Update

I've had a few comments on my last post asking for an update so people can see how I'm getting on. This post doesn't mean I'm going to be posting regularly again yet though.

The past few months have been extremely hard for me for several reasons. The first is the break-up with my boyfriend which I'm still not completely over, even if I have stopped crying about it on a regular basis. I still think we should have worked together but I can't sit around waiting for him to realise he's been an idiot. I'm not over him yet, I'm not ready to start dating again by a long way but I'm getting there.

I started a new, challenging job in September. I went through a few months of not being sure I was doing the job right, wondering why they'd hired me and thinking that I was never going to get the hang of things. I think I have now. It's got to a point where I think I'm doing a useful job and I'm really enjoying some of my work.

The other implication of the new job was it meant moving home. I moved to a new town most of the way across the country (this is England, not Amercia, so it's not as bad as it could be) from where I'd been living. This means I'm a fair distance from my friends and family. That was incredibly tough.

But I've survived these changes.

I had some bad days. I had some really bad days. And I had some occasions where I spent too much of the weekend eating half the menu of the local Chinese take-away.

There were some extremely rough moments when it felt that relapse would be all but inevitable, but I got through them.

One of the things that helped was something I wouldn't have expected to. I started taking kung fu. I went to the class for the first time more or less on a whim. I'd been here a couple of months and barely knew anyone outside of work, so I could go the entire weekend without real human contact. So I looked up classes and courses that were on at the weekend just so I'd be out there meeting people. I saw kung fu listed and figured why not.

I think that was a good decision for a wide range of reasons. Firstly, and probably most importantly, it's fun. I enjoy the classes and like the instructor. I like the other people taking the class so I get some socialising and am even starting to meet a couple of them outside the classes as well. But the reason that has most significance for me as a formerly disordered person: it's exercise that I don't control.

My instructor is the one who decides whether we have a hard or an easy class. He's the one who determines what we do and when and tells us we should be going home at the end of the session. He is the one who determines how hard I should be pushing myself, not the amount I ate the day before. If you go to the gym, you're in control of how much you exercise, how long and how hard. If you've had over-exercise as a symptom of a disorder, this can be dangerous. But my kung fu instructor has no way to know whether I ate normally or binged the day before, so the exercise is separated from the food. It becomes something that I do, not something that I do out of guilt.

My instructor also brings up the subject of food occasionally in class. For some people, this might be off-putting, but it helps me. He tells people off if they don't eat enough. One of the worst mistakes you can make is admitting in class that you haven't eaten breakfast. It's nice for me to hear someone saying that we should be eating more. He encourages healthy eating, but he does it by encouraging eating, rather than saying things are forbidden.

It's been good for me to know I have an instructor who cares about my general health and who won't be afraid to ask me what I've eaten. I hate lying, so I'm more likely to eat decently to avoid having to if he should ask me. The second time I nearly fainted in class, he started taking a strong interest in whether or not I was eating enough. He doesn't know I used to have an eating disorder and I doubt I'm going to tell him but it's reassuring to me to know that there's someone who'll ask me whether or not I ate after getting home from work, so I'm less likely to skip meals.

If you're in recovery and you had over-exercise as a symptom of your disorder, it can be difficult to know how to get back to exercise. There's no clear boundary between exercise and over-exercise. So I would recommend joining a class or a club of some sort. Make it something you enjoy, so exercise is fun not punishment. And make it something where someone else is in charge. That way, you'll be doing the same level of exercise regardless of whether dinner was half an apple or half the fridge. By turning over control to someone else, your disorder isn't the thing determining how hard you exercise.

So, in conclusion, I'm doing alright. I'm enjoying my job, I'm starting to make friends here and I've found a form of exercise I can enjoy without abusing it. There's another good thing that's happened to me over the past few months that proves there can be good even in bad times. I signed a publishing contract towards the end of last year and my first novel will be in book shops from September.

Weekly Update 8th June

I am not in the right mood for writing an entry in a recovery blog.

I'd gone over seven months since I'd had a real binge. About eight months since I purged afterwards.

Tomorrow will be a better day.

Cry in the Dark

Recovering from an eating disorder is incredibly difficult. Fortunately, there are charities and support structures out there.

If you live in the UK, there is beat. If you live in the states, there is NEDA. Both of these organisations should help you find help near you.

Sometimes, there are no local groups. Sometimes, the thought of facing someone and telling them what you do is just too terrifying. In those cases, online groups can be an amazing help.

Livejournal communites like ed_friends and purgatorium can help you feel you're not alone. Be careful though, some people find that reading others going on about their disorders can trigger relapses. Make sure you join a group that supports recovery. Look at different communities and read a lot of their posts before joining. You want to join a group that's supportive and friendly, one that doesn't offer tips for continuing behaviour and one which will applaud you as you try to recover.

