Bulimia—Bingeing and Purging

The eating disorder known as bulimia nervosa is characterized by bingeing (rapidly consuming large amounts of food, perhaps up to 5,000 calories or more) and then purging (emptying the stomach, often by vomiting or using laxatives).b

In contrast with anorexia, bulimia is not easily recognized. The sufferer may not be unusually thin, and her eating habits may seem quite normal—at least to others. But for the bulimic, life is anything but normal. Indeed, she is so obsessed with food that everything else is unimportant. “The more I binged and threw up, the less I cared about other things or people,” says 16-year-old Melinda. “I actually forgot how to have fun with friends.”

Geneen Roth, a writer and teacher in the field of eating disorders, describes a binge as “a thirty-minute frenzy, a dive into hell.” She says that during a binge “nothing matters—not friends, not family . . . Nothing matters but food.” A 17-year-old sufferer named Lydia describes her condition with a vivid analogy. “I feel like a trash compactor,” she says. “Shovel it in, smash it, throw it out. Over and over, the same thing.”

The bulimic is desperate to prevent the weight gain that would normally result from her uncontrolled eating. Immediately after the binge, therefore, she either induces vomiting or takes laxatives to eliminate the food before it can be turned into body fat.c While the very idea of this might seem repulsive, the experienced bulimic does not view it that way. “The more you binge and purge, the easier it becomes for you,” explains social worker Nancy Kolodny. “Your early feelings of revulsion or even fear are quickly replaced by the compulsion to repeat these bulimic patterns.”

Bulimia is extremely dangerous. For example, repeated purging by vomiting exposes the mouth to corrosive stomach acids, which can wear away the enamel of the bulimic’s teeth. The practice can also damage the sufferer’s esophagus, liver, lungs, and heart. In extreme cases, vomiting can cause stomach rupture and even death. Excessive laxative use can also be hazardous. It can destroy bowel function and can also lead to ongoing diarrhea and rectal bleeding. As with repeated vomiting, abuse of laxatives can, in extreme instances, lead to death.