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How can I tame my eating disorder?
January 22, 2013 6:07 AM   Subscribe

I have had an eating disorder for years, but only sought professional help recently. I'm on a waiting list for therapy, but I don't know how much longer it will take to get an appointment. Looking for books/hacks/advice...anything to try and get myself back under control.

I'm 38, female, and otherwise very physically healthy and fit: gym for weights and cardio 4x a week, very rarely get sick, not over/underweight. I know a lot about nutrition and eat very healthily (except my binge food). I take no medication except 150mg of Pristiq daily. I don't have private health insurance (nor am I American/in the U.S.).

I have been bingeing and throwing up since my teens, with a few weeks/months of respite here and there. I currently live alone, but even when I didn't, I managed to hide this very well. About 3 months ago, I got up the courage to tell my doctor (general practitioner), and cried the whole time, I was so embarrassed. He referred me to a program run by a psych who has an excellent reputation in this area; unfortunately, it's government-funded and I went to the bottom of the waiting list because I have a healthy BMI and am therefore considered to be not in immediate danger.

At this point, I am bingeing and throwing up nearly every day. Does anyone have any mental tricks, or book recommendations, or self-administered CBT...anything to help me calm things down until I can get seen by a professional? I know I should just stop, but I can't. I've read the previously posted questions on this topic, and have taken some useful stuff from the answers, but none of them really address my question. It's not even about my weight anymore: I know, objectively, that I'm not technically overweight (I'm nearly 6 foot tall and a US size 6-8), but many days I feel it. Even when I'm feeling relatively good about myself, though...I can't stop the bingeing and purgeing. How can I slow it down until I get help?

I can't afford any other options, and I am desperate for absolutely any advice. Thank you.
posted by anonymous to Health & Fitness (28 answers total) 10 users marked this as a favorite
 
My eating disorder was different but perhaps the most important thing I learned that eventually helped me to get on top of it was that if I fucked up one day that wasn't the end of the world. Pick it up again the next meal/the next day. And don't try to make up for that error by overdoing it. Just keep trying; don't give up. Some times you'll be strong. Sometimes weak. Accept the faults without overcompensating for them and also reward yourself emotionally for success (don't punish yourself for failure).
posted by seanmpuckett at 6:13 AM on January 22, 2013 [1 favorite]


Hang in there, it gets better.

I have found the Tapping Technique to be a great obsessive thought disrupter. It's used by people with PTSD, and can help you de-stress and get into a better place mentally.

Here's a You Tube

Here's another

Intuitive Eating was recommended by my therapist and I found it to be very helpful.

Those of us with eating disorders fight it everday. I'm a compulsive overeater and I have to be mindful and questioning of my impulses to eat all the time. It's hard, and although I'm still fat, I'm not mindless munching garbage any more.

You are not alone, and you are just fine, exactly the way you are.
posted by Ruthless Bunny at 6:16 AM on January 22, 2013 [7 favorites]


You may be able to find a support group nearby. Go to a meeting. They may also be able to point you to other resources in your area.
posted by inturnaround at 6:16 AM on January 22, 2013 [2 favorites]


I've heard really good things about this book: Overcoming Binge Eating. Hang in there.
posted by whalebreath at 6:17 AM on January 22, 2013 [1 favorite]


Many people have gotten relief from Overeaters Anonymous, a 12 step program. Members have all sorts of eating disorders. It only costs a buck.
posted by shothotbot at 6:22 AM on January 22, 2013


Eating disorders (binging and bulimia particularly) have a high co-morbidity with alcohol abuse/dependency. if this is true for you go to an AA meeting. A failure to manage the alcohol abuse/dependency does not bode well for successfully managing the eating disorder. I would also encourage you to consider Overeaters Anonymous. Wishing you the best of outcomes. It is one difficult disorder but it absolutely is manageable. I know this as a professional and a father.
posted by rmhsinc at 6:31 AM on January 22, 2013


I'm so sorry it is taking so long to get help. Seriously, I feel for you. You aren't alone in this. I agree with above about looking in to support groups in your area.

