Eating disorder

Bulimia and Booze: Dangerous Partners in Crime

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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.


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Briohny Smyth and Yoga for Eating Disorder Treatment

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Jordan Shakeshaft’s Q&A with Briohny Smyth on  is truly inspiring. Briohny shares how yoga was the starting point for her recovery after battling eating disorders for years.

Yoga helps people struggling with body image issues and eating disorders because practicing yoga gets people out of their heads and focused on balance, pose, breathing, and most importantly—the concept of “being one with nature”. Yoga also appropriately challenges someone dealing with poor body image to begin  acknowledging, feeling and seeing their bodies with positive regard. In yoga you learn to become aware of your breathing—our bodies provide us with life. Learning poses require you to discover and learn knew bodily sensations—our bodies deserve loving touch not self-harm. Yoga makes you sexy—our bodies are most desirable when they are healthy, strong and exude confidence 🙂

Read the Q&A with Briohny here.



Can Someone With an Eating Disorder Be in a Relationship?

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Calculating calories, avoiding situations where food will be present, obsessing about body image and isolating can make finding love pretty difficult. I cringe when I hear or read people personifying his or her eating disorder and referring to it as “Ana,” “Mia” or “Ed.” It personifies an eating disorder and perpetuates the idea of harboring a “relationship” with one’s eating disorder instead of experiencing intimacy with others. The feelings of unworthiness, depression, anxiety and crippling insecurities are what make it difficult to be in a healthy relationship; eating disorder behaviors, or maladaptive coping skills, offer the patient a reason not to participate or even try–it occupies his or her time.

Anorexia, bulimia, binge eating disorder (BED), and eating disorder not otherwise specified (EDNOS) impair judgment, compromise health, lead to isolation or erratic behaviors, and are life threatening. Relationships affected by eating disorders can work if treatment, time and tolerance exist. However, more commonly these relationships are toxic because of destructive behaviors and enabled roles.

An adult’s unconscious attitude about unresolved issues can cause him or her to seek a partner that will fulfill the part of the person(s) who taught him or her at a young age a certain belief system. The person will find people that accord to this in order to trigger familiar feelings. For instance, if a young girl hears she has no chance at success because she isn’t smart enough, as an adult she may seek men who berate her in order to experience the familiar feelings associated with being “not smart enough,” thus, perpetuating negative coping skills.

One of the most difficult things for someone with an eating disorder to do is to be honest about what is really going on. It’s a genuine fear for someone who has been using an eating disorder as a way to deal with uncomfortable feelings. Until they know another way, their eating disorder serves a viable function in their life. In the beginning, alone, speaking the truth aloud can begin the journey of taking back one’s life. The next step is talking to a counselor or trusted adult. In addition, if enough courage and trust exist, talking to a significant other is necessary if there’s any hope for that partnership to evolve.

I knew a beautiful, smart woman who struggled with anorexia and bulimia. She had dated as a younger woman but eventually closed herself off from any opportunities to meet new people. “I trust him,” was the last journal entry that she shared with me. I think she was finally beginning to accept herself and trust others again, but years of anorexia and bulimia had compromised her health and she passed away that spring. The memory of her laughter provides a smile and that warm, fuzzy feeling you get when you are in love. Therefore, I guess love and eating disorders can exist, just not happily here on earth.



The Fashion Industry Doesn’t Cause Anorexia


Kate Moss modeling skinny jeans, Fashion Week, and the rest of globalized fashion predict how some men and women see themselves; however, models wearing anything from haute couture to discount clothing does not result in the diagnoses of anorexia−it’s not that simple. One of the main criteria for anorexia is refusal to maintain body weight at or above a minimally normal weight for age and height (body weight less than 85% of that expected). Therefore, a 5’4 adult woman whose normal weight range is between 108 and 132 would weigh 92 pounds or less. How many fashion-blog obsessed women or fashionistas do you know who are super skinny like that? Not that many I bet. Deeper psychological issues in addition to probable genetics have more to do with anorexia than fashion does.

The fashion industry influences people’s clothing choices for obvious reasons, and striving for an on-trend look or wanting to look good isn’t a crime. Although, when people have uncomfortable feelings about themselves, they tend to externalize their issues and often focus on their outward appearance, including their fashion. For example, a woman focuses on the “perfect, slimming outfit” in hopes that she’ll appear a certain way instead of looking inward to figure out how she can be her best. A lot of men and women will use fashion in a sense to avoid their feelings and focus on something outside themselves. Fashion becomes their scapegoat.

Fashion is an art form and a business. Designers, marketers, PR companies and retailers rely heavily on provocative imagery to shape their targeted audience. It’s manipulation. The same can be said of the music, broadcasting and advertising industries. Significant clothing trends like corsets, feet binding in China, minis, and variations of skinny jeans have been around for a long time – so has anorexia. Fashion and anorexia linked when media had its growth spurt in the 1980s. But I like what Judy Scheel, Ph.D., L.C.S.W. says, “Culture provides context, not cause.”

The tragic death of Israeli fashion model Hila Elmalich, or the accusations of models’ appearances in Madrid causing eating disorders help explain why the finger pointing happens. However, doctors and researchers still don’t have an answer for what causes anorexia, yet it causes the highest rates of death among all mental illnesses. Upgrading insurance benefits for treatment and additional funding for education and awareness would garner better results than erroneous articles on whether or not a model has an eating disorder or holding the fashion industry accountable for anorexia.