Most people have no idea what it is really like to suffer with an eating disorder. They think it is the need to be skinny. They think the person with bulimia nervosa could quit if they really wanted to. “Just don’t do that” is a phrase repeated by family members, friends and some therapists. There is so much misunderstanding of this complex disorder that I am going to bring you into the mind of a person in the depths of the disorder. You will never view the disorder in the same way after reading this. If you relate to this story know it is common to many more people than you realize. But most important I want you to know that with help even this person recovered . . . fully.
The way I learned to deal with my feelings was not to feel. One of the ways I learned to do this was to think of something different. For instance, I looked forward to getting some candy from the little store on my way home from school. I would get a cola soft drink and a frosted pastry or candy. I always felt better when I ate that. Little did I know that I was opening a floodgate of addiction with this newly learned coping behavior.
I gained weight and decided to go on a diet. I would go for days eating nothing or very little. I lost a lot of weight, but no one said anything about it. Then there were days when I had to eat. Once I did, I could not quit. Eventually I progressed from anorexia to binge eating to bulimia and finally to anything that would make me numb. I never realized that someday my life as a bulimic would overshadow everything.
The first thought that comes to me upon awakening is what I did last night. I check my stomach to make sure my pelvic bones are the highest point and my stomach is concave. They aren’t. I use the bathroom and then weigh myself. This is the first of several times I will be stepping on the scale today. But the morning brings the most important weigh-in. This will be the lowest weight of the day and it determines the course of events to follow. Some people read their horoscope. I read my scale. The number on the scale is in direct proportion to how I will feel today.
I clean up the mess from last night. There are scrambled eggs spilled on the stove top, an empty cereal box sitting on the counter, and on the kitchen table I see an empty carton of pecan ice cream, an empty potato chip bag and empty cans of diet cola. As I am cleaning the stove top, I promise myself that today will be different. I am sick and tired of living life like this.
I look at the clock and see that the cleaning took longer than I thought. My anxiety mounts with every moment, along with beating myself up. “I’m always late… I can’t do anything right… I’ll probably get fired… I’m not good at my job… I’ll never amount to anything.” The last phrase is from childhood but it is Me telling myself this now.
Before I get into the shower, I weigh myself and check my body in the full-length mirror. I feel disgusted. My thighs are touching and my stomach is sticking out. I try to rationalize that it is that time of month and that’s what is wrong with my stomach, although I rarely have a monthly cycle. The doctor said my lack of periods is because of my hormones being out of balance, but I have so many more symptoms. My hair is getting so thin, my nails are brittle, and my skin is so dry. I’m tired all the time and there are times when I faint, especially after throwing up. I get so shaky that it’s hard to put my mascara on.
I put on my makeup carefully, avoiding looking into my eyes. When I do look into my eyes, I feel such loathing and disgust. I hate myself. I dress impeccably. I have always tried to look pretty. People tell me I am beautiful, but I don’t believe them. In fact, many people compliment me on the shape of my green eyes. If they only knew.
I feel anxious about getting to work on time and doing a good job today. I look at the clock in the car and see that I am already late. On the way to work, I make up a story to tell my boss about why I am late again
When I get to work, I try to get to my desk unnoticed. Someone brought donuts today. I decide to have one. It tastes so good. This is the best part of my day so far. I savor the sweetness. I try to make it last but the donut disappears too fast. I’ll have another one, I think, trying to recapture that sensation I feel with the first bite. But it doesn’t taste like that. I keep thinking the next bite will do the trick. The second donut disappears faster than the first. What have I done? I will gain a lot of weight from eating two donuts. I must get rid of it.
I go to the bathroom but someone is in there too. I wait for them to leave, but as they leave someone else enters. I can’t wait much longer. The calories are already dispersing into my fat cells and I have been away from my desk too long. I vomit as I flush the toilet hoping the sound will cover up my purging. I clean up and look into my blurry red eyes. It looks like I have been crying and I have broken a blood vessel in my eye. I check my stomach in the mirror and it looks bigger.