I don't have much experience on the purging end of things, but I have a long history of bingeing and that is how I got myself up to 335lbs (and I'm only 5'4"). It can be so hard to ignore that need/desire to binge. For me the root of my binge eating was loneliness and being intensely self critical. I never thought anything I did was good enough, and I tried to eat away those feelings of inadequacy.
- I still struggle but the thing that helped me the most was have everything in the house pre-portioned. Realizing that I am a "package eater" has been a huge turning point. If I had a bag of chips I would eat the whole bag. If I had a single portion bag I would be a lot more likely to stop at just that.
- I started tracking my food. Well, I joined Weight Watchers, but the act of tracking everything I ate had a profound effect on my bingeing. It is one thing to binge and then try to pretend it wasn't that much or that it didn't happen. Seeing it in black and white how much I actually ate was a major wake up call that helped me break out of it.
- I also have had to learn (which took a while and I still struggle with someone) to stop before I eat something and check in with myself, ask if I am actually hungry or if I am sad/lonely/upset/bored/etc. I even put notes in the fridge and in the cupboards (which I moved around frequently so that I'd continue to notice them) prompting me to stop and think about why I was eating.
- I figured out what my trigger foods were and tried to keep them away as much as possible.
- I tried to replace the bingeing activity with something else. I became obsessive over the gym and working out, and now when I am upset, rather than punishing myself with food, I "punish" myself with a big workout. This worked great for me beacause it distracted me from my binge desire, it still was hard and punishing (but in a good way), and it helped me lose weight and get healthier, which has increased my feelings of self worth and confidence.
- I had to learn how to keep things in perspective. I have lost about 100lbs but occasionally still binge eat, and when I do I still get really upset but I also try to remind myself that one slip up does not equal total failure. I've had to learn to be kinder to myself.
- I am extremely open and upfront about my bingeing with my partner. If I am upset and feel strongly that I "need" to binge, I tell him so. I tell him that I'm in a bad place and am feeling like I need to eat my feelings. I also tell him to remove trigger foods/whatever I am bordering on binging on and he will. Bringing it out in the open and not having it be a toxic secret helped a lot. You say you live alone -- is there a friend you trust that you could call and talk to when you're feeling that way?

As for purging, I have a close friend who has struggled with that. What has helped her has been to start a workout routine (which you're already doing), and also to be open about it and talk to people when she is feeling like she's feeling that way.


I hope that you're able to get in to therapy quickly, but until then remember that you aren't alone and this is something a lot of people struggle with. It CAN and WILL get better. You've taken a huge step in the right direction by telling your doctor, and that makes me feel like you're ready and strong enough to break out of this cycle.
posted by PuppetMcSockerson at 6:33 AM on January 22, 2013 [4 favorites]


After struggling for over 20 years with bulimia, I finally stopped and have been free of the for over 10 years now. What worked for me was to eat low carb. I read Atkins and followed the diet down to the letter. Any processed carbs totally throw me into a tailspin with cravings and out of control eating. It's a horrible cycle, but once I tamed the cravings by eliminating flour and grains from my diet I was able to stop binging and didn't have the absent minded compulsion to eat any more. I would start a binge in a bit of a trance, like I had no control over my actions. Also, take a lot of vitamins that are recommended in Seven Weeks to Sobriety helps a lot. I would read that book too, as it there some interesting information on the link between alcoholism and vitamin deficiencies, which are also linked to bulimia and other addictions. Grains and especially white flour is like crack from some people. I can't even eat brown rice! But I eat tons of fresh food, veggies, nuts, meat and dairy. As much as I want and never gain weight. Think the Paleolithic diet.
posted by waving at 7:10 AM on January 22, 2013 [7 favorites]


The Archives of Resistance
posted by vitabellosi at 7:20 AM on January 22, 2013


When struggling with body/food related anxiety I at one point took down every mirror in my house because I figured out that it was somehow triggering for me.

Same for anything else that seemed problematic: scales, certain foods, certain people, clothes that felt small, alcohol, etc. They were all removed until I felt like I had my head on straight enough to be in the same room with them.


Hang in there.
posted by skrozidile at 7:21 AM on January 22, 2013 [1 favorite]


Can you contact your doctor to find out if there are any support groups in your area to go to while you wait? Or are there help or support lines you could ring and ask, they don't have to be an eating disorder helpline. I don't know where you are based but in Australia (and the UK I think) there is an organisation called Lifeline and they have trained volunteers that help with everything from substance abuse to suicide prevention pretty much anything. They are amazingly supportive and good listeners if you need to talk to someone and it is all anonymous so you don't have to be self conscious. They have a great deal of information on hand on resources that are available. It might be worth you seeing if a group like this is available where you are that you can call.
posted by wwax at 7:29 AM on January 22, 2013


There's an online version now of a self-help-based CBT program for bulimics--Overcoming Bulima--that was originally developed as a CD-ROM program and that has been the subject of multiple clinical trials over the past decade. I don't have personal experience with it, and it's also more costly than a book (65 GBP). Requires registration and, annoyingly, the use of Firefox as your web browser.

