What goes on in the life of someone who struggles with binging and purging in bulimia nervosa? The possibilities are many, of course, but getting a glimpse of the lifestyle that accompanies this eating disorder may shed light on the behaviors of someone you know.
Food in the Lifestyle of Bulimia
To live a bulimic lifestyle, a person must have access to significant amounts of food. This usually means frequent shopping trips or fast-food runs. Because there is a great deal of shame associated with bulimia, it is common for shopping to occur at a number of locations to avoid arousing suspicion.
Food costs money. How much does someone with bulimia spend? It varies, but a food bill of $30-$50 a day is common. In extreme cases, this amount can be much higher -- even hundreds of dollars.
Binging and Purging Rituals in Bulimia
Bulimia nervosa usually manifests itself in rituals. The individual will have particular foods that go into each binge. As the person becomes more experienced, she will settle on foods that are easier to purge afterward (if she purges by vomiting, at least). Frequently, she will eat her food in familiar surroundings at predictable times, because interruptions to the binge/purge cycle are very threatening: Again, it is important to her that no one knows.
In advanced bulimia nervosa, the kind on which media outlets usually report, the binge/purge cycle can occur 20 times per day or more. More common is to binge and purge a handful of times per day.
The Demand for Convenience
Because of the need to purge, a person with bulimia often will plan his day around the availability of convenient outlets for this behavior. He may refuse to join friends for meals at restaurants because of the chance that he will not be able to purge soon enough after the meal. The bathroom at the restaurant chosen may be unavailable, or not private enough, and it is absolutely unacceptable to wait until he arrives at home: By that time, she may have digested some of the food (actually, food begins digesting right away).
Bulimia and Laxative Use
Some persons avoid purging by vomiting, choosing laxatives (or purgatives) instead. Laxatives are readily available and inexpensive, but buying a bunch at a time can raise eyebrows at the drugstore's checkout line. So, buying laxatives may mirror the process of buying food, with purchases occurring at a number of stores.
In mild cases of bulimia nervosa, one or two doses of the laxative of choice may be taken per day. But the body builds a tolerance to them, and it may take more and more laxatives to achieve the desired effect. Some take hundreds of laxatives per day. This trains the body's digestive system to underfunction, making digestion difficult if and when normal eating patterns begin later.
Loss of Time and Money
As bulimia worsens and the frequency of binges and purges increases, the disorder takes more and more time to maintain. A single binge/purge cycle may only take twenty minutes, but ten or twelve such cycles waste several hours. Shopping requires extra time as well. Preoccupation with binging and purging, however, is the most insidious time sponge. When someone who knows she will binge and purge later thinks about it constantly, as she often will, there is little opportunity to be productive.
Time loss is still greater for those who compensate for binges with exercise. Exercising several hours a day is common.
Since those with bulimia often spend lots of money on food, they may have less money for other things. People close to those with the disorder may be puzzled about their inexplicable lack of money. In some cases, having no money can contribute to shoplifting behavior.
Bathed in Shame
When asked to describe the time between a binge and the subsequent purge, most persons with bulimia will decline. It is usually a very short period of time -- a few minutes at most -- and the time in which those who struggle experience the greatest levels of shame. Because they generally believe that they should be thinner, and that binging proves that they lack control, people with bulimia are at their lowest points when they have ingested food that they intend to purge. Purging, then, becomes a relief: It may be shameful to be in the cycle of binging and purging, but in the moment it seems far less shameful than it is to eat too much and let it digest.
Bulimia Is an All-Encompassing Lifestyle
As it progresses, bulimia nervosa takes over a person's life. It compromises the body, uses up time and money, limits social contacts, and narrows emotions to those that support the disorder itself.
At the same time, it is comforting in its predictability. Giving up the disorder means having to fill all the parts of life that the eating disorder has taken -- making choices about how to spend money (rather than having the choice made by the disorder), rebuilding friendships, and finding ways to be productive with time. It is these life-giving things that many of us take for granted that are so frightening for the person with bulimia nervosa.
Source:
Thomson G. Eating disorders. At humanillnesses.com. Accessed 09/24/06.