I go back to my desk and start looking for the eye drops in my purse. I keep looking and realize I forgot what I was looking for. I remember, find it and then get back to my work. I am making modifications to a software program. I write some code, then get stuck. My self-talk takes over. “Who are you trying to fool? You don’t know what you’re doing. You will never get this done in time.” I think about the donuts. That will make me feel better. I go into the break room and eat one, then another and another. I make sure no one sees me. I feel like I am in a different place, zoned out and calm at last. Someone comes in and asks where the donuts are. I answer that everyone must have liked them because I was finishing the last one. I can’t get to the bathroom soon enough. I feel like a trapped rat and I must get away to my safe place of empting my stomach
I go home for lunch. I don’t want anyone to see how much I eat. When I do go to lunch with my co-workers, I can usually manage eating very little (and then binge afterwards). However, sometimes I can’t control my eating when I’m out to lunch with them. I hear comments like “How do you stay so skinny eating so much?” I feel like I want to hide under the table and become invisible. I promise myself that I will not eat with them again. It is much safer going to the take-out window and ordering as if it’s for the whole office, but I eat it all. I even buy extra drinks to make it look like the order is for more than one person. I eat in my car on the way home and continue the feast in my kitchen. I wash it all down with diet cola and end with ice cream. Ice cream makes the food easier to come up.
I clean up the mess again, weigh myself, apply some more makeup and eyedrops, and then hurry back to work. I’m late again.
I am working on my software program when my boss comes and tells me that if I am late again there will be consequences. I think of stopping at the bakery and ordering six chocolate chip cookies and six more with nuts. I work through the afternoon feeling anxious and fearful, but know that I can get some relief when I get to the bakery.
After work I drive in a daze to the bakery. I get my cookies and I decide I will eat one in the car. After eating it, I see that it was just what I was looking for. My mind clears of all negative self-talk, my anxiety is abiding, and my fear is gone. Right now is all there is and nothing else matters at this moment. I have another cookie and another. I suddenly realize that I have eaten the last one. If I had noticed that it was the last one, I would have savored it more. I am still in the parking lot. I can’t go in again and get more cookies.
I decide I will go to the grocery store and get some food to take home. I get chips, an apple pie, more cookies, ice cream and paper towels to camouflage the contents of my cart. I throw in a loaf of bread just to make it look like a normal shopper’s cart. Besides, I can make toast and sandwiches with the bread. As I am checking out, I see the clerk looking at my items. I try not to notice. I wonder if anyone else knows what I’m doing? I will shop at a different store tomorrow.
I eat the chips on the way home. I take my groceries into my place filled with anticipation about feeling numb again. I vomit away the cookies and potato chips after drinking a diet cola and then weigh myself. I am gaining weight.
I take off my suit and change into my large food-stained T-shirt. I am happy to see that I have not stained my suit. I turn on the TV. It doesn’t really matter what’s on. I just need the noise to divert my attention from feeling anything. I half-listen as I fix a piece of apple pie with ice cream on top. It is so good. I start mentally beating myself up about all the bad things I think I have done and for who I am.
I can’t believe this has been my day again. Am I possessed or something? I eat enough for three people. Maybe I have multiple personality disorder. Maybe it is a demon possession. I can’t stop this even though I want to stop.
The phone rings and I ignore it. The answering machine picks it up. I hope they do not leave a message because then I will feel bad if I don’t call them back. I just want to be left alone. The voice on the machine is asking me where I am. Oh no, I was supposed to go to therapy this evening. She will be so mad. I can’t make appointments with anyone because I never know when I will be available and not busy with my eating disorder.
I start thinking of a story to tell my therapist. “My sister got sick and I had to take her to the hospital.” That will probably suffice for missing my appointment. I could never tell her what I was really doing.
