I used to find myself standing alone in my kitchen wondering what’s next the morning after all-night partying. I wanted to keep the party going and would binge and purge. The bingeing was something to keep me excitedly busy and the purging gave me a sense of accomplishment. Occasionally, I’d drink after my eating disorder behaviors to muffle my negative talk for doing them. The shame and guilt I felt made me want to drink. I had a client who said very matter-of-factly, “I binge and purge for a couple of hours, and then ya know, I drink.” I understood what she meant. When I was a therapist, I enjoyed working with the bulimics more than those with other eating disorders. These women were more outgoing and they knew how to have fun. Yet sometimes, that carefree attitude—which was one of the positive attributes they had going for them—led to another addiction. Studies done in community and clinical settings continue to demonstrate that the prevalence of substance use disorders is higher among women with bulimia versus women with other eating disorders. Alcohol abuse or dependency is not the only substance seen co-occurring with bulimia, but because alcohol is legal, accepted by society and is a depressant that calms the central nervous system, the two commonly exist together. And this kind of roller-coaster voyage of seeking mood regulation is depleting.
People use both bulimia and alcohol as maladaptive attempts to self-regulate. Bulimia or alcohol abuse/dependency alone causes severe health issues, but marry these two and a person’s window of opportunity for help significantly decreases. Some bulimics start out drinking to numb the uncomfortable feelings following the eating disorder behavior, while others in recovery return to past behaviors to offset the high calories in alcohol. I haven’t known many alcoholics who later became bulimic. But alcoholism and bulimia are both hard to kick regardless of how the coexistence happens.
Bingeing increases levels of serotonin in the brain, and the purging raises levels of the brain’s feel-good endorphins. Most bulimics will say that bingeing is like a high and purging is a welcoming release; that it feels good. Once a tolerance for this is acquired, something else is needed to feel “good.” Habitual bingeing and purging compromises the body’s chemistry and alters the brain’s reward system. The body sets up an oppositional process to restore itself. This means more of the drug—or behavior—is needed to overcome the body’s efficient corrective processes. I’ve known women who have spent the entire day eating and throwing up; however, in most cases another addiction—such as alcoholism—was adopted. And though alcohol serves to numb or alter the person’s thinking and overcome the corrective process, it does so in a different way than bingeing and purging does. Wrestling moods in this manner perpetuates an obsessive cycle, one that can lead to life-threatening complications like organ damage, electrolyte imbalance, internal bleeding, ketoacidosis, pancreatitis, seizures or death.
I’d be lying if I said I was 100 percent eating disorder free, but I can say that I know the warning signs and how to prevent going as deep into it as I once did. And based on past clients’—and my own—recovery, talking about mindfulness, charting food and locking empty bathroom doors doesn’t work for bulimics who drink. Understanding when to open your mouth does. Speak your truth to champion yourself instead of fostering an alter ego that no longer serves you by bingeing, purging, drinking and repeating.
image courtesy of morguefile.com