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What Is Bulimia Nervosa?

What is bulimia and how does it work?


If you're asking "what is bulimia nervosa?" - you probably either suffer with bulimia or know someone else that you suspect may have bulimia. Either way, here you'll find specialised professional information on what bulimia nervosa is, what bulimia does, how bulimia works, the signs of bulimia, the symptoms of bulimia, the side effects of bulimia, where to get help and most importantly of all - how to recover from bulimia.

There's a lot of genuinely specialised and helpful information on this page. If you're just window shopping then this information isn't for you. If you're serious about learning the elusive secrets of bulimia and genuinely want to recover - the next fifteen minutes of your life will be an investment that will pay huge dividends. If your future isn't worth fifteen minutes of your life - you simply aren't ready to recover yet...

If you have already done enough information gathering and are now looking for help to recover from bulimia - our bulimia help page would be a good place to visit. Just a quick note, although we see clients face to face at our Clinic in Staffordshire we can also work with clients anywhere in the UK via Online Consultations.


The Hidden Truth Behind Bulimia Nervosa...

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If you were to ask an average man in the street what bulimia was, he'd probably reply that it's an eating disorder. This perspective of bulimia isn't limited to public opinion by any means as the media and even many health professionals view it in the same way.

It is certainly true that food and eating are an important part of bulimia... but is it really just about food? The problem with focusing in on food (obsessing, binging or purging) is that it can detract focus and attention away from the real problem behind bulimia. If attention is not focused on the genuine cause behind bulimia - recovery is unlikely.

The truth is that the binging and purging cycle is merely a coping strategy for something else. For the majority of bulimia sufferers the real problem and hence the motivating force - is emotional. Food is just something that the mind has attached to in order to temporarily deal with negative emotions and temporarily elicit positive ones.

Looking forward to binging elicits excitement and anticipation which are both pleasant, positive and motivational emotions. The actual binging releases reward hormones through consuming sugars, carbohydrates and fats. If the sufferer swings between starving and binging episodes the body can effectively become malnourished and the hormone rush can become intensified to signify great reward for replenishing needed nutrition. Thus the binging process is surrounded by multiple pleasurable emotional states and rewards.

Following the binge the sufferer may feel a temporary fulfillment or euphoria, although this is generally short lived and makes way for feelings of anxiety, shame, self-loathing and guilt. These unpleasant emotions trigger the purge phase of the disorder generally (but not always) through fear of weight gain or body shape change.

It is also possible that following a particularly severe binge (in terms of time and the volume of food consumed) the stomach can feel so full that it is physically painful. This can lead to a physical need to purge in addition to the underlying emotional turmoil mentioned earlier.

Following the purge there is a rush of relief (from the previous anxiety / guilt emotions) as the sufferer psychologically sidesteps the potential consequences of their binge. The mental realisation that the calories previously consumed in the binge will not lead to weight gain or negative body shape changes leads the sufferer to feel this sense of relief. The relief essentially temporarily discharges many of the negative emotions the sufferer has been coping with.

However, many sufferers claim that they then enter a state of regret and shame. Sometimes they vow, "that was the last time" or "never again"... but the cycle continues.

If you read between the lines it becomes obvious that bulimia is actually driven by emotion whereas food is merely a vehicle used to cope with and switch between emotional states. Each stage of bulimia offers the potential of feeling good and the sufferer begins to associate the bulimia process with 'feeling good'. We are designed to seek out pleasure which bulimia provides in terms of emotional states such as anticipation and excitement as well as hormonal fulfillment from eating. We are also designed to avoid pain which bulimia also provides through the purging process where anxiety and guilt are swept away. This all comes down to the sufferer using bulimia to control their emotions.

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Bulimia Nervosa - I Am Ugly, I Am Worthless, I Am Not Enough...