If you're not on livejournal, there are forums. One that is pretty quiet but very friendly is ED Friends Unite. This forum is very strictly pro-recovery, so it's a good place to go for any eating disorder. If that doesn't suit you, just search google. Remember, always look for pro-recovery. As with the livejournal groups, read through posts and check that the place is right for you. It should be supporting the fight to recover, with friendly members and not sharing tips for how to make your disorder worse.

All Alone in a Crowd

So, yesterday I went to meet the people who are starting on the same graduate training scheme as me. One part of the day was a "speed dating" section which involved us finding out each others' main hobbies. Three of the guys put down drinking.

Watching a presentation about how much fun last year's graduates had had on the scheme, there were an awful lot of pictures of people with drinks in hand.

Talking with the other people, there were plenty of comments about drinking, nights out and hangovers dropped into the conversation.

And suddenly I'm back to feeling like a sixteen year old freak who doesn't want to try drinking, isn't interested in dating and would rather stay in with a book than try and sneak into clubs. I was lucky in school; there were a couple of other girls who also didn't rush to the toilets to check their make-up at the end of the day, just in case they passed a guy while on the way home. I found a couple of people who weren't fussed about grabbing a boyfriend or going out clothes shopping or getting drunk. At university, I found a surprising number of friends who don't drink and plenty of others for whom alcohol is something occasionally sampled as a glass of wine at a party.

But there is still often that sense that I don't fit in. This loneliness and feeling of not being like everyone else was, I think, a large contributing factor in my developing a disorder.

I was talking to my mum the other day about one of my cousins. It seems he really doesn't fit in with his classmates at school because they're all interested in drinking, smoking, drugs and having sex (or at least pretending to be so for the sake of appearences). I went to a private school with a strong emphasis on academic acheivement, which meant that the crowd interested in those things was smaller and less influential. He's at a comprehensive and seems to be the only one not wanting to get drunk, high or laid.

I don't see most of my cousins that often, but I do sometimes worry. There is strong evidence that eating disorders have a major genetic factor. I can remember comments from my aunt in the past about how he seems to eat a lot but stay thin. Maybe he's lucky. Maybe he's energetic. Maybe my aunt has a different value for "a lot of food" than I do.

But I wonder and I worry and I wish there was some way that I could let him know that things get better. He won't always feel like he's the only one not interested.

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.

Breaking free from bulimia Part One

Breaking free from bulimia is difficult and can take a long time, so I thought I'd share a few ideas that have helped me. They may not help everyone because everyone's different, but if you suffer from bulimia, search for your own tools to escape this disease.

Avoiding binges

Stopping binging is really the key factor in recovery, because this prevents the guilt and dangerous purging methods. Binging can be caused either by emotional factors or by physical ones. The physical causes are much easier to deal with than the emotional ones.

The human body has had billions of years of evolution go into its creation and in most of that time, food was short so we have evolved instincts for avoiding starvation. Your body doesn't want you to die. So, when you restrict too much or exercise far more than your consumption, these starvation instincts kick in. You start craving sugary and fatty foods. This is a natural response that almost everyone has (the ones that don't are probably diagnosed anorexics). When you deprive your body of food, you will feel an overwhelming need to eat. Your body has evolved in times of little food so that when you see an availabilty, you will stuff your face because your instincts don't know when you'll have another opportunity.

This is a perfectly natural response that can be avoided. Never let your body get so hungry that a binge is instinctive. Eat regular meals and light snacks between them. I always have a supply of carrot sticks and dried fruit so that I can have something to eat if I get peckish and never get starving hungry so that I end up eating half the contents of a vending machine in one go.

Another method of avoiding binges is to remove the opportunity. Don't keep binge foods around. If you don't have any in the house, this puts an obstacle between you and the binge and can make it easier to resist.

Whenever I went to the supermarket, the temptation was there to fill up my basket with all the fatty sugary junk I used to binge on. So I never went to the shop on my own. Persuade a friend to go with you. If they know about your eating disorder, explain that it's to make sure you don't end up buying binge foods. If they don't know, then presumably you don't want them to know so it will be easier for you to resist buying all the things you know you shouldn't. Another possibility is ordering food online. I get most of my weekly shopping delivered by Tesco. It's much easier to resist a picture on a screen than a packet of biscuits within easy reach.

Someone on a forum mentioned a time locked safe. She puts biscuits and things like that into a safe that she can only get into once a day. When it opens, she can take out a couple of items, but for the rest of the day she doesn't have the ability to get in so she can't end up binging on whatever's stored in there.

Find whatever method is right for you, but make it hard to binge. If the nearest shop to you doesn't accept cards, make sure you never carry cash around. That way, you'll have to go further to buy supplies.