If you haven't already, check out the Something Fishy site and boards.

I've heard good things about Life Without ED, by Jenni Schaefer. I've also heard good things about Intuitive Eating, and the writing of Geneen Roth (Feeding the Hungry Heart and several other more recent titles) may or may not resonate with you, but I find it pretty enlightening.

One thing that may be worth thinking about in the meanwhile is about what exactly constitutes "healthy eating" (or healthy exercise) for a person with an eating disorder (e.g., see orthorexia, or exercise purging). It may not be the same thing as what gets called "healthy eating" for a general population obsessed with dieting and weight loss.
posted by drlith at 8:11 AM on January 22, 2013 [2 favorites]


I think you've gotten some great advice on the bulimia end of things, so I'll recommend that you also make another appointment with your regular doctor and one with your dentist. Years of stomach acids flowing through your esophagus and over your teeth can do some pretty serious damage, and it would behoove you to get your physical health evaluated. There are also other complications that your GP should evaluate you for--anemia, kidney and liver damage, heart irregularities, and osteoporosis.

Of those things, it turns out that I bought myself some kidney damage and severe osteoporosis due to anorexia/bulimia during my teens and early 20s, and it was worth finding out so that I could get some monitoring and treatment of those issues.

Be kind to yourself. Eating disorders can be worse than drug addictions--recovering drug addicts aren't forced to consume and manage their reactions to their drug of choice three times a day or more. You've already done the hardest thing, admitting that you have a problem and telling someone else. While waiting for professional help, consider trying Don't Break the Chain. I've found it helpful for everything from remembering to take my bipolar meds to eating healthy and exercising.
posted by xyzzy at 8:16 AM on January 22, 2013 [5 favorites]


You don't say a lot about what your triggers are, but I have a thought. When your feelings/desire to binge become very intense, do something physical as a distractor. This is a really helpful tool taken from Dialectical Behavior Therapy. You can check out a workbook on DBT, such as this one (a lot of them are written for people who have a diagnosis of Borderline Personality Disorder, but what we know is that this technique frequently works well for people who engage in a dangerous self-harming behavior as a result of intense feelings that they're not otherwise able to manage, so please don't interpret my suggestion as a diagnosis of BPD, because it's absolutely not).

Here is a website with some decent info on "self-help" DBT. I would encourage you to focus on the "Distress Tolerance" lessons/concepts until you are able to work directly with a therapist. Hang in there!
posted by so_gracefully at 8:18 AM on January 22, 2013 [1 favorite]


Also wanted to add: I obviously don't know what path you have followed in your pharmacological history, but in that realm the first-line medication of choice for treatment of bulimia is Prozac/fluoxetine (at a fairly high dose). As with everything related to "head meds" very YMMV, and you may have been there/done that in the past for treatment of depression with zero or negative results. If you've not tried it, though, it's worth discussing with whomever is prescribing your current medication.

And in addition to being checked for the medical complications that xyzzy mentions, there are certain electrolyte imbalances such as potassium imbalance which should be tested for. These are the result of frequent purging and can be are dangerous in general (leading to cardiac irregularities and other problems), especially if you are engaging in strenuous exercise. I mean, not to cause you panic or anything, but there are all kinds of medically dangerous but asymptomatic complications from bulimia other than low weight, and your GP should rule those out in the meanwhile, if s/he hasn't already.
posted by drlith at 8:37 AM on January 22, 2013


I've heard good things about Brain Over Binge. I have not had an episode of all-out binge eating since reading it several weeks ago, but I've definitely overeaten. I'd stopped making myself throw up a few years ago after a couple of decades of it because it was destroying my teeth. Somehow that was enough to stop (and then I started just binge eating without purging.)
posted by indognito at 8:59 AM on January 22, 2013 [1 favorite]


Also, typed my last answer in a rush, but feel free to MeMail me if you would like any support. Bulimia is a profoundly shitty disorder and you have my best wishes for overcoming it.
posted by indognito at 9:22 AM on January 22, 2013


Is there a possibility of seeing a sliding scale therapist who specializes in eating disorders? It sounds like you really need help - if you haven't spent a good couple of hours on the phone sussing out your options, try to do that. I'm afraid internet stranger advice is only so helpful.