Someone knocks at my door. I wonder who it could be. I tiptoe to the door to look through the peephole and see a man I dated a few times. I hope he doesn’t smell the food or hear the TV and think I’m home. He is a nice guy but he questioned me about being sick at the restaurant again. I told him it must be the flu, but when it happened again he looked at me funny. He might know. I can never see him again. He leaves after a while and then I vomit. It takes a lot of trying to get all the food out. I weigh myself and see the scale still is heavier. I try again but nothing comes up. When I finish, I am lightheaded. I hope I don’t faint again. People will be asking me about the bruises. I feel shaky. I fight off the urge to get more food and lie down on the bed.
I guess I fell asleep because I awoke at 2:00 am in a sweat. I was craving my favorite brand of donuts. The one store that would be open is on the other side of town. It is in a rough area. But the more I think of the donuts, the less I care about my safety. I throw on some sweat pants and a jacket over my stained T-shirt. I drive to the donut shop and it is open. What a relief! I get a dozen glazed donuts and a large diet cola. There are two drunken guys walking by and they start yelling at me to come over and talk to them. I get in the car and drive off as fast as I can. When I am a safe distance away, I open the carton of donuts. They are still warm. I put one into my mouth and everything is OK again
I get home and finish the rest of the donuts, get rid of them by vomiting, weigh myself and go to bed. I have to get up in an hour to get ready for work. I fall asleep fast and the next thing I know it is 10:00 am. I was supposed to be at work at nine o’clock. Anxiety washes over me. What now?
Over the years I have been asked if there is such a thing as food addiction. First, let’s look at what is an addiction? Here is one definition: An addiction causes people to engage in a recurring activity that causes harm to the person. It is often described as a compulsion to engage in some specific activity to produce mood-altering experiences, and this experience has life-damaging consequences.
Addictions often have both physical and psychological components. There is discomfort upon quitting the addiction. Most people would not overindulge in anything that hurts them physically, emotionally, mentally or spiritually. With addiction, one or more of these areas are negatively affected.
Now look at how addiction can relate to food. Ask yourself these questions:
- Does your eating behavior create a problem in your life, but you continue to do the same thing over and over?
- Do you eat to change how you feel?
- Do thoughts of food, weight and body size enter your mind at unrelated times? Do you feel out of control with your eating?
- Are you afraid to start eating something because you are afraid you cannot stop?
- Do you obsess about eating certain foods?
- Do you find yourself eating when you had resolved not to eat?
- Do you eat more than you want to?
- Do you use other activities or substances to stop your eating behaviors?
Not long ago, there was a potato chip ad that challenged, “Betcha can’t eat just one!” Many took on the challenge and lost. Food manufacturers have done an exquisite job of recognizing and tapping into our cravings. Why does this challenge some of us and not others?
It is a widely accepted fact that some people are more susceptible to becoming addicted than others. Some have a hereditary disposition to becoming dependent on mood-altering substances. Sometimes people are self-medicating, stuffing their feelings or are deficient in emotional regulating skills.
Any behavior engaged in repeatedly can become a habit. A habit is simply an activity that you do so often that it becomes a part of your routine. Most people observe that any activity repeated for about a month becomes a habit. It is important to be aware of the habits that we are forming. This can be used as a positive, life-enhancing activity or the building blocks of an addiction.
Even our thinking becomes habitual. Our negative self-talk can become so well established that we don’t even realize that we are beating ourself up or that it is having an effect on our life. It takes work to create a good habit, but it makes life easier. Bad habits are easily formed but make life harder.
Common Food Addictions
I have never met a client who was addicted to broccoli. Why? Although broccoli is good for your body, it does not produce mind-altering effects like some other non-foods. Isn’t it interesting that the most common food addictions are comprised of manufactured fats, chemicals, salt and/or sugar?