If you do feel the need to binge, go somewhere that doesn't give you the ability. Go into a cafe and order something small. You will be able to eat and get rid of any physical hunger, but you won't be able to binge.

Just keep putting hurdles between you and the binges and eventually you'll be able to resist them. Find whatever method works best for you.

Try and avoid triggers. What makes you want to binge? Are there certain places or types of events that make you feel the need to binge?

For me, loud parties with lots of people getting drunk always make me feel out of place, awkward and antisocial. I get miserable and feel like a freak for not enjoying myself. Then I go and eat. I've learned to politely turn down invitations to these events. It means I feel antisocial when I reject the offer, but I don't have a miserable evening that makes me go to the nearest late night shop or vending machine and stuff my face.

If there is any event that almost always makes you binge, don't go.

If you struggle to resist temptation when there's a large availability of food, don't go to places that offer a free buffet or eat anywhere that sells all you can eat.

Triggers are different for different people. Try and work out if there are factors that link your binges and then try and work out ways to avoid those factors in future.

That's not enough to be free. You will still struggle and binge and hate yourself for it, but if you can reduce the number of binges, you'll reduce the self-loathing and that will reduce the desire to binge again. There will still be the emotional factors affecting your desire to binge. It may be that the best way to deal with those is to talk to friends or see a therapist. Because the contributing issues are a varied as the sufferers of this disorder, I can't give a list of ways to make them go away. You'll have to deal with those yourself or get professional help.

What I'm offering is just a couple of tools. You'll have to built your own toolkit that helps you fight back against this disease.

Recovery

Another blog I read posted a list of what recovery looks like. I thought I would try the same with my own experiences.

Recovery is...

• Walking into the supermarket and coming out again with only the things that were on my shopping list.
  
• Not instantly thinking of an excuse to leave when a friend mentions ordering take-away.
  
• Eating a slice of birthday cake and feeling good that it's my birthday not horrible about the amount of fat and sugar.
  
• Going out for a meal with my boyfriend and focussing more on him than working out the calorie count of my dinner.
  
• Buying an item of food because I like the taste, even when it has five more calories than another option.
  
• Standing on the scales in the morning, seeing my reflection and feeling hideously fat, then going and eating a healthy breakfast.
  
• Having a bad day, eating a load of junk in one go, and then managing to eat more than a stick of celery the next day.
  
• Taking a biscuit when a friend offers me the packet and knowing I'll be able to stop after one or two.
  
• Going to the gym because I want to keep fit, rather than because I want to burn off a binge.
  
• Not having a load of wrappers hidden around my room because I'm scared people will spot them if I throw them in the bin.
  
• Eating a bar of chocolate, fretting about the calorie count and then managing to cook dinner.
  
• Going for a long walk and not having to worry that I'll faint on the way.
  
• Being scared that I'm fat and hideous, but not letting it stop me living my life.
  

One and Lonely

Another Superchick song.

I would like to point out for any Americans who are watching this that the "size 12" mentioned at one point is the British size 12. This is size 8-10 in US sizes.

What Disorders Look Like

I had a comment asking, not quite so politely, why I wasn't skinny if I'd had an eating disorder so long. Why is there an assumption that eating disorder sufferers must be thin? Many aren't.

In this post, I will describe the general trends in weight of sufferers of the four main eating disorders COE, binge-eating, bulimia and anorexia. I won't discuss EDNOS, since the sufferers can have a wide range of symptoms and fall just about anywhere on the spectrum.

I would like to emphasize that I'm generalising. With the number of eating disorder sufferers in the world, there are bound to be exceptions.

Compulsive Over-Eating Disorder

Trying to find a clear definition of this disorder, I've found a lot of sites trying to tell me that this is the same thing as binge-eating. It's not There are similarities and there are wide grey areas between the two where sufferers might be classified as one or the other, but they're not the same.

With COE, the sufferer has an addiction to food. They will use it as a means of coping with emotions. They will eat when they're not hungry, eat until they feel uncomfortably feel uncomfortably full and spend excessive amounts of time thinking about food. COE sufferers might binge, which is why this disorder is often confused with binge-eating disorder, but they also might graze. Grazing refers to constantly picking at food.

Almost all sufferers are overweight or obese. Some might exercise or try to graze only on healthy foods, so the affects might not always be obvious. Generally though, these people are consuming far more calories than is healthy and so will be overweight.

COE is possibly the most misunderstand disorders, because people assume sufferers are just greedy or lazy.

