Breaking free from bulimia Part Three

After my near miss with binging yesterday, it seemed appropriate to continue with my posts on recovery since the third in this series is about perseverance. Recovery is a hard and slow process. It can take years and for half of the time not seem to be getting anywhere. There are bad days where you seem to forget everything you've learned and embrace the bad habits completely. But it is always worth fighting.

The day when you put the food back on the shelf at the supermarket and decide you're not buying binge supplies, that day makes the ones where you've slipped up seem less important.

The day when you can eat normal meals with friends make it worth the struggle.

There is no miracle cure. You don't just get better. But recovery is still possible.

Keeping going

Don't aim for a complete cure in one go. You're certain to slip up a load of times before you reach recovery. Trying to get better all at once is going to lead to you seeing these slip ups as failures. They're not. They just happen.

Instead, set smaller goals. "I will not binge at all tomorrow." "I will go two days without purging." "I won't binge on more than x amount of food."

Set yourself targets of short lengths of time without binging. Start with a day, then go to two days, then three. It will take a while and there will be many occasions when you don't meet the targets you set yourself, but it will feel amazing when you can say that you've gone a week without binging.

Try not to be discouraged by the times you don't meet your goals. Just set yourself another, possibly making it slightly smaller, and try again. That's the important point. Try again. And again. And again.

Sometimes it can help to try with other people, whether in real life or online. There are pro-recovery groups and online communities. Ask other members to join you in trying to go without binging for a few days. It may make it easier to succeed if you have to admit to others when you slip up. Some people find this just puts pressure on them, makes the whole thing more stressful and makes them binge more. It's up to you to do what works for you. If sharing your attempts at binge-free days helps you, then do it, if it doesn't, find something else that helps.

It might help you to keep a record of when you binge. Over time, you can look back and see the binges getting less and less frequent. On the other hand, this might be discouraging if all you see is a list of all the times you messed up. Remember, only do this if it helps you. It might be better to record the days when you don't binge, focussing on the food rather than the bad.

Find reasons to recover. Spend time with friends and people you care about. Spent time doing things you enjoy. Life can seem bleak and horrifying when you're disordered, but it is worth living. Try and spend some time each day doing things you like doing that aren't connected with food and this will serve as a reminder of why you're trying to get better.

Always, always keep fighting.

No more exams

Today, I had my last exam at university. This is a wonderful feeling.

I hate exams. I feel I have to get perfect marks. I'm terrified of doing badly. So, I eat. That's how it's worked since GCSE. Even since recovery, exams = eating. I eat more than is healthy, sometimes picking at food when I'm not hungry, sometimes eating quite large amounts in one go. It's as though for the length of the exam period, I acquire the symptoms of compulsive overeating disorder.

I know I don't have this disorder, but exams make me act like I do.

I don't purge anymore. I don't fast or skip meals. I exercise a healthy amount. I don't swallow loads of diet pills daily.

I worry more about purging techniques than I do about binging, which means that the week or so after exams, I feel horrendously guilty about what I've eaten, but don't get the satisfaction that always used to come with over-exercising or skipping meals. I eat way more than I should for the week or so that I have exams, but I don't burn it all off the way I used to. It means that weeks or months of being healthy get undone in a few days as the fat piles on again.

The worst times during my disorder were when I had exams. The times I've come closest to relapsing afterwards have been during exams. Today, after I've gone so long without a real binge, I went to buy something for lunch and ended up buying:

• A pack of sandwiches
• Two mini apple pies
• A snack-pack of biscuits (two biscuits)
• A packet of jaffa cakes
• Two bottles of fizzy drink
• A packet of crisps
• And a huge, huge bag full of pick 'n' mix

Compared to binges in my past, that list is very short. The fact that some of the food remains uneaten is a sign of how far I've come. It was helped, no doubt, by the fact that I met a friend soon after buying all this. I could have gone and eaten it all in one go. Instead, with little difficulty, I stayed and ate some of it in a large, but not binge-like lunch. The rest stayed hidden in my bag.

I didn't binge today. I ate more than I should and this food, combined with dinner, have left me feeling fuller than is comfortable, but I didn't binge.

