Bingeing and Purging: Breaking the Bulimic Cycle

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The cycle of bingeing and purging is exhausting and demoralizing, yet it is a pattern that many people with bulimia seem powerless to control. Stopping the cycle can be immensely difficult. As someone who has struggled with this cycle, Linette describes her experience:

I have committed I won’t eat my trigger food, cookies, because gaining weight is unacceptable to me. Sometimes when I see them I can resist, other times I think I will have only one. Most of the time, I feel an indescribable pull to eat them. Once I eat a cookie, I instantly feel awful and think that I have a self-control problem. Most of the time, since I know I am going to purge anyways, I think of all the other things I can eat that I usually do not allow myself. I often spend over an hour going through my cupboards or driving across the city to get some specific food before I actually purge. After I am done, I am filled with guilt and regret. I know this isn’t helping me, but I just do not think that I can stop.

In the mind of a person with bulimia, mental space is often occupied with thoughts of food, their body, worry about their body weight and shape, fear of eating, and worry about how to get rid of the food they have eaten. In addition, many people with bulimia feel intensely out of control when they are bingeing and/or purging. Learning how to stop this pattern of powerful cravings coupled with the all-encompassing urge to get rid of the food they have ingested is a great deal of work. Here are some insights into where to start interrupting the cycle and some changes that could help break the cycle.

1. Take an honest look at the benefits and the costs of the binge purge cycle.

While many people say they know it is not good for them, they do not have good insight into the reasons and costs of continuing the behavior. Most people do something because it serves an important function in their life. For the person with bulimia, the cycle has a personal and important function. In addition, choosing to stop means letting go of the benefits provided by the disorder. I encourage people to write out the benefits of continuing with the eating disorder, and the benefits and costs of letting go of the eating disorder.

2. Make a commitment to take action.

If this has become a serious problem, a person with bulimia has to move from thinking about wanting to stop to making a plan of action to stop. Once the plan is in place, they can start taking action. Making a commitment could mean writing a commitment to yourself, telling a partner or friend, or asking a mental health or medical professional for help.

3. Get an accurate baseline of your problem.

To understand how to best solve each person with bulimia’s problem, it is important to see where they specifically struggle. Self-monitoring is an incredibly useful tool to understand what is working, what isn’t, what the triggers are, and where the high-risk situations are. While this may require some time and effort, it is incredibly beneficial. It helps to establish patterns, connections, and triggers.

4. Think of the eating disorder as a problem that needs to be solved, not a character flaw.

Even once the person with bulimia is aware of the costs, where the problem exists, and wants to change, the change process can be hard. The more pervasive the problem, the more daunting the task. Solutions may include learning how to properly meet the body’s energy needs, working to normalize eating patterns, learning impulse control strategies, enhancing emotional regulation, or improving self-esteem.

While stopping the binge-purge cycle may look like a lot of work, imagine a life without fear of losing control of eating, the constant fret of weight gain, or the worry about how to get rid of the food ingested. To do this, the person with bulimia may need to be willing to let go of some of their body and food ideals and see life in a new way. In many cases, medical or mental health interventions are part of the recovery process. While it can be hard to tell your medical professional, there are health related consequences of bulimia that should be monitored.

While the person with bulimia may feel trapped, there is a way out. Some helpful places to start are talking with your health care provider, a psychologist, self-help workbooks, or Anorexics and Bulimics Anonymous.

Amber McKenzie, MSc, CPsych
Trainer, Crisis & Trauma Resource Institute Inc.

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References

McCabe, R.E., McFarlane, T.L., & Olmsted, M.P. (2004). The overcoming bulimia workbook: Your comprehensive, step-by-step guide to recovery. Oakland, CA: New Harbinger.
Anorexics and bulimics anonymous: The fellowship details its program of recovery for anorexia and bulimia. (2008). Anorexics and Bulimics Anonymous.

Fairburn, C. (2008). Cognitive behavior therapy and eating disorders. New York, NY: The Guilford Press.