Binge-Eating Disorder and Bulimia

I'm discussing these two together because I feel they fall at either end of a range. With both disorders, the sufferer will binge, where they eat vast quantities of food in a short period of time. With bulimia, the sufferer will try to compensate for their behaviour by various means such as induced vomiting, diet pills, exercise and fasting. With binge-eating disorder, there are no compensatory methods. I say they fall at either end of a range because it's hard to put discrete values on these compensatory methods. There is no clear line where binge-eating disorder becomes bulimia. A sufferer of BED might occasionally exercise or try diets, but not classify as bulimic. A bulimia sufferer might not use some of the more extreme methods and so be closer to being a BED sufferer than others. With these definitions, we are dividing a continuous scale into discrete sections.

Sufferers of binge-eating disorder will be overweight or obese. They will consume large quantities of food in their binges but there will be no purging activities to bring their weight down between binges or to prevent digestion of the food.

If someone displays the symptoms of binge-eating disorder but is not particularly overweight, it is more likely that they are bulimic, even if they don't induce vomiting after binges.

Bulimics can be overweight, or even obese. Bulimia often starts when a person tries to diet but ends up depriving their body of too much food and causing instinctive cravings for fat and sugar. A large number of bulimics will be a healthy weight or slightly overweight. Even with the purging form of bulimia (where the sufferer induces vomiting after a binge) it is impossible to empty the stomach completely and some of the food will be digested. Since the body is in "starvation mode" all the food will be stored as fat. Between binges, the metabolism will be slowed so fewer calories will be burned than for a normal person.

Some bulimics are underweight. This group will almost always perform extreme purging methods and many will have strong anorexic tendencies. Again, we get back to the problem of indistinct boundaries. Where do you draw the line between bulimia with anorexic behaviours and anorexia of the binge-purging type?

So, bulimics might be underweight, sometimes severely, or they might be a healthy weight, or they might be overweight, sometimes severely. That makes it rather difficult to tell if someone is a sufferer just by appearance, though there are more subtle signs.

Purging bulimics will usually have damaged teeth from the vomiting. This is very often not obvious, particularly if the sufferer is aware of the damage and tries not to open their mouth too wide.

Purging bulimics may also have cuts on the back of their hands. However, they could easily try using something other than a finger to induce vomiting if they wish to leave not visible marks.

A large number of bulimics suffer malnutrition or nutrient deficiency. This is because the foods used in binges are often high in fat and sugar. These junk foods are often lacking in nutrients so even if they don't purge, they won't gain any goodness from what they do eat. If the bulimia sufferer fasts or skips healthy meals, they will miss out on essential vitamins. The signs of nutrient deficiency are often invisible. A bulimic may be pale or tired-looking, but this is difficult to judge. If someone tans easily or has a naturally darker complexion, paleness will not be to any extent which makes it noticeable.

Another sign is brittle hair. Sometimes the hair will fall out. This is a symptom that the disorder has in common with anorexia, but because the bulimics get some food, this symptom usually sets in after the disorder has been present a lot longer than would be the case with anorexia.

A person can be bulimic for years before the signs ever become visible.

I think this is one of the major problems that needs to be overcome when a bulimia sufferer seeks help. Generally, they will not look ill. This can lead to people believing they are putting it on for attention or the sufferer being scared to ask for help because they fear that's how it will seem.

Anorexia

This is what people think of when they think of eating disorders: people so thin that their bones are poking through their skin. The physical signs of anorexia are much harder to hide than with bulimia, though sufferers will often try, wearing baggy clothes and severe make-up.

The obvious sign of anorexia is weight. To be classified as anorexic, a person has to be noticeably underweight.

There are other signs, but by the time these are visible, the weight will usually be enough of a giveaway. An anorexic will be pale, tired-looking and will have brittle hair, sometimes falling out in clumps.

There are plenty of other physical symptoms, such as bad teeth and lack of menstruation, but in terms of appearance, you won't need to see these to know that there's a problem.

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So there you have it. A person with an eating disorder may be any weight and the problem may be almost invisible if you don't know the precise signs to look for.

Never assume that a person doesn't have an eating disorder simply because they look a normal weight.

Dear Anonymous

I received a comment on one of my earlier posts. The commenter gave a question, but since he/she was anonymous, I don't have any way to reply. So I will answer it here.

"how are you still kind of fat if you spend so much time starving yourself? You're not huge, but you have a lot of fat on your stomach area..."

Thank you for that wonderful boost to my self esteem. [/sarcasm]

I gained weight during my eating disorder. Quite a large number of bulimics do. During the periods of starvation/eating only vegetables/strenuous exercise, there are parts of the brain that are tricked into believing there's a famine. The body starts to crave fatty and sugary foods as a survival instinct. The metabolism slows down because the body is getting less food and so outputs less energy as a response.

Then I would binge. I would eat a huge amount of junk, most of which was full of sugar and fat. My body would then store all of this as fat. Even bulimics who throw up never manage to completely empty their stomachs. The body still digests part of the binge as stores it entirely as fat. This is why the majority of bulimics are a healthy weight or even overweight. Those bulimics who are underweight tend (this is a generalisation and not always true) to be bulimic with strong anorexic tendencies. Some may even qualify as anorexic with binging when their body mass drops enough.