Seriously, I worry that every thought I have of how to help you maybe end up hurting you more. I'm glad that you're seeking help - bulimia is serious shit that can go undiagnosed for a long, long time.

The only suggestion I feel moderately okay giving: Is there a specific way that you binge? And is there a way to put up some sort of barriers to binging in this particular way?

I know you can't afford fancy treatment, but there are affordable therapy options.
posted by ablazingsaddle at 9:41 AM on January 22, 2013 [1 favorite]


It really depends on your triggers. I know that one of mine was feeling angry or overwhelmed. So whenever I felt those feelings, I identified them, and then I did angry artwork. Throwing paint, beating clay, even just tearing up paper. Anything that was cathartic. It was a small piece in a much larger web of treatment, but that always styands out as the thing that helped the most with urges.
posted by picklesthezombie at 9:45 AM on January 22, 2013 [1 favorite]


What waving said! I have struggled with weight all my life, and started Paleo for New Years. (I've done Atkins before, but stopped when life shit happened.)

What is good about Paleo (and other low-carb) is that you really start to feel the satiety. I haven't been watching portions, but because I am not getting carb cravings, I don't have the desire to binge. I'm really beginning to believe binging has much more to do with carb/sugar cravings that I previously thought.

The other thing that's helped me is to get rid of all of the bad food from the house. I only have meat, seafood, fruit, and veggies. A few times I've wanted to binge but since I didn't have any crap food around, I had some baby carrots. It takes 7-14 days, I think, for your body to adjust, but I've been feeling healthier than I have in years.
posted by Chaussette Fantoche at 11:56 AM on January 22, 2013


Yay!!!! You reached out for help!!!! Twice!!! That's awesome.

I'm a recovering bulimic. I haven't purged in over 2 years. I realized the other day, I had forgotten that my new office has individual bathrooms and how awesome that would be for puking in. So, I hear you.

Bulimia's a bitch.

-if you're doing it every day, you need a bone scan (DXA) and an EKG.
-The very first thing other than therapy that I found to be helpful was a coping bank. I made about 100 cards for things that I could do other than binge or purge. If one didn't work, I moved on to the next one and so on.
-I promised myself 3 minutes, meaning, no matter what, I would wait 3 minutes before I binged or purged. Sometimes (and only sometimes, it's not a cure-all) it allowed some distance between me and the coping mechanism of bulimia.

There's more you can do, but start there.

Please feel free to memail me if you want.
posted by Sophie1 at 11:59 AM on January 22, 2013 [3 favorites]


I suffered from bulimia for years and recovered completely through CBT, it's effective I highly recommend it. Those are the few on-the-spot tricks I used when I regained control and ended the binges. Some might not apply to you, but you get the idea and you can develop your own, the important thing is to have some.
-Recognise when the need to binge arises as early as possible. Tell yourself it's okay, but that it matters, take it seriously, no dissmissing. Decide that even though you feel the need to binge, you dont actually want to do so. Tell yourself you still might do it, but you will try not to.
-Keep small activities that you truly enjoy at hand, like reading gossip magazines, a game on your phone you really like, a book that captivates you, anything. Stop everything if possible and give yourself a time out for a couple minutes doing whatever it is. The urge will still be there, but let it be there and give it a chance to go away as it came.
-Lay somewhere comfy, close your eyes and count. I used to lay under my bed, it felt safer. Sometimes I would go in the closet and sit in the dark, counting and focusing only on the present moment. It helped to be somewhere I never went routinely. I knew all I had to do to get through this was breathe, it would ease away eventually.
-Always have non-guilty binge food available in case of a slip, mine was berries and grapes (frozen grapes are chewy and taste like very sweet popsicles, and the cold calms you down). Those are tasty but I would feel okay bargaining with myself to keep it afterwards, even if I was full like a balloon because I knew it was healthy food.
-If you binge, go a little bit slower than usual. Be casual in your mind like "yeah okay im bingeing whatever, no biggie." Even if you don't believe it, say it. It's absolutely not what it feels like, I know, but slow it as much as you can, you will feel the first bits of control back.
-Avoid purging as much as possible. Try delaying it and see if you will end up not doing it. If you do, try purging less, quit sooner or go easy. I used to think about how much it hurt my body and how better it is to just pack a few pounds. If this makes you only feel worse, think about something else until the moment is over.
-Remember to give yourself permission to choose not to purge. Granted, it's a lot easier said than done, but you first might think about thinking about it, then you think about it, then you consider it and eventually its the natural option.
Some people might find it helpful to go outside and do something to keep busy. You can try different things. The key is to take it seriously but telling yourself it's okay, that you are stronger than this (you are) and it will soon all be in the past. This is what I know from my experience, I really hope it helps!
posted by proximacentauri at 12:19 PM on January 22, 2013 [4 favorites]


This might also help. It helped me.

Bulimia, or any eating disorder, is not about the food. Food is the enemy, the friend, the confidante, etc., but it's still not about the food.

You are going to have to get underneath the food to figure out why bulimia works so well as a coping mechanism. Changing your diet might stop some behaviors temporarily, but I've binged and purged on every diet and every food plan there is. Eventually, the thing under the food needs to be confronted. You'll do that when you're ready and not a day before. In the meantime, do what you can to reduce your risk. Eat soft foods if you're going to binge and you know you have to purge. Make yourself wait if you can. Be gentle.
posted by Sophie1 at 1:42 PM on January 22, 2013 [1 favorite]


"On Eating" by Susie Orbach is one of the books on recommended reading lists for both therapists and patients dealing with eating disorders. It's very short, a series of tips, very practical and easy. It may help you.

The "coping bank" thing mentioned above sounds like a very helpful idea.

While on the waiting list for that specific therapy program, is there anywhere else you can turn to in your area, like a specific organisation or counselling centre? There must be some local or national centre for eating disorders, especially if you have government-funded programs. They may not provide individual therapy but offer some kind of reference and help in the meantime anyway. Good luck!
posted by bitteschoen at 1:45 PM on January 22, 2013


Something I learned from Something Fishy at the turn of the century:

Know that voice that tells you to binge and purge? Give it a name, and tell it to shut up every time it pops up. It will take time and practice, but you'll get used to it.

Best wishes to you. Eating disorders are tough to beat, but it's worth the effort!
posted by luckynerd at 9:43 PM on January 22, 2013


From the OP:
Thank you very much for all the answers. They are all helpful, and I can't tell you how much I appreciate the support. I now feel that I have some 'emergency tools' to work with.

To those of you who asked about issues with alcoholism: definitely not, but I appreciate the concern. :-) My teeth are, surprisingly, also quite good. As for my doctor...he didn't do any follow-up tests when I told him. I think he was shocked, and didn't hide it well.

The hardest thing is wanting to remain anonymous. There are chapters of Overeaters Anonymous that meet in my city, but...it's quite a small city, and I've lived here my whole life. I'm so, so nervous about anyone knowing my problem because I'm embarrassed. And because I'm not over- or underweight, I can't deal with the questions that would certainly be forthcoming from anyone who sees me there.

I don't have any friends I can talk to about this. They all think I am healthy, normal, in control. I can't imagine telling them the (disgusting) truth.

Thanks again for your help.
posted by taz at 11:00 PM on January 22, 2013


The hardest thing is wanting to remain anonymous. There are chapters of Overeaters Anonymous that meet in my city, but...it's quite a small city, and I've lived here my whole life. I'm so, so nervous about anyone knowing my problem because I'm embarrassed.

Please, please dont let this stop you. The meetings are probably in some church you can make up an excuse for going into if you really need to (Oh, I was dropping off some old clothes).

You have a condition which is making you miserable and will eventually kill you. The small chance of embarrassment is not worth forsaking people who you can talk to about it, which is what you will find in the meeting. Go today! If you find the worry about someone finding out is too much, you dont have to go again.
posted by shothotbot at 6:33 AM on January 23, 2013


I can't imagine telling them the (disgusting) truth.

Understandable but completely unnecessary way to talk about this. I was astounded when I started talking about some of the stuff I went through in college to post-college friends at how many of them either went through the same thing, similar, or otherwise identified. I tend to seek out similarly anxiety prone intense cool people, and they universally have experienced some lows and developed some weird coping mechanisms that they have had to refine over the years. What is the strangest is that I can't even tell before these conversations that these friends would ever have something like this in their life at any point.

Sometimes it helps to be able to open up and admit you are struggling to your support network - so don't feel like you need to tell them exactly what is going on. I found it helpful to let my close friends/supportive family know that I was dealing with "anxiety" and asked them if they were able to provide a little extra support. If yes then I'd ask for things like having them over more than the usual amount on the weekends so that I didn't get lonely (trigger), I admitted I was working out a little too much to try to cope and asked for responsible work out partners, I asked for feelings silos when I needed to vent, etc.

Good luck.
posted by skrozidile at 4:20 PM on January 23, 2013


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