Brain Over Binge (2 page)

A Note to the Reader

For the sake of simplicity, throughout this book, I use the term
therapy
or
treatment
to refer to the collective treatment I received for my eating disorder, and I use
my therapists
to refer to the collective professionals who treated me over the years. During my college years, I saw three mental health counselors, two psychologists, three nutritionists, a psychiatrist, and a medical doctor about my bulimia. I was also an avid reader of anything pertaining to eating disorders. I got much advice from eating disorder experts by reading informational and self-help books and from resources on the Internet. Naturally, I don't remember exactly where I learned each specific item of information; so when I say, for example, "my therapist told me ..." or "this is what I learned in therapy," it's possible that the advice quoted could actually have come from a self-help book or another expert source. When I do mention specific therapists' names, I have given fictitious ones.

Introduction

T
he stories I've read of bulimia recovery are of two types. My story is neither of the two.

The first is what I call the "butterfly tale." It goes something like this: The bulimic—the caterpillar of the story—is not happy, her relationships are not fulfilling, she tends toward depression and negative thinking, she lacks true direction and purpose in her life, she holds on to hurt from her past, and she doesn't like herself. She binges and purges, supposedly to deal with her pain, but that only makes her more miserable.

Then she enters the recovery process—the cocoon—and there, she works to resolve issues from her past, learns how to cope with everyday problems and major stressors, learns how to manage feelings and emotions, and finds peace within herself.

The recovery process is not comfortable: it is hard work, and the transformation inside the cocoon can take an extremely long time. But when the bulimic is finally ready, she emerges as a fundamentally changed person—the butterfly of the story. She has become happy and fulfilled. She is in touch with her feelings and involved in satisfying relationships. She is at peace with her past and is able to live joyfully in the present; her ambitions for the future are quickly becoming reality. As a result of her transformation, she no longer needs to hold on to her eating disorder. She can fly away.

The second type of recovery tale is what I'll call the "tamed house pet story," and it goes something like this: The bulimic—the untamed animal of the story—lives a destructive and dangerous life. She binges and purges, and in so doing, she finds herself isolated, struggling through every day, and never safe from her bulimia.

Then she enters the recovery arena and begins the arduous process of taming her disordered eating behavior. After much training, practice, attention, and patience from therapists and support networks, she learns to reduce her binge eating and purging. She may even stop these behaviors—for the most part—after a long and difficult recovery process.

This type of recovered bulimic is like a wild animal who is taken into a home, trained diligently and painstakingly, given much attention and care, and learns to live a new and better life. However, even though the house pet learns to behave correctly most of the time, it still retains its untamed instincts at some level, and the owners may never be fully confident with the house pet in all situations.

In this type of recovery, an occasional binge is excused, just as occasional inappropriate behavior is expected from a tamed house pet. The bulimic falters every now and then, but she gets back on track afterward. Her relapses are welcomed as learning experiences or as signals that something else in her life needs attention. When they occur, the bulimic seeks support, tries to address what she believes to be the underlying emotional causes of the binge, and learns some new coping skills so as to avoid binges in the future.

This type of recovery eventually becomes fairly secure; however, the recovered bulimic can never get too comfortable. She has to take it "one day at a time." Just as the owner of a tamed house pet has to keep it away from, or train it to deal with, anyone or anything that could trigger its past behaviors, the former bulimic has to either avoid, or ensure she copes well with, things that could send her back to binge eating and purging. She has to be on guard against feelings and life events that could allow her untamed ways—her binge eating and purging—to return. These events and feelings are termed "triggers" in the eating disorder community. The recovered bulimic has to continue to deal with issues from her past, ensure that her emotional needs are met, and make sure she eats the right type and quantity of foods to avoid triggering a relapse.

The improved quality of life of the "tamed house pet" former bulimic is, undeniably, a vast improvement over the daily torment of bingeing and purging, just as the pet animal is unquestionably better off than when it was living on its own. But remaining free of bulimic behaviors is certainly not effortless—it takes constant maintenance.

When I was in the depths of bulimia, none of these stories made sense to me. Butterfly tales of triumph are commendable and inspiring, and no doubt very real; but in six years of trying, I found I could not relate to the idea of a long journey into a rich and full life while struggling daily with my incessant urges to binge. My failure to transform myself into a butterfly wasn't for lack of effort. Sure, I wanted to become happy and fulfilled; but that was not happening for me, especially while I continued to eat thousands of calories at a time and while I was exercising to exhaustion to try to undo the damage to my body.