I would starve myself and use diet pills and exercises and every trick I could think of to lose weight. But I would put it all back on when I binged.

Being eating disordered doesn't mean being skeletal thin. With most bulimics, you'd never know by looking at them that there was anything wrong.

Other cultures

The statistics in this blog entry are from three different sources, so they don't analyse exactly the same thing and I can't be certain that they define anorexia in exactly the same way. This basically means that any conclusions are scientifically invalid, but I'll keep my opinions nonetheless.

I've spend considerable time in Finland including a three month stretch last summer. I noticed a lot of things about the country but one of them was that the population was, on the whole, thinner. Sure, there were overweight people, but a lot less than I see in England and usually not quite as fat. I don't remember seeing a single morbidly obese person in my time there.

The canteen at the place I worked served, on the whole, healthy food and there was always an option to go for the "green line." This was a wide variety of salads with something light as the main meal. It was very rare for there to be anything particularly unhealthy. Even the deserts were usually of the stewed fruit and yoghurt variety. Occasionally, there were cakes as an option, but no more than once a week at most.

There was also a lot of emphasis on exercise and sport. Children play a lot of sport at school, there are wide cycle paths through the city and alongside the main roads (something I wish Britain would imitate) and people walked quite a lot.

Then, there might be a genetic element to it. Finland gets incredibly cold in winter, so maybe, over the centuries, Finns have bred a tendency to a good metabolism because keeping the body warm means they're more likely to survive the cold season. Certainly, the Finns I saw didn't seem to skimp on the portion sizes and were still a healthy size.

Whatever the reason for it, the Finnish population appear, on the surface, to be a much healthier group than in the UK. They appear to have a much healthier relationship to food and exercise than those of us in the US or the UK. From what I'd seen and the people I'd met, I wouldn't have been at all surprised to find out that eating disorders were rare in Finland.

So let's look at the stats.

According to a nationwide study, 2.2% of Finnish young women suffer from severe anorexia nervosa. Up to 5% of Finnish women suffer anorexic symptoms in their lifetime.

That doesn't look very good. Then again, there are some large figures floating around the web stating how a huge proportion of people in America have an eating disorder. I looked solely at the numbers relating to anorexia, since those were the only figures I'd found for Finland.

According to the National Institute of Mental Health in the US, somewhere between 0.5 and 3.7% of females suffer anorexic symptoms in their lifetime.

That's low. That's a lot lower than in Finland. Now, maybe the definition is less strict in Finland. Certainly, I feel that the American definition has some problems with it, because it focuses on physical rather than psychological symptoms. I can't be sure. But it's obvious the result I was expecting doesn't seem to be forthcoming.

So let's look at the UK. According to the eating disorder charity Beat, 1-2% of women are anorexic at any one time. Comparing this with the other Finnish figure now, it seems that more than that were anorexic at the time the study was performed.

Again, different definitions of anorexia might be responsible, but it seems obvious to me that appearances can be deceiving. On the surface, it might seem that Finland has a much better relationship with food and exercise than we do in the UK, but anorexia is at least as common. Maybe Finland has lower rates for binge eating disorder, compulsive over eating, bulimia or ednos. Maybe not. Until the results of a nationwide survey on those released on the web, I can't be sure.

I think it's reasonable to believe that eating disorders appear in every country, even ones where the culture and social behaviour is quite different from that of the UK. Maybe we shouldn't be so quick to blame our schools, media and culture.

Pull the String

Continuing my weekly video pattern. I'm not sure how long I'm going to be able to keep this as a weekly thing, because there's a limit to the number of songs I can use.



One thing that I've shown in this video are the scars on my wrists. I tried to kill myself when I was fifteen. It was undoubtedly the stupidest thing I've done in my life, but I'm glad I did it.

When it failed, I admitted to two of my friends that I'd been depressed. I didn't tell them about the binging because, at the time, I still didn't believe I had an eating disorder. But I was able to talk about other issues that bothered me and they were able to support me through the bad days.

My best friend was so completely distraut when I told her I'd tried to kill myself that I decided never again. I swore to myself that no matter how bad things got, I would never try to take my own life.

Which meant I was left with two options: I could spend the rest of my life being miserable and hating myself, or I could get better. That was the turning point for me. Yes, the binging continued for a couple of years more, but I was determined that I would recover. I was able to make more friends when I started sixth form, do things I enjoyed and actually have fun.

I feel quite proud when I look at this video and see that the scars are barely visible at this quality. I hid them for ages under bracelets when it seemed like they'd never fade and that they'd declare my idiocy for the rest of time. But they have faded. The evidence can only be seen if you look closely. And I kept my promise.