It doesn't change the fact that my reaction to stress is to go out and buy food. Even if I don't eat it all, that habit still lingers from my disorder. I haven't acted in a way that would classify as bulimic for years. So why can't I be rid of this need?

Can you hear me now?

I've seen various documentaries about eating disorders. I can't think of one that doesn't, at some point, mention rape or abuse as a possible "cause" of eating disorders. I remember one documentary talking about how eating disorders sometimes start when a teenager's parents get divorced. They stated clearly that not everyone whose parents divorce will develop an eating disorder, but failed to even mention that a lot of disorder sufferers have parents who are happily married.

I think people look too often for causes in the environment. Some people are biologically susceptible to developing disorders and the triggers can be just about anything, sometimes events so small that the sufferer doesn't even remember them later.

I've read posts in other blogs talking about how families are often seen as the cause of a disorder, with people believing that someone develops this illness because of problems at home. So often, that's not the case. Eating disorders can be started by anything. What matters is recovery, not finding someone to blame.

To tell or not to tell

I was meeting up with a group of friends in a coffee bar on campus before going off to an event. I'd been eating healthily all day, done a fair amount of walking and hadn't had a great deal for dinner. I was feeling proud of myself for not binging despite it being exam time, usually my biggest challenge.

So I decided to get myself something to eat. I hadn't had anything sugary all day and I thought it would be alright to treat myself, so I bought a rice crispie cake and a chocolate bar. I was actually feeling good about buying them, telling myself that I was like any normal person and didn't have to feel guilty about induging in sweet things every once in a while.

In the group was one girl who a few people had been teasing about the amount of sugary drinks she consumes on a regular basis. She's fine with this and happily joins in the joking. Then she sees what I've bought myself and comments that maybe she's not the only one who should cut down on sugar.

My first reaction was, "Oh god, my friends all think I'm a fat, greedy pig."

I know she didn't mean it in that way. She was continuing with a light-hearted conversation and did not for one moment intend it to sound insulting. She had no way to know that the teasing she'd been happily receiving would seem like a crushing blow when aimed at me.

I don't advertise the fact I've been disordered. The number of my friends who know is probably so low that you could count it on your fingers and not run out of digits.

After the other day, I began to wonder if I should change that. My friends can accidentally hurt me without ever realising, because they don't know what a difficult subject food is for me. Because they don't know, it would be easy for them to step onto what is for me very rocky ground.

But I don't want to tell them. There's so much misunderstanding about eating disorders. I still worry that they won't understand, that they'll think I'm trying to get attention or that I was just a silly teenaged girl trying to lose weight by a stupid method. Even if they try to understand, most of them probably won't.

Then there's potential awkwardness. Food comes up so often in social contexts and I dread the idea that they would start acting differently towards me at those times. I want to be normal and that means being treated normally. I don't want my friends to start worrying if they ought to be offering me a sweet. I won't want them to wonder what I'm doing if I need to use the toilet after sharing a meal.

I want things to carry on as they are. But at the same time, I want them to know not to make comments I can interpret as them saying I'm eating too much.

I guess I can't have it both ways.

Breaking free from bulimia Part Two

As with part one, what I'm offering here is suggestions. My ideas won't work for everyone but if you think they might help, give them a go. They idea is for you to build up a collection of tools that help you cope with your illness and move on from it. Find what works for you and never stop trying.

Avoiding purging

By purging, I don't just mean induced vomiting; I'm referring to all forms of purging behaviour. This is where bulimia gets dangerous. Yes, there are health problems associated with binging and overeating, but the health risks associated with bulimia generally come from purging techniques.

Find out what those dangers are.

Whether you purge by vomiting, laxatives, diet pills or excessive exercise, there are dangers. Work out a list of what you do to try and lose weight after or between binges, then look up the dangers of those online. There are websites with some gruesome pictures of the dangers of repeated vomiting or laxative abuse. There are photos of the bodies of dead bulimia victims. It's horrible and it's gross, but looking at those pictures are a good way to scare you into wanting to avoid dangerous techniques.