Many of us have our favorite food, but what makes food an addiction? If we apply our previous addiction definition of craving, obsessive thinking, and compulsion even in the face of harmful effects, we may come up with a list. See if any of these foods cause a problem for you:
|potato chips||ice cream||processed snacks|
It is important to note that broccoli and other whole foods usually are not addictive, but this list can be expanded. Looking at these items, we can see some similar ingredients – sugar, carbohydrates or white flour.
Carbohydrates are our major energy-producing food. We need carbohydrates like vegetables, fruit, whole grains, nuts and beans. Note that different types of carbohydrates turn into sugar at different rates in your body. For addiction purposes, let’s look at refined carbohydrates. These are the ones that spike your insulin level, and then drop you onto the blood-sugar rollercoaster. Even the blood sugar drop causes cravings, bingeing, depression, lethargy, irritability and drowsiness.
But there is more going on than just blood sugar fluctuations. During functional MRIs, scientists have observed that refined carbohydrates light up the reward system of the brain for some people – just like an addicted person using their drug of choice.
It is a good idea to think it through when you are tempted to consume one of these products. Do I really want to feel that way afterwards? Do I want to battle the incessant cravings again? This is one rollercoaster I choose not to ride. There are too many other factors that occur that triggers overeating. There is one sure way to eliminate this physiological response. Don’t put these blood sugar spiking foods in your mouth.
Food and Other Types of Addictions
Food addictions can progress to other addictions, starting with appetite suppressants and diet pills. Many patients at Rebecca’s House Eating Disorder Treatment Programs have progressed to methamphetamines, cocaine, speed and heroin to curb their appetite and stay skinny.
There are many forms of addictions, but let’s look at how we may be addicted to a few commonly ingested legal substances. Alcohol is probably a good place to start. Many people do not have a problem with alcohol, and they can drink normally without any consequences. They don’t obsess about it or try to control their intake. It has no power over them.
Then there are others who become alcoholics. They will tell you of the constant thinking about drinking, not drinking, getting their next drink or recovering from the effects of their last bout of drinking. This is the hell an active alcoholic lives with. The person may quit drinking only to find the obsessive thinking and surfacing feelings are too much to bear.
Is this anything like our compulsion to eat? Have you experienced that numbed out feeling during eating? Do you eat to make the feelings or thoughts go away? When something upsets you, do you look for comfort in food? I have had people tell me that they are thinking about food, weight, diets, body image, exercise, and so on about 95% of their waking hours. Does this make sense? Not for someone who has no problem with food. However, if you are trapped in the obsession of a food addiction, you know what I am talking about. Does eating really fix the situation or feeling, or does it often compound the problem?
Over the years, I have seen a great number of people recover from alcoholism only to switch to a food addiction. They use food in a similar way to how they used alcohol. I don’t need to go into the debate of which is better; I just want to point out the similarities.
I especially see people who are recovering from alcoholism also being addicted to sugar. That makes so much sense. Alcohol is metabolized in the body as sugar. Although it may not have the same devastating effects short-term, sugar can and does kill. Refined sugar is in almost everything now, even in some brands of potato chips!
You can get scientific articles about sugar addiction and download a Sugar Awareness assessment at www.SugarAwareness.com.
If you can relate to any items discussed in this article, you can get a free eating disorder assessment by calling 800-711-2062 or visit www.RebeccasHouse.org.
It was officially reported that Demi Moore is seeking help for stress, exhaustion, and substance abuse, but it also appears that Demi is suffering from an eating disorder.
Over the years I have followed her movies. I have watched her extreme body changes, diets, and exercise. Demi Moore has been engaging in an eating disorder. This has been going on for years in front of our eyes as we have watched her on the screen. It was in plain site, but most people are not even aware of eating disorders, especially exercise bulimia. Even now it is officially reported that her hospitalization is due to other causes.