I never tried again.

I never will.

This is another video of my experiences with eating disorders. I may make this a regular weekly feature, but I might run out of songs.

This video shows the way I used to behave, not how I currently do. It shows the methods of purging I used: mainly diet pills, skipping meals, throwing away food, eating only vegetables and excessive exercise. It also includes vomiting. This was a very rare occurance for me, but I felt it worth including. Every time I threw up after a binge, I swore it would be the last time. That promise was rather difficult to keep.



I show myself reading a novel at one point. This is Perfect by Natasha Friend. It's an excellent story of a girl suffering from bulimia.

The next clip shows me with a DVD. This is the movie Sharing the Secret, which is based on a true story. It deals with a bulimic girl being discovered by her mum and her journey towards recovery.

I took a lot of comfort from stories like this because it helped me feel less alone.

There are also clips of me looking at websites. These are Food Focus, which is a site for calculating calories eaten and burned, Anorexics Advice, a site aimed at wannarexics but helpful to those with eating disorders, Why We Hate Anorexia and my own blog.

Blame

I read a piece on another blog about blame. The author there felt that she was pressured into pointing fingers and blaming parents or the media or biology. She felt that we don't need to blame anyone.

Her piece got me thinking about my circumstances and who I should blame for my own disorder.

One scapegoat a lot of people point fingers at are pro-ana sites. These are definitely not to blame in my case. I didn't these sites. I never even considered joining a group discussing eating disorders because I didn't believe I had one. I never looked for tips on how to hide food or to burn off more calories. So the pro-ana cult is completely innocent, at least as far as my history is concerned.

Another common scapegoat is the media in general, with magazine printing pictures of super skinny models and stories about how this actress has that eating disorder. Never read them. I couldn't care less about actors' social lives and I never fussed about the fashion pages. The only magazines I ever bought were ones to do with writing, and I don't think they ever mentioned the subject. So I didn't feel pressured to be thin by pictures of celebrities.

Then you get to bullying and abuse. Nope. I've never been abused physically, sexually or emotionally. I was never bullied at school. The school I went to was a good one which encouraged respect and where getting good grades was a thing to be proud of, not a cause of bullying (at least for most of the pupils, including me). None of the other kids at school ever made comments about my weight. It helped that the friendship group I was in wasn't openly fussed about that sort of thing. They weren't into fashion and trying to date every other guy in the boys' school down the road. They would have accepted me no matter what.

So we get to parents. Another very common subject for blame. Do I think my parents played a part in my eating disorder? Certainly. Do I blame them for it? No.

When I was in my early teens, I was a bit overweight. I wasn't hugely fat, but it was enough to be noticeable. My family has a history of diabetes and one of the factors that can affect whether someone develops diabetes is their weight. My mum advised me to be careful and to start thinking about weight. Genetics plays a huge part in whether or not we're predisposed to be thin and my family certain aren't. My mum thought it would be easier to start thinking about weight then and being careful than becoming seriously fat and then trying to diet it away. She was of the opinion (and generally, I believe her) that keeping weight off was easier than losing it once gained.

She was always nice about it. She didn't talk about it in terms of how I needed to lose weight, but suggested that we both get a bit more exercise (she was suffering from middle aged spread). She wanted us to support each other, help each other and encourage each other in a sensible diet.

So, yes, my mum called me fat and that made me self-conscious about my weight, but I can hardly hate her for it. She was concerned about diabetes which is, at best, a life-altering condition and, at worst, a life-threatening one. She was trying to ensure I had a healthy future, as well as looking good and not being a risk of being teased for being overweight. She only ever had my best interests at heart and I think her encouragements were sensible. I don't want to have to worry about insulin injections or maybe lose a limb to a condition, so I'm happy to have received that advice.

Then consider my sister. There were plenty of times through my teenage years when I hated her for merely existing. She's three years older than me, thinner than me, pretty and has always done extremely well academically. To top it off, she's an excellent musician, good at art and gets near-perfect grades. I know my parents never compared us, but it was hard, when I fourteen and fifteen, for me to see it that way. I struggled to see me good points and just saw all the talents that my sister had that I hadn't.

I couldn't sing a note. She reached grade three in piano in less time than it took me to reach grade one.

My pencil sketches were mediocre at best and my paintings worse. She had a painting framed in the kitchen.

I did well at school. She'd been there before me and had a list of A's, so even if I got good results, it would be nothing special.

When I was doing my GCSE's, she was doing her A-Levels and doing well. She was applying for university and getting offers from Oxbridge.

My parents never pushed us to compete or favoured one of us more. I know the competition was all in my mind, but it was there nonetheless. I wanted so badly to be as good as my perfect sister, but I didn't believe I ever would be. She never bragged. She didn't try to encourage me in my belief that she was better. She's told me since that she hated me for a portion of her teenage years because I did well at school, shone in maths and could write better stories than her. It seems that each of us had a competition going on in the privacy of our heads and the each of us found ourselves to be the losers.