The previous paragraph talked about a sufferer using bulimia to control their emotions. This is pivotal in the majority (although not all) of bulimia cases. Many sufferers develop bulimia specifically because they feel they lack control in their lives. They feel emotionally bad about themselves and their situation. This often comes down to a set of unquestioned core beliefs such as:

  • I am ugly
  • I am worthless
  • I am not enough
  • People don't like me
  • I have to be thinner to be liked / acceptable / attractive / enough

So why do people continue with bulimia? Basically it's the lesser of two evils. Binging and purging is definitely unhealthy, unnatural and expensive... but it gives the sufferer pleasure and relief... which is more than they were getting without bulimia. The bulimia sufferer wants emotional pleasure in their life. They want relief from anxiety and feeling bad about themselves. They want something that they control... that's theirs! Bulimia ticks all the boxes.

This demonstrates that bulimia is merely a vehicle which enables a sufferer to temporarily feel pleasurable emotions, temporarily avoid feeling bad about themselves and to be in control of at least something in their life. The mind views bulimia as a solution to a problem and more often than not - so does the sufferer.

The prospect of 'losing bulimia' to many sufferers is like losing happiness, losing control, gaining weight and inevitably facing a future of feeling bad about themselves.

Of course there are always the downsides of bulimia, like the financial expense, the secrecy, inconvenient friends and family getting in the way of binges, rotten teeth, throat infections, lung infections, getting vomit in your eye, your clothes smelling of vomit, your bedroom smelling of vomit, containers full of vomit, disposing of wrappers, obsessing about food, living with shame, worrying about getting found out... and the list goes on.

For some sufferers the downsides begin to add up. They don't want to let go of the pleasure, the relief or the control... but the price seems to get higher and higher as bulimia shifts from being their salvation to running (and often ruining) their lives. They are indeed trapped in an obsessive compulsive cycle.

However, understanding the cycle is a big step in any bulimia sufferer getting their life back...

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The Secret Behind How The Obsessive Bulimia Cycle Works...

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What we mean by the obsessive part of the cycle is the constant (obsessional) thinking, focus and attention the sufferer pays to their body, weight, how they look and of course to food. The 'thoughts' with respect to how they perceive themselves tend to be critical, unkind and scathing. It normally takes the form of internal dialogue which is essentially the voice in your head saying horrible things about yourself. Mental imagery can also play a part insofar as it is used to compare yourself with others you consider to be somehow better or more attractive.

An important distinction to make here (and essential for successful recovery) is that these critical thought processes create the negative emotions (feeling bad). Let's just clarify that for those particularly stubborn people who don't want to hear it!

Feeling bad about yourself is created through your thought processes NOT by how much you weigh. Got it?

Your thought processes create your self perception... which is the real cause driving your bulimia. It doesn't matter how much you weigh or how much weight you lose, so long as your self perception causes you to feel bad - no amount of weight loss or hitting a number on your scales will be enough! It isn't about your weight or how you really look - it's how you THINK you look that makes you feel bad and this in turn maintains the bulimia.

The truth is that you can have bulimia (and anorexia too) from now until the day you die and no amount of using food as a drug or tool will change your self perception. The bulimia (and this is true for anorexia too) will make you believe that at some point in the future... if you keep doing the eating disorder rituals... you'll reach a point where you'll like yourself.

There's also the other side of the coin where the disorder plays on your fear and insecurity. It tells you that if you stop doing the rituals things will get much, much worse! Of course if things did get worse... your self perception would no doubt plummet too. Is it any wonder you're trapped?

Perhaps you should take stock of just how messed up your life is right now, the shame you feel and what you put yourself through every day and wonder how much closer you are to liking yourself today compared with six months ago. Is it really working? Is it time you woke up and realised the disorder has lied to you all along?

You may be rationalising that what we say is probably true BUT you can't help the way you think. Well we agree with that. This is the reason so few people manage to overcome bulimia without specialised help.

They way you think is based upon habit (which is the negative stuff you've practiced a lot) so it's no wonder you've become good at it. There will also be underlying beliefs about yourself which help drive the thought processes. At the moment you wont even question these (self perception) beliefs because you're in so deep. However, in reality any belief is graded by the intensity of the emotional response it elicits. Your beliefs elicit intense emotional responses so they are pivotal in your life... but that doesn't make them TRUE.

Hitler's 'belief' with respect to the Jews was that they poisoned society and caused the downfall of Germany. He was driven to order the extermination of millions of human lives because of this belief. His belief was driven by the emotions of intense rage and revenge - but was it true? Do Jews really poison society? Did Jews really cause the downfall of Germany?