No matter what I uncovered from my past, no matter what I resolved in the present, no matter what I envisioned for my future, my urges to binge eat still consumed me. No wings grew, no brilliant colors appeared. No matter how well I managed to cope with emotions and feelings and conflicts and problems, I still gave in to those urges time after time. As time went by, I saw what should have been some of the best years of my life quickly passing. I began to think that if I was waiting to become a butterfly to stop binge eating, I could be waiting forever. I began to think that the "tamed house pet" type of recovery was my only chance at a semi-normal life.

Yet the tamed house pet recovery stories didn't really appeal to me any more than butterfly tales did. These stories don't even promise the complete freedom of the butterfly tales, because even after recovery, the bulimic is still very much reliant on therapists, therapeutic techniques, and support systems in order to remain recovered. I was tired of meal plans; I did not want to have to follow one every day after recovery. I did not want to continue going to therapy and support groups indefinitely. I did not want to have to deal with my bulimia one day at a time—I wanted to be free of it completely. I wanted recovery to mean a life where I would no longer have any desire to binge eat, no longer have to be on guard against triggers, and no longer binge—ever.

As I write today, I am completely free of binge eating, purging, and any type of disordered eating. I don't have to watch out for triggers, and I don't have to follow meal plans or attend therapy. I no longer have any urges to binge, and there is no possibility of relapse. Yet my recovery did not involve any major self-transformation—I found another way to end my bulimia. My daily struggle with food is finished; the pain that my habits brought me has disappeared; the misery of those years of binge eating is gone. The relief I feel to have put my eating disorder behind me is beyond words.

My recovery was not typical. It did not involve special diets, emotional self-discovery, or spiritual enlightenment. It did not result from a decrease in anxiety, an increase in happiness, an improvement in self-esteem, a new medication, or any major life change. It was simply me, armed with a bit of knowledge, finally taking control of my own behavior.

Today, perhaps I am not the perfect, successful, confident, shining example of what a recovered bulimic should be—"in love with life and in love with myself"—but each day, I do have the opportunity to live a real life, with all the joy and pain it brings. I still have many of the same faults, problems, and weaknesses that I had when I was bulimic; but without the bulimia, those problems are immeasurably more manageable. I now have a family of my own, and I can be available to them and to all the people I care about. Without my bulimia consuming me, I am better able to tackle the daily challenges that I face, even if I don't always cope well.

I hope that my story will point other bulimics in a new direction—away from the myths of the butterfly theory of recovery and the constraints of the tamed house pet theory of recovery, and into a kind of recovery that is secure and lasting. I believe that, at any time we choose, we can take another path and use our own resources to end bulimia.

This book is divided into three parts.
Part I
is a memoir of my eating disorder and my recovery. I share how my bulimia developed and grew over the years, my experiences with unsuccessful therapy, and how I finally conquered my bulimia on my own.
Part II
is an account of my journey to figure out what my bulimia was all about to begin with and to explain to myself how I was able to recover so quickly and completely. The answers I found were surprising to me, and very different from what I had learned in therapy. In
Part III
, I discuss topics that were often the focus of my unsuccessful therapy, such as low self-esteem, poor body image, coexisting problems, and eating a normal diet.

In this book, I primarily address bulimics and those with binge eating disorder (BED); but anyone dealing with episodes of binge eating can benefit from what I've written. For those who are unsure if they fall into this category, here is a definition of
binge eating
adapted from most recent edition of the
American Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR),
published by the American Psychiatric Association:

An episode of binge eating is characterized by eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances,
and
by a sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating).

Binge eating disorders affect many people. BED is more common than bulimia, with an estimated 2 percent of all adults in the U.S. affected (as many as four million Americans), according to a 2001 report.
9
Bulimia occurs in about 1 percent, although the rates are probably much higher because bulimics often hide their disorder from others;
10
furthermore, bulimics are harder to identify because they do not have emaciated bodies like anorexics.
11
Among teen girls, bulimia may affect as many as 5 percent.
12

So far, I have used a female perspective in describing those with eating disorders; but this book can benefit men as well. Although 90-95 percent of those with bulimia are female,
13
males can develop the disorder too. BED affects more men than bulimia; for every three females with BED, there are two males, which amounts to well over one million men.
14
For ease of writing, I will continue to use feminine pronouns; however, this book is not excluding males, and in fact, my ideas may be especially appealing to males who feel alienated by female-oriented, emotionally intensive "talk" therapies.

