I recently received a bullet in the heart: my youngest sister has started (without being conscious of it) to develop anorexic/bulimic patterns. Even though Bulimia and Anorexia are almost members of our family, it was like an electrical shock for me. I have suffered from bulimia for years now and my other sister has been quite unsuccessfully treated for anorexia; my mother and grandmother also had anorexia issues. It feels like a duty for me now to share what I have learnt from my personal experience at the very heart of eating disorders. Some researchers work on the the possibility of a genetic cause; but was I born like this? I don't think so. I believe I became bulimic because I was taught so. How did it happen? Here are some clues and perhaps the key to getting rid of eating disorders for good.
fig.1 Numbers on eating disorders (source)
Prejudice vs science
Eating disorders are as taboo as they are common: it is estimated that more than "30 million Americans suffer from [it] in their lifetime". Even though it is not a brand new disease (Freud wrote about it during the 19th century), it is still a medical mystery; doctors have a list of various causes, among which “social, psychological and biological” (Garner, D. M., Rockert, W., Olmsted, M. P., Johnson, C., & Coscina, D. V. (1985). Psychoeducational principles in the treatment of bulimia and anorexia nervosa. Handbook of psychotherapy for anorexia nervosa and bulimia, 513-514.). In other terms, nobody qualified can explain how one becomes victim of eating disorders. Nevertheless, some people who have almost never heard about it have their own hypothesis: one is anorexic/bulimic because he/she wants to be lean. I fought against this idea, during years, thinking it was much more to it than only this. Eating disorders had to have underlying causes, a trauma that couldn't be remembered of. Yet I was wrong. As a matter of fact, most of the prejudices about eating disorders are true: an anorexic deprives herself/himself of food to loose weight, and a bulimic only needs to stop bingeing & purging, to not be bulimic any longer. If the maths are so simple, why is it so hard to heal?
The condition has a very vicious establishment. It slowly turns from beliefs to habits, and therein lies the rub. Let's start with having a brief look at the Minnesota semi-starvation experiment: both physically and mentally healthy people were chosen for a large scale experiment. At first they received normal portions of normal food for some months, then the calorie intake was reduced. The experiment was exploring how the group would adapt to normal access to food after this semi-starvation period. They found that the participants developed a pathologic relationship to food during the experiment. Some would avoid the dining room when others would make dinner last by playing with food, and one even ate so much food once, that he needed an emergency stomach purge! This is typical bulimic behavior.
fig.2 Men starve in Minnesota (source)
Two brains coping with a merging problem
Kathryn Hansen, recovered bulimic and author of Brain over binge, explains what happens as such: your upper (or conscious) and lower (or subconscious) brain are in conflict, while both are trying to help you survive. This conflict is at the core of the binge & purge cycle- an evil dance between starvation and overeating. Basically, your subconscious will read the message of you being starving as a death threat and will start the binge. Meanwhile, your conscious brain, because of the wrong (and dangerous) belief that food is evil, will act on it through a purge (then you will either puke, fast, overexercise, or abuse laxatives). This is not where it stops–there is even more trouble: once you have repeated this pattern through time, the brain understands it as a process which would be necessary for survival. This is when it becomes a habit, no matter how it started. And if you have other “bad” habits- e.g. eating your nails, you might imagine how hard it becomes, passed this point, to get rid of an eating disorder.
Disordered eating habits or patterns, rather than being fed by a wrong emotional path, actually have both cognitive and physical roots. My therapist noticed that the pattern was similar to an obsessive compulsive scheme. At some point in my life I merged with food. It became more important than anything else in life, so much so that I now think about it 24/7. An important step in the recovering process will be to break this symbiotic thought. Meanwhile, the body learns from what we teach it. For example, it knows exactly how high a step in a staircase should be; if you go up stairs which are a little bit too high or too small, you will inevitably have trouble going up. The body calls for what it is used to. For eating disorders, it's the same: I taught my body that a certain quantity of food of a certain quality is unacceptable and has to be thrown up. Now, every time I eat differently from what I would like to, the food is treated as poison and it is extremely hard to keep it inside: not only my brain but also my body calls for bulimia. In other terms, every single inch of me has fallen into it.
fig.3 How I trained myself to react to panic (source)
The bottom line of this article is that I actually found the secret to not having this plague, please let me share it with you: it's to never let it in in the first place. And it starts with not restricting food intake- ever. It might be too late for me- hopefully not, but it is still something you can act on for the people you care for. Let's stop spreading silly & vain expectations that make our people sick. Let's embrace food for what it is: an enjoyable need.