Once you've worked out your list of techniques and the dangers, list the techniques you use in order of how significant the health risk is. For example, induced vomiting is more dangerous than excessive exercise, taking large quantities of laxatives is more dangerous than taking the recommended dose of diet pills, and so on.

It would take incredible will power just to stop purging completely all at once. It's easier to try and cut down slowly. You now know which behaviours are the most likely to do permanent damage or even kill you, so cut down on those. If you perform purging behaviours that have very little associated risk, keep going with those while you try and tackle the more dangerous ones.

As you reduce the number of binges, it naturally becomes easier to reduce the purging.

If you still feel the need to purge, try and remember those horrible pictures and they might remind you why you don't want to be doing this.

Now I'll try and give you ideas for avoiding specific types of purging. Don't just follow this list. Everyone's behaviour is slightly different, so you may find your own tricks that work better for you.

Try and spend time with other people. A lot of purging activities are time consuming and you will be able to do less if you're with friends. This will also help reduce binging. Because bulimic behaviour is very private, it's unlikely that you'll want to perform any in front of friends. This may also help reduce depression and increase self-esteem if you're spending time with people you like and who like you. Have fun and just try to spend time not thinking about your body.

Spend more time in public places, even if you're on your own. Instead of staying in your house, start hanging around in places where the only toilets are public ones with several cubicles. You won't want to throw up when anyone could walk in and hear you and start asking if you're alright.

It's about reducing the opportunity. It's a lot easier to resist the temptation to purge if you have less chance.

If you purge by excessive exercise, schedule trips to the gym but make sure they're before something else you need to do. That way, you can go to the gym, do a healthy amount of exercise but then you'll be forced to stop. If you know you have only an hour to exercise before you need to go and meet someone or attend a lecture or perform some task, then you won't be able to do more than an hour.

Exercising for small periods of time is a good idea. It will help reduce feelings of guilt from eating and any binges which might still be happening. It will keep your body healthy but, by keeping the exercise sessions short, you won't be putting too much strain on your body.

Set a limit on the amount of exercise you will do a day; an hour would be a reasonable amount. If friends or family know about your illness and that you're trying to recover, tell them about this limit. That way, they will see if you go over it. They will be able to persuade you to stop and it will be easier for you to keep to the self-imposed limits if other people can see you doing so.

Throw out any diet pills or laxatives that you have. You can't use them if you don't have them. If there is a shop you go to that sells them, try and only go to that shop with other people, because then it will be easier to resist the temptation. If you do give in to the temptation to buy more, throw them out again. It may be a waste of money, but it's better than damaging your body.

Now for the hardest idea of all, try to convince yourself you don't need to purge. Even if you eat a large meal or have a bad day and binge, tell yourself that you don't need to get rid of it. This will not be easy and it will not happen all at once. If you can delay the purging, that's a good start.

Try and work out the emotional reasons behind your binging and purging. I won't advise you how to tackle these issues; you'd be better off talking to friends or a qualified therapist. There will be emotional issues involved in your behaviour. If you can find a way to tackle those, the rest will become easier.

And just keep trying. There will be bad days. There will be worse days. But there will be good days too. Just keep hoping and fighting until the good days come more often than the bad.

Weekly Update 25th May

My weight's stayed stable this week. I haven't binged. I haven't over-eaten. I haven't over-exercised. This is almost a surprise, because I had an exam this week and I've another one next week. Exams are usually my trigger for a major pig-out.

On Wednesday, I had to take my car to have its MOT done and I had to spend several hours wandering round a nearby shopping centre because I couldn't go home until they were finished with my car. This involved a few hours sitting in cafes and coffee shops, but I managed to avoid overeating. I did fall back on bad habits in that I ordered for lunch a sandwich containing an ingredient I didn't like, simply because it was the lowest calorie option.

I also bought some more diet pills. These have actually be scientifically tested and there are clinical trials showing they bind to fat and prevent digestion. They don't appear to have had any effect on my weight, probably because I usually eat very low fat foods, so there's not a lot for them to bind to.

I know the diet pills were a bad idea because they bring me back to old habits, but I'll be able to stop taking them when I finish the packet and not have any feelings of guilt, because I know they don't make much difference.

All in all, this was a good week.