It doesn't matter if you are male or female; it doesn't matter how old you are, how frequently you binge, how long you've been doing it, or how large the quantities of food you consume—binge eating can create havoc in your life. So even if you don't quite fit the typical pattern of bulimia or BED, or you don't meet the diagnostic criteria for either disorder, you may be able to relate to my story and find help in this book.

A word of caution: all this book can help you do is end your destructive eating habits. It won't tell you how to become assertive, spiritual, emotionally satisfied, or happy, or solve any of your other problems. It won't teach you how to love yourself, build meaningful relationships, heal hurt from your past, eat a perfect diet, maintain your ideal weight, or exercise optimally. Recovering from an eating disorder will not magically change you into the person you want to be. That's a lifetime's work. But putting aside your bulimia or binge eating disorder
can
be the first step in a process of self-transformation, if that's what you desire.

Reading this book certainly won't give you wings, but it will give you hope, and more importantly, it will give you a clear path to recovery.

PART I:
My Bulimia and Recovery

1
: A Typical Day's Binge

I
t was near midnight on January 6, 2000. I lay on an old couch in the basement of my college dorm, a Pop-Tart wrapper and empty Diet Sprite bottle at my side. As I began to wake from a deep sleep, I noticed the back of my shirt was damp; but it was so hot in the basement that I wasn't sure if the moisture was sweat or soda. I didn't really care. All I could think was,
I can't believe I've done it again.

This was supposed to be a new year, a new semester, and a new start.

I had vowed not to binge eat in the second semester of my freshman year, yet here I was: full, bloated, and sick of myself. I sat up and stared down at the couch. It was gross—muted purple, spongy with brownish stains. I thought that any other freshman girls who had been here had probably been drunk, because no one would have been on that couch if they were thinking clearly. I only wished alcohol had brought me here; that would have been OK for a college freshman. But for me, it was not beer—it was food.

I was so ashamed. It was only my first day back at the university after spending the holidays with my family, and it was already a disaster. The holidays, too, had been disastrous; I had binged many times at home as well. Yes, everyone overeats during the holidays, indulging in treats that come around only once a year; but for me, it was different. During every meal, I struggled with controlling myself, trying to eat slowly and take small bites. I always tried to be mindful of how hungry or full I felt as I ate, but this was very frustrating because I was rarely satisfied. No matter how much I consumed at a meal, I usually wanted much more.

I'd indulged like everyone else during Christmas dinner, but afterward, I'd longed for our guests to leave and my parents to go to bed so I could truly eat the way I wanted to. I wanted everything to myself: the stuffing, the sweet potatoes, the pies, the cookies, the chocolates. I wanted to eat fast, swallowing large mouthfuls at a time until I was dizzy. I'd tried to talk myself out of it, but I couldn't reason with myself when I had such strong urges to binge.

If I hadn't experienced the urges for myself, I would never have believed that such strong cravings for something so irrational were possible; and I wouldn't have believed that saying no to something harmful could seem completely out of the question. I had always been a conscientious person who valued personal responsibility and good choices. But my urges to binge made me throw all of that out the window.

Christmas night was one of those times when my conscientious self seemed completely absent, and saying no to my irrational desire to binge seemed unfathomable. So, as soon as I was alone, I walked slowly into the kitchen, trying to remain calm even though my heart was racing. I told myself I would have only a little, as I usually did before a binge. Possibly one more piece of pecan pie—because it was Christmas, after all—and I could always work out the next day to make up for it.

I told myself I wouldn't let a little snack turn into a binge, but halfway through the first piece of pie, I knew I would eat much more. My heart beat faster, and I began taking bigger and bigger bites. In a matter of minutes, I had eaten two more pieces of pecan pie, two pieces of cherry pie, six Christmas cookies, and ten chocolate candies. (I still know what I ate during binges many years ago because I always wrote it down the next day in my journal.)

I let go of all self-restraint and it felt good. I proceeded to eat from the leftover dishes until it was no longer pleasurable to eat; that is, until I was hunched over with stomach pain. Then I poured myself a large bowl of cