However, this past week I was again reminded that people who are not fully versed in eating disorders (by fully versed I mean eating disorders are their main focus rather than a subset of, for example, brain disorders/mental illness) forget a basic principle. I'll get to the principle in a moment.
I thought of this principle in frustration the last few days and know that behind this basic idea is the message that the film Someday Melissa and other media continue to remind us of: bulimia can be invisible except to the person who has this eating disorder. (The blog linked within the site for Someday Melissa includes this post revealing that well known people like Lady Gaga, Katie Couric, Sally Field, Jane Fonda and Jessica Alba have fought this, as well.) I know it was for my parents; they didn't have any idea. I know it was for me when my family member seemed to be better for six or seven years before the relapse. I know the seriousness of bulimia can become less visible to a treatment team when they are looking mainly for weight loss. Why? because often, those with bulimia maintain a steady weight and appear okay; because often, those with bulimia carry on their binging and purging in secret and the effects can be invisible except to those who know what to look for. The side effects of bulimia can and do kill.
The National Eating Disorder Association provides a helpful/informative summary here. Re the effects of bulimia on teeth, I believe destruction of teeth not just staining would be important to add.
Years ago at the Grand Canyon I remember noticing a sign posted somewhere (I think at the South Rim) that says, "Water is Life." Without water one can die on the trails of the Grand Canyon. Without water, one can die.
Well, food is life, too. Without food, life dies.
A drug addict or an alcoholic can quit the drug or quit the alcohol and continue to live. This decision can be more difficult for some than others, but they can quit. Those who have managed to quell these addictions and maintain recovery sometimes believe that those with eating disorders should be able to quit, too. Straight forward thought but misguided.
One cannot quit eating food and continue to live.
Overcoming anorexia is hugely difficult but can be done, especially if the family of the person allies with their relative to seek assistance to overcome it early. Overcoming anorexia subtype bulimia is also hugely difficult because the anxiety and the fear of food is still there but in addition the person has developed an addiction to binging and purging that leads the person to eat the very food(s) s/he is afraid of. A vicious cycle. But not insurmountable.
Recovery is possible. Habits can be broken and these diseases can be overcome. How?
To quote Sarah Ravin in her excellent post "Expanding Our Minds: Towards a Biologically-Based Understanding of Eating Disorders" of January 18, 2014:
".... behaviorally-based psychological treatments focused on symptom management and skills building can be very effective, in large part because they change the brain [emphasis mine]."
One effective treatment for bulimia is dialectical behavioral therapy (DBT). Dr. Ravin writes,
".... CBT and DBT are forms of psychotherapy which involve a relationship with a therapist who instills hope, provides support and feedback and accountability, promotes awareness of thoughts and feelings, and teaches adaptive skills for managing life’s challenges."
I encourage adults and older teens who are fighting bulimia to take a look at Kathryn Hansen's book, Brain Over Binge. I reviewed this book here on my blog. Again, one can change the pathways in their brain and learn new healthy behaviors.
Family members can be allies here, too.
I again refer the reader to Dr. Shari Manning's book, Loving Someone with Borderline Personality Disorder. Although the book is written for family members and friends of those with BPD, in fact the information and skills provided helps family members ally with their loved one against bulimia.
My closing question is this: how does one solve the "food thing" as a transition for an adult who lives independently?
Food is life.
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