Are your beliefs about yourself genuinely true... or do you just believe them to be true because they make you feel intense emotion? Are you told by other people how ugly, worthless, unattractive and fat you are with the same viciousness and regularity you tell yourself? It's time for a reality check. How much of this is real and how much of it is maintained in your head?

Shifting your beliefs is very hard to do on your own, as simply rationalising things can only get you part way there. However if you are tired of suffering, want your life back and are willing to help yourself - we can help you to recover from bulimia.

In the next section we're going to teach you how the obsessive thought cycle self-perpetuates. This will help you to understand why you get constantly bombarded with unsolicited thoughts - you know the ones we mean...

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Where Do The Obsessive Bulimia Thoughts Come From?


Unsolicited (obsessive) thoughts are an essential part of any anxiety disorder... and bulimia is no different. We've already discussed how 'thoughts' create emotional states and the knock-on effect with respect to bulimia... but where do the thoughts come from?

In order to answer this question we first need to consider an aspect of how our thoughts and emotions work together in order to make sense of our experience. Let's ask a simple question - "How do you know if something is important?"

We'll examine a couple of basic examples in order to draw a real life conclusion:

Example 1. You notice a charity collection bag in your hallway. You've looked at it many times and thought it may be a good idea to clear out some of your old clothes and give them to the charity shop. You ponder for a moment and decide now is not a good time and sit down to watch TV.

Example 2. You receive a call late at night and are informed that your best friend has been involved in a serious car accident. They're alive but badly injured. Unfortunately there's no visiting at the hospital and there's nothing you can do.

Which of the above examples would elicit a strong emotional response?

Obviously the second example would elicit a strong emotional response. Would you say that made it important? This is actually how we assess what is and isn't important in life. The more intense the response - the higher the importance. However, this isn't just applicable to events... it is just as true for thoughts. The brain does not discriminate between events and thoughts when it comes to firing off emotional states. Hence you can remember things from the past or speculate about things in the future (such as being fat) and the brain fires off the emotion as though it's actually happening in the present. If you suffer with bulimia you'll be really good at this already!

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So now we understand how we calibrate an event or thought as being important through the intensity of emotion it elicits. The next thing to understand is that the brain has to deal with loads of information and decide what to keep and what to discard. The truth is that the brain uses a kind of importance scale to rate a thought, memory or event in order to decide what to do with it. If the thought, memory or event elicits no emotional response, it's unimportant and gets deleted. If it elicits a low to medium emotional response the brain files it away in the depths of your mind, just in case. However, if the thought, memory or event elicits a strong or intense emotional response the brain files it right at the top of the 'important pile'.

Now, the brain is basically a thought generator - that's its job. If you doubt this, simply close your eyes, sit quietly for one minute and have no thoughts. You know as well as we do that thoughts will pop into your head even when you don't want it to happen. First, that demonstrates the brain is in fact a thought generator (as we said) and second, that you don't actually run the 'thought generating' show. If you did run the show and call the shots - your mind would have been quiet when you asked it to!

So, the brain automatically pops thoughts into your awareness. However, these thoughts are NOT random. The brain selects thoughts (to bring to your attention) from the top of its 'important pile'. Thus it would follow that the thoughts generated are the ones relating to (other) thoughts, memories and events which previously elicited strong emotional responses. Are you beginning to recognise what you do yet?

However, when such a thought (for example thinking about binging) pops into your head, you dwell on it and play out scenarios in your minds eye. The playing out of scenarios or reliving of experiences generates (intense) emotional states. The brain then associates the intense emotional state(s) with the thought and puts it back at the top of the pile ready for bringing up later. This is how the obsessive thought process self perpetuates. Each thought runs its own cycle. If you have a hundred intense thoughts (with respect to different things) - they each run their own cycles over and over...

  1. An unsolicited thought pops into your mind
  2. You focus your attention on the thought and play out different scenarios
  3. When a scenario goes wrong - you feel anxious / guilty / worthless etc
  4. The brain associates the intense feeling with the thought
  5. The brain labels the thought important because it elicited a strong emotional feeling
  6. The brain files the thought as ‘important - please recycle’ at the top of the pile
  7. When your attention drifts the thought gets recycled back into your awareness - Go to 1.

As you can see - the obsessive thought process is self-feeding and self-renewing. This applies not only to keeping your bulimia running but also to your underlying self perception beliefs. The more you dwell, the more it cycles. The more it cycles the worse you feel. The worse you feel the more real it becomes.

Essentially what you're trying to do (unsuccessfully) with bulimia is to break this cycle. However, in reality food and weight have absolutely no bearing on this process whatsoever! This is the reality of why eating disorders never deliver on their promise to make you feel better.

We hope the psychological side of bulimia is starting to make more sense to you now. We work every day with people just like you - with the same problems, perceptions, guilt and shame. You can overcome this with our help. We've been doing this successfully for over fifteen years and we know our stuff.

Let's now have a look at how the compulsive eating cycle works. Although this is symptomatic of the psychological (thought process) stuff we've already discussed - for the sake of completion we'll go over it with you.

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Why Do I Get Compulsions To Binge And Purge?


Whether your first purge was through guilt, an attempt to lose weight or a control thing... it doesn't matter. What matters is you did it... and then you did it again... and again...

The purging almost certainly started off as a choice. It was something you could control. It was something you could possess and call your own. You believed it served you because you could eat what you wanted and not feel guilty or gain weight... in fact you probably felt initially that it helped you lose weight and look better.

Then things started getting out of hand. Rather than you controlling it - it began controlling you. In addition to your obsessive thoughts and intense emotions you now had uncontrollable compulsions to deal with.

Here's an example to help you understand why the compulsion is there:

We're going to do an exercise. Now use your discretion here. If you have any sort of medical condition or you're particularly frail - don't do it. It's understanding the conclusion that's important!

Read the exercise fully before starting:

Sit comfortably and hold your breath for as long as you can. Don't block your airways or do anything else that's stupid. Notice how long you can hold your breath before you start breathing again.

Now, ONLY if you're fit and healthy and comfortable with the exercise... go ahead and do it.

So how long did you last? 20 seconds? 30 seconds? A minute?

Normally you breathe on autopilot and don't have to think about it. But for this exercise you tried to overcome a natural subconscious behaviour through your conscious willpower. Sure, you managed to hold your breath temporarily - but then what? When your mind detected an oxygen shortage it decided it was going to override your decision and start breathing again. You'll perhaps also notice that your first breath in was a seriously large one... as you needed the extra oxygen to regulate your body and survive.

Now, what are you doing with bulimia? You are starving your body of nutrition. Binging is the brains way of taking the deep breath in. However, following the breath holding exercise you allowed your lungs to have the oxygen your body needed - so you don't have an ongoing compulsion to take deep breaths. With bulimia you take the food in (to satisfy the compulsion) but then purge it out again before the body can absorb the nutrition.

Thus what is happening is your mind and body realise even after a compulsive binge the nutrition it was expecting wasn't absorbed. So it gives you a compulsion for another binge and focuses your attention on food. Each time you follow a binge with a purge the brain has to run another cycle of trying to get nutrition into your malnourished body. It's working in panic mode just like when it feels you're suffocating from a lack of oxygen.

YOU are causing this! YOU are bringing this upon yourself! YOU keep this process running through your fears and self perception!

Essentially what you have is a conflict between your brains core programming (to survive and be healthy) and the habitual thought processes that make you feel bad regarding your own self-perception. When you go to war with yourself... you can only lose.

As mentioned earlier, the compulsion to binge comes about BECAUSE you purge (however you do it). The reason you purge is BECAUSE you feel bad (guilty, anxious, fearful of weight gain). The reason you feel bad is BECAUSE of your thought processes and beliefs. The problem is that bulimia doesn't address your thoughts or beliefs - does it? This is why you're trapped, feel so bad and potentially face much worse in the future.

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Common Fears When Overcoming Bulimia...


Using food and bulimia to feel good about yourself and gain control in your life simply doesn't work long term. You've no doubt discovered this for yourself. You've probably also discovered that the patterns of behaviour (obsessions and compulsions) are addictive and you've become trapped by what you once saw as a 'way out'.