But can I blame my sister? No. The need to be perfect came entirely from me, not from her. My sisters grades were something I fixated on but I should hardly expect her to do less than what she was capable of, simply to appease me own ego. She did well and that's great for her. A large part of my problems back then stemmed from my desire to compete with her, but she didn't know about it and she isn't to be blame. I created the competition not her. I was the one who set myself standards of perfection I could never reach.

School played a huge part in my depression that led to my binge eating, which lead to everything else.

The school I went to was an excellent one, with helpful teachers who encouraged us to achieve our potential. My parents never told me I had to get the best marks. They never sat me down and forced me to do my homework. They never put excessive pressure on me. But still, I knew I was expected to do well. I come from a family of high achievers and it was generally accepted that I would be one too. I felt that a lot as I was working for GCSE's, and later A-Levels.

I felt that anything less the perfect marks would lead to my parents being disappointed in me. I wanted to please my parents. I loved them, they'd given me the best that they could, and I wanted to live up to their expectations. So I pushed myself into believing that I had to get straight A's.

I know now that my parents would still have loved me had I done badly in those exams, but it was hard to believe it at the time.

I would like to blame school for my eating disorder. I would love to blame exams, which sort us out and rank us so that the world can see who's better. The exam boards slot us into categories so that getting a B at a school full of A's and A*s feels like a crime.

Yeah. Please can I blame exams?

But I should be honest with myself. I was the one who put so much meaning on these little letters. I was the one who cared so much and felt that the world would come crashing down if my marks weren't good enough. I was the one who stressed so much that the only way to feel calm was in that numb period where I was shoving food in my mouth without thinking.

I'm running out of scapegoats.

Can I blame biology? Probably. In the end, everything comes down to biology.

I watched a documentary on eating disorders. It said when they look at the families of eating disorder sufferers, there's usually a family history of anxiety conditions (and often other eating disorders). My mum jokes about chocolates being anti-depressants, so I know that food can be a comfort for her.

My grandmother on my dad's side is a worrier. She plans everything to the tiniest detail and then panics if things don't go 100% right. I'm no psychologist, but I'd say she has an anxiety condition. I wouldn't have said the same was true of my maternal grandmother, but she did like everything to be in its place. I can't comment on my grandfathers because I barely remember one and never knew the other.

I know my mum has problems with anxiety. Apparently, it used to be even more severe, but she's got passed the problem and managed to build herself a life she can be proud of.

I think there's a decent case for my family being predisposed to anxiety and passing on those genes to me. So I guess I can blame my parents, since they're the ones who gave me these genes. But it's not fair on them to do so. They had no choice when they gave me an anxious disposition than when they gave me brown hair or type A blood.

There's a lot of evidence to support the theory that eating disorders are influenced by biology. I'm willing to believe that I was born with a natural tendency that made me susceptible to developing bulimia. The pressures from school, my parents and my sister only gave me a slightest nudge, but I was born standing on the edge of the precipice, so that nudge was all that was needed to send me spiralling into disordered eating.

Everything else, all the other pressures, were dreamt up by me. I can only really blame myself for the things I did.

But that goes both ways. I may have caused my own condition, but I shouldn't focus on blame.

I was also the one who cured myself and I should be proud of myself for that. And I'm the one who'll keep fighting for the rest of my life if I have to, and I'm pleased with that determination. I won't focus on the fact that I can drive myself into despair. I'll focus on the fact that I crawled my way back out of the depression and into happiness.

I did that.

Me.

And that's a good part of myself that no one can take away.

Weekly Update 1

This is the first of what will be a series of weekly updates about how I'm coping and whether I slip up.

I mentioned in my first couple of posts that I went to the supermarket last week and bought supplies for a binge. The good news is, I didn't binge. The bad news is, I showed no self-restraint whatsoever and the last of the food went yesterday.

I'm just trying to cling on to the fact that I didn't eat it all in one go.

On a brighter note, I went to the shop again yesterday because I was out of milk and low on vegetables. The most unhealthy thing I bought was a packet of low-fat, wholemeal biscuits. They're sitting in a cupboard in the kitchen and I'm determined to eat them gradually.

I've been to the gym a few times for a couple of hours at a time. The sessions have been tiring, but I've not been pushing myself too hard.

Overall, I've gained a couple of pounds this week, but I can cope with that. Everyone goes through bad patches and I'm not about to start starving myself over this one.

Non-purging bulimia

When people think of bulimia, most of them would think of the classical pattern of binging then throwing up. A lot of people don't realise that there's far more to it than that. Plenty don't even imagine there are different forms that bulimia can take.

