vicious circle. The more emotions I felt the more I ate to cover them up. I used the food to anaesthetise myself - it gradually helped me to opt out of life and living. I was thankful that I had stumbled upon a convenient escape route from the pressures of a fledgling career and stormy personal relationships."
"The actual disposal of the food made me feel good because I could exercise some degree of control over my life without getting fat. That initial high inevitable plunged to depression when I thought of the amount of money, food, and sheer energy that I had wasted."
Food for thought
As her illness took on obsessive proportions Rebecca's life revolved around food - where to get it, what to eat next, and how to get rid of the evidence: "I was literally eating and throwing up. Occasionally I would get up in the middle of the night to be sick. When my stomach threatened to seize up I dosed myself with laxatives or stuck things down my throat until the rawness and swelling became unbearable. Keeping the illness from those around me was the hardest part. Rather than arouse suspicion by disappearing to the toilet after meals I resorted to vomiting into a bucket and bin-bags which I kept locked in my private study. I usually disposed of the evidence around the garden hedges or poured it outside the drains when no-one else was at home. At one stage I rarely ventured into friends'bathrooms without a spray deodorant in my bag and elastic bands to tie back my hair. Fear of discovery kept me away from local grocery outlets. I travelled miles each day purchasing fresh supplies of food."
Denial
As personal relationships and a promising career crumbled under the strain Rebecca clung to food as her last source of comfort: "Desperation merely fuelled the illness although I convinced myself that I was still in control of the habit. By now family and friends feared that I was hooked on drugs. Alarmed by my secretive behaviour and sudden mood-swings their genuine concern sparked a vehement, almost vicious, denial of the illness." After more than two years of persistent self-abuse Rebecca was forcibly admitted to hospital where she underwent months of intensive treatment. Angry that she had been compelled to seek help she continued to deny that she had a serious psychological problem: "In the early '80s hospitals were dealing mainly with anorexics. I was put in a bed beside anorexics which suited all of us since I was more than willing to eat into their limited food quota at every opportunity. Some of the nurses wondered why I had been admitted as a long-term patient. They never got to see my crazy behaviour or destructive mood-swings simply because I was not allowed access to large amounts of food. Although the standard of treatment is higher and more varied today, at that time it tended to focus on the bulimic's physical condition rather than their long-term mental well-being. Desperate to return to my comforting world of binge-vomiting I quickly perfected the art of acting normal. Looking back I don't think that anyone could have helped me at that stage since I had not yet accepted that I had a problem. Ultimately all forms of treatment are doomed to failure if the sufferer lacks the sheer will to confront the illness and get better."
Ability to deceive
On her release from hospital Rebecca's physical condition had dramatically improved. Her determination to binge-vomit was stronger than ever: "I knew that it wasn't normal behaviour but I didn't even try to stop. Humiliated that the more disgusting aspects of my disease had been so ruthlessly exposed I resolved to cover by tracks with more elaborate ploys and lies.
"Most of my family didn't know how to react to the revelation. Although my parents were deeply shocked and upset the illness was simply beyond their realm of understanding. People tended to adopt a cautious approach. They never referred to bulimia in conversation but I was painfully aware of them watching me and I didn't like it. Weeks after my release from hospital my brother found a bucket of sick in my study. I was sorry that the discovery affected him so badly. He was nothing but repulsed." The bewildered reaction of Rebecca's family and friends stemmed from their inability to cope with the self-destructive nature of the illness. By refusing to accept or even acknowledge offers of help she fuelled their feelings of inadequacy and despair. Alarmed by the intensity of her mood-swings, few could begin to understand why this attractive and intelligent young woman was so intent on committing a slow form of suicide.

Stress related
Like many of her fellow sufferers, Rebecca had been a conscientious and ambitious teenager. Her illness baffled those who had singled her out an early age as a potential high-achiever. Today Rebecca attributes the failure to take control of her life to over-protective parents and an oppressive education system. While both demanded outstanding results, neither encouraged self-motivation: "Part of my problem was growing up in an environment where I was never allowed to think for myself rather than pursue my own goals. I resorted to people-pleasing at an early age. Eager to impress parents and tutors but incapable of taking decisions I sought advice from hundreds of people about the choices I should make at various stages in my career. Inevitably I ended up more frustrated and depressed. I tortured myself for being half-pretty and half-talented. Terrified of failure I developed a complex that I did not have.
Sick of being sick
Rebecca was not ready or willing to get better until 19 when she reluctantly contacted Overeaters Anonymous (OA), a self-help fellowship which caters for overeating and bulimia. There she finally learned to think and feel for herself. "By 1988 I was literally sick of being sick, of the hiding and deceit. After years of half-heartedly doing the rounds of doctors, psychiatrists, self-help groups, and treatment programmes I actually began to think about getting better.
"OA encouraged me to recover at my own pace. I was never bullied into contributing to group therapy sessions. You can sit there for a year without even introducing yourself. Simply listening to others talking about their experiences of the illness relieves the loneliness and a great deal of pressure. Six months passed before I was ready to open up and really explore my emotions. It was a terrifying experience but I had tremendous support from people who were like me and knew exactly what I was thinking. There was a great sense of solidarity and guaranteed anonymity. Eventually I began to realise that I could think and feel without food."

One day at a time
Rebecca continues to attend OA on a regular basis. Rebecca continues to attend OA on a regular basis. Since 1988 her bouts of binge-vomiting have grown sporadic. Although she remains convinced that there is no absolute cure for the illness she is now dealing with her bulimic tendencies on a day-to-day basis. "Fighting bulimia has been an up-hill struggle I will always feel nervous and slightly vulnerable around food. Bulimia is like gambling or alcoholism. It's a turning to something else because you can't cope with the basic demands of living. "Although I do sometimes resort to binge-vomiting it's mostly stress-related. I no longer use food to hide from my feelings. Over the last five years I 've discovered an inner strength which has helped me to rebuild my career and make ammends for the pain inflicted on those closest to me.