It is common for bulimia sufferers to make contracts with themselves such as 'never again' or 'this is the last time'. However the reality is that the obsession and compulsion are too great for 'just words' to make any difference. The truth is, you need outside specialised help.

Although the idea of overcoming bulimia and getting your life back seem tempting, there are sometimes underlying fears running in the background. These fears can include weight gain, loss of control, emotional breakdown and for many sufferers the shame and embarrassment of talking to someone about their problem.

Let's address these common fears one at a time:

Weight gain. If you've been purging via vomiting then it is very likely that you're dehydrated and possible you are also malnourished. This is simply what happens when you induce vomiting (or other forms of purging) over a prolonged period. Continuing with bulimia wont solve this - it'll just make it worse. Malnutrition will also causes your hair to be thin, dull and eventually fall out. Your teeth will rot. Your bones will become brittle. Your skin will dry out, thin and wrinkle. Yet you use bulimia to 'look good'. Is it sinking in yet?

You will almost certainly gain at least a few pounds as your body rehydrates to a healthy level. This is your body getting water into your cells so that they can function correctly. You will not gain any significant fat - it simply doesn't work that way provided you follow our advice. Remember that obsessing about weight is what keeps you trapped in the bulimia cycle. However, we've already discussed that weight isn't the real issue - it's down to your thoughts and self perception that makes you feel bad. We can teach you how to change this... but only if you're willing to help yourself.

Loss of control. This is simply the bulimia playing on your insecurities again. Overcoming bulimia actually gives YOU control and lets you make your own decisions rather than having your hand forced by obsession and compulsion. The only thing that's going to lose control is bulimia and if it's bringing doubt into your mind it's probably because it senses (because of the options opening up in front of you) it may already be losing its grip.

Emotional breakdown. Once again you are speculating as to what may happen due to insecurity. Overcoming bulimia would be better described as an emotional rebuild. This time however, we'll build your emotions and self perception into something that serves you rather than destroys you.

Shame and embarrassment. Remember that shame and embarrassment are something only you bring to the table. There is never any judgement on our part other than us respecting you for having the courage to commit to help yourself. You having the courage to contact us should be met with celebration. The time for shame and embarrassment is if you make lame excuses and stick with the bulimia.

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How To Overcome Bulimia And Get Your Life Back...

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In your life at the moment there seem to be only two options.

Option one is living with the misery bulimia brings you.

Option two (the alternative) is to be fat, unattractive, unaccepted, unworthy and disliked.

If you perceive the world this way and you take away bulimia - what are you left with? Option 2 - right? These are your current options and this is why you're very unlikely to overcome bulimia on your own.

However, with our help there is certainly option three, option four and probably more to choose from.

Option three. You can eat without obsession or compulsion, resulting in you being a healthy weight. If you want to be slim that's fine by us - as you can be slim and healthy provided you do it in the right way. You can like yourself and feel comfortable with the way you look. You can be kind in your thoughts and considerate with respect to treating yourself well. This results in your skin, hair, eyes and everything else about you becoming healthy and vibrant. When your perspective and mindset is healthy you'll find loving, happy people will gravitate towards you. They'll want to know you and be around you because you make them feel good.

If you don't believe this is possible - the bulimia (which has deceived you right from the start) is playing on your insecurities yet again.

Option four...

We've left option four bank because if option three isn't quite everything you desire - you can create whatever you want for yourself here. If you're going to rebuild your life, it may as well be specifically how YOU want it to be. We'll engineer your recovery to include whatever you choose.

You see, recovering from bulimia with our help isn't about taking things away. It's about having more options and choices. At the moment you are stuck between a rock and a hard place because those are your only options. Working with us will give you option three and option four if you want it. You'll still be able to choose option one or two if that's what you want... but realistically why would you?

We have been successfully working with eating disorders of over fifteen years at our established Anxiety Clinic in Staffordshire. Although we do work with clients face to face, we also offer Online (Skype) Consultations for clients living outside of our region. The great news is that working online greatly reduces our operating costs and overheads so we are able to offer the most specialised help in the country whilst maintaining very competitive fees. For more information on how we work, our fees and our no quibble money back guarantee - choose from the following links:

I'm interested in Face to Face Consultations at the Anxiety Clinic in Staffordshire

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