Bulimia affects more women than men, and commonly starts in the
late teens or early twenties following a strict diet or stressful life event.
The individual most likely has a poor self-image, and places much emphasis on
needing to be thin to be attractive.
In
bulimia, the individual will try to control their weight by restricting their
diet, but then crave food and binge. This is followed by vomiting,
over-exercising or taking pills (laxatives, diuretics, diet), and are often of
normal weight.
Binge
eating can occur in the same way as bulimia, but there is no use of
weight-controlling strategies such as vomiting, laxatives, over-exercise, and
individuals are often over-weight. Others binge eat as a way of coping with
distressing emotions: extreme "comfort eating", but binge eating ends up making
them feel worse about themselves.
Common thoughts, physical
symptoms, emotions and behaviours are:
Thoughts
Negative self
beliefs: Judge self by what I eat and look like
Strict and rigid
rules about what I can can eat (impossible to stick to) - I must stick rigidly
to my diet regime
Focus of attention is taken up
with food and eating
What I should or shouldn't eat
Self-critical thoughts when don't
keep to rules: I'm a failure, I'm useless and weak, I'm worthless
I'm unattractive
and unlovable
If I start eating,
I won't be able to stop - I'm out of control
If I'm not perfect, then I'm a
complete failure
If I eat, I'll
feel better
Physical symptoms
Weight gain -
weight can vary due to alternating bingeing and dieting
Nausea, bloating,
abdominal pain
Dizziness
Dry and flaky skin
Difficulty concentrating
Sleeping problems
Dehydration
Tired, weak, run-down
Damage to teeth -
sensitive, discoloured.
Mouth sores
Swollen hands or
feet
Sore throat,
hoarse voice
Swollen cheeks
Long term:
(bulimia) anaemia, kidney
damage, lack of menstrual periods, cardiac failure, loss of teeth, stomach
ulcers, risk of rupture of stomach and oesophagus, heart problems
Long term: (binge
eating) obesity and associated health problems, including type 2 diabetes, high
blood pressure, heart disease
Emotions
Depression
Anxiety
Guilt
Shame
Low self-esteem
Behaviours
Over-eating, often
in the evenings
Controlling food
intake: try to stick to rigid diet, fail, then binge
Don't eat normal
meals
Eat alone, perhaps
at night, secretively
Attempts to
control weight (bulimia): Vomiting after
eating, Disguising sound
(run taps, flush toilet) and smell of vomiting (air-freshener, mints, perfume,
mouthwash); Using laxatives, diet or diuretic
pills; Exercising too much
to try to control weight gain, or crash diets
Vicious cycle
of Bulimia -
what keeps it going?
Vicious Cycle of Binge Eating
- similar, but no purging
Before starting any self-help
plan, particularly one that includes a diet and exercise plan - see your GP (or
other appropriate health professional)
Doing things differently
Spend some time
working out the times when you're most likely to binge - notice the thoughts
that you often seem to have, the physical sensations, the emotions and how you
react to them - then do something differently at those times.
See this page
Create a simple menu plan with a
suitable health professional - and stick to it! E.g. 3 meals and 3 snacks
per day
Weigh yourself no
more often than weekly
Exercise contract - again, agreed
with a suitable health professional. Stick to it!
(Guide - 30 minutes of moderate exercise each day, include e.g. getting off the
bus one stop early, taking stairs instead of lift)
Use medication appropriately and
only as prescribed - avoid laxatives, diet pills, diuretics
Eat with trusted family and
friends rather than isolate yourself
Don't rush food -
sit down and eat slowly, enjoying the taste.
Eat mindfully
Reward and treat yourself with
something other than food when you've done well - something relaxing or fun
Positive
self-talk - encourage yourself, tell yourself: I can do this, I am
strong and capable - find an affirmation that works for you (even if you don't
believe it at first!). Write it down and memorise it for when you need
it. See Affirmations
Be aware of those
unhelpful thinking habits, including "compare and
despair" - comparing yourself to others which trigger upsetting thoughts
Ask yourself:
Am I doing that "compare and despair"
thing where I compare myself to others, which makes me feel bad about myself?
Is there another way of
looking at this?
Am I getting things out
of proportion?
Am I underestimating my
ability to cope?
Am I mind-reading what
others might be thinking?
Am I doing that
black-and-white thinking? There are shades of grey! I don't have to
be 100% perfect, it's ok to be just ok.
What advice would I
give someone else in this situation?
Am I putting more pressure on myself, setting up expectations of
myself that are almost impossible? What would be more realistic?
Just because I
feel
bad, doesn't mean things really
are
bad.
What do I want or need
from this person or situation? What do they want or need from me? Is
there a compromise?
What would be the
consequences of responding the way I usually do?
Is there another way of
dealing with this? What would be the most helpful and effective action to
take? (for me, for the situation, for the other person)
Am I exaggerating the good aspects of others, and putting myself
down? Or am I exaggerating the negative and minimising the positives? How would
someone else see it? What’s the bigger picture?
When dealing with cravings or trying to break a
binge:
Put on
some music - sing and dance along, or just listen attentively (use music
that is likely to help you feel your desired emotion - avoid sad songs if you're
depressed)
Grounding techniques - look around you, what do you see, hear, smell, sense?
Hold a comforting object.
Engage
in a hobby or other interest - if you don't have one, find one! What
have you enjoyed in the past? What have you sometimes thought
about doing but not got around to?
Write
down your thoughts and feelings - get them out of your head
Just
take one step at a time - don't plan too far ahead
Pamper
yourself - do something you really enjoy, or do something relaxing
Positive
self-talk - encourage yourself, tell yourself: I can do this, I am
strong and capable - find an affirmation that works for you (even if you don't
believe it at first!). Write it down and memorise it for when you need
it. See Affirmations
Do
something creative - make a box of items that remind you to use the
techniques that help, or put photos on paper, or write and decorate a
list
Tell
yourself: "This will pass, it's only temporary". "I've got through
this before, I can do it now". When we're going through a tunnel and
become fearful of being trapped, there's no point in stopping - we just have
to carry on in order to reach the end of the tunnel. That light is
there, and waiting!
If you have a setback
and binge - tell yourself it's ok, it's only once - don't dwell on it too much
(other than see what triggered it so that you can then get back onto your self
help plan)
(Guide - 30 minutes of moderate exercise each day, include e.g. getting off the
bus one stop early, taking stairs instead of lift)
about doing but not got around to?