Even in groups that deal with eating disorders, when people talk about bulimia, they usually mean the purging kind. When people talk about the dangers of bulimia, they mostly consider the dangers of repeated, induced vomiting. They don't consider that there are other actions that lead to the same disorder. So I'm going to explain a little about a different form bulimia can take.

The definition for bulimia talks about binges – eating vast quantities of food in a short space of time and feeling out of control while eating. The definition also talks about feeling of guilt follow such binges and self-evaluation being based on image and body shape. Then it mentions purging behaviours.

Purging behaviour can include vomiting, laxatives, diet pills, fasting or excessive exercise.

Note the "or."

It is completely possible to be bulimic without throwing up.

I'll explain a little about how I used to act, but I don't believe for a moment that this is the only pattern non-purging bulimia can take.

I used to binge. I would buy a load of junk food and then stuff my face. A binge would usually be a bag full of biscuits, sweets, crisps and cake. Sometimes I would buy a microwave meal as well. Sometimes, I'd stop by the sandwich shop and buy a sausage or a bacon sandwich. If I didn't have enough food, I would eat something from the fridge or the larder as well. I would eat until I felt stuffed but I wouldn't be able to stop.

Then I would hate myself for being so weak and greedy.

So I would focus once more on my diet and be determined to be even stricter with myself to make up for my behaviour. My diet consisted of skipping meals whenever possible. My mum went (and still goes) away on business quite a lot. Once my sister started university, it was my job to cook dinner. I always tried to time it so that I would finish cooking a few minutes before my dad got home. That way, I could pile most of the food onto his plate and leave just enough on mine to make it look used. Then Dad would get home and I'd just be finishing up the last bit of carrot or piece of broccoli. When I mistimed things, I would be careful about serving things out, so I would get more vegetables and he would get more of everything else. But I couldn't do it too much or he'd notice, so I absolutely hated those meals.

At school, I would make a show of eating. I would obviously go to the vending machine and make jokes about how I ate quite a bit. I knew I wasn't losing weight. I would rather my friends thought me slightly greedy than guess that I must be binging and know that I was a disgusting pig. So I made certain they saw that I was eating... then I would throw away the packages with almost all of the food still in them.

I never ate breakfast. When I had to eat other meals, I tried to make them as low fat as possible and threw away anything I could get away with.

And I exercised. I played a lot of badminton and went to two different clubs. This let me play for at least five hours a week without anyone being even slightly suspicious. I went to the gym with my mum one evening a week. And I went jogging. I would get up early on a weekend morning and go out running. I tried to do this before anyone else was awake, because I didn't want them to realise that I wasn't losing the weight that I ought to be doing. I would rather my family thought I was lazy and didn't exercise enough than guess that I must be eating so much sugar and fat when they weren't looking.

Then, in the privacy of my room, I would do sit-ups and lunges and any sort of exercise I could given the confined space. The rest of the time, I would worry about how many calories I was burning. I would sit in my lessons at school and twitch my legs or wriggle my fingers or anything to give just a little bit more movement.

I bought myself an ab belt. It's one of those machines that you put over your stomach and it promises to give you more definition and a flatter stomach. The one I had said on its instructions not to use it for more than half an hour a day. I used it for at least three on full power.

I took diet pills. I tried loads of different brands and varieties: thermogenics, appetite suppressants, fat metabolisers, detoxifying complexes. I was careful about how many I took, because I didn't want to accidentally overdose. I would follow the instructions for each packet carefully, taken the maximum recommended dose. But I would be taking at least two different brands at the same time. Again, I was worried about overdosing, so I was careful to take brands of different types. I'd happily take a dose of detoxifiers and one of an appetite suppressant, but I wouldn't take two different thermogenics.

I also tried cold baths. I'd heard that people burned off loads of calories keeping warm, so I would run a deep bath of cold water. Sometimes, I was able to sneak some ice cubes from the freezer to the bathroom and put those in. I would sit in the icy water for at least an hour, shivering like mad and delighted that I was burning off fat. It usually took me ages to get to sleep after that, because I'd be lying in bed still shivering. But at least shivering used energy!

Then, after maybe a day or so of this, I'd be famished beyond belief and craving sugary, fatty food. I'd smell something delicious and lose all control and rush to the shop to buy another hoard of junk.

But I didn't often throw up. I only stuck my fingers down my throat on less than half a dozen occasions and, generally, it didn't work. The times when I did throw up, it was usually unintentional. I'd just eaten too much for my body to cope with. This particularly happened if I binged late in the evening and then went to bed with my stomach still too full.

I didn't believe I had bulimia, because I didn't stick my fingers down my throat after each meal. I didn't force myself to vomit so I didn't fit the standard pattern.

I want people to understand that there's more to it than just throwing up.