If we look at Demi Moore’s highly publicized dieting we can find eating disorder behavior resembling anorexia. She used the Zone Diet, Carbohydrate Addict’s Diet, Raw Food Diet, and other extreme methods of calorie restriction. She became vegetarian eliminating whole food groups making it easier to avoid eating, which is very typical with someone with anorexia. At Rebecca’s House Eating Disorder Treatment Programs we often see patients who are afraid that if they start eating they will not be able to stop.
At Rebecca’s House we are seeing an increase in eating disorder patients who are in their 40’s and 50’s. This corresponds to recent national statistics. Typically this age group has been engaging in eating disorder behaviors for years but they have been able to keep their symptoms obscured. Demi Moore has been using over exercising (exercise bulimia) and extreme dieting, but it has been masked as preparing for her movie roles.
When women struggle with their maturing body, launching children into the world, and marital problems it can cause an untreated eating disorder to re-emerge. The focus of child rearing has provided a temporary reprieve, but even this focus to avoid looking at oneself profoundly affects the children creating a second generation of eating disorders. When the emptiness that was filled with child rearing is gone the eating disorder can become critical. With the children grown relationship problems now come into focus, marriages dissolve and that profound emptiness takes over. Women often focus on their bodies to distract themselves from the pain of relationship issues with their mate and themself.
Coping with loss, change and especially a feeling of a loss of control can send a susceptible person back into the throes of an eating disorder. Demi Moore said in a Harper’s Bazaar interview, “What scares me the most is not knowing and accepting that just about everything is not in my control. That makes me feel unsafe.” Very often women use their weight and diet as a way to control something when other areas of their lives feel out of control.
The eating disorder is used as a diversion to suppress the feelings and fill the emptiness. The thoughts of food, weight, diet, and body image soon consume every waking moment of their life. I ask my patients at Rebecca’s House Eating Disorder Treatment Programs “how much time do you spend thinking about food, weight, diet, and body image” and most will say “99% of the time”.
Earlier this year Demi Moore revealed to British Elle that she used to have an unhealthy “extreme obsession” with her body. In the recent Harper’s Bazaar interview, Demi Moore said she had struggled with body image for years. She said her deepest fear “is that I’m going to ultimately find out at the end of my life that I’m really not lovable, that I’m not worthy of being loved. That there’s something fundamentally wrong with me. …” At Rebecca’s House this is a statement we hear from almost every eating disorder patient. Low self-esteem and feeling unlovable is very evident in eating disorders.
In the early ’90s her trainer, Rob Parr, said she biked or hiked for up to two hours a day, six times a week while pregnant. On the day she gave birth to her second daughter, Scout, he said they did a 22-mile bike ride that morning. After the birth of her daughter Demi Moore wanted to be camera-ready 30 days postpartum. She was obsessed with exercise. Demi Moore’s self-confidence was bound up in her roles and her body image.
In 1996 to prepare for her starring role in Striptease, Demi Moore followed a daily regimen of long predawn runs, three hours of dance, a session with her trainer and yoga.
Then in 1997 to prepare for her role in GI Jane, Demi Moore went through a grueling fitness regime for her role. She spent two hours a day pumping iron and then ran 6 miles. She was envied for her hard body, but no one thought she could be using exercise as a manifestation of her underlying eating disorder. Then in 2003 Demi Moore, age 41, was back in the spotlight as a shockingly buffed bodied bad guy in Charlie’s Angles: Full Throttle. No one said that this could be exercise bulimia.
Demi said she was obsessed with working out to prepare for these roles but now she is kinder to her body, staying super fit with Pilates, walking, and light weight training. The recent hospitalization seems to contradict this.
But that is the most important fact about eating disorders. You say and believe you can stop on your own. That is the reason so many people die from eating disorders. Eating disorders have the highest mortality rate of any mental illness, but with eating disorder treatment you can recover. At Rebecca’s House Eating Disorder Treatment Programs, we see patients come back to life. They find meaning and purpose that the eating disorder had taken away. And most important is they are able to live without those obsessive thoughts that fuel the eating disorder behaviors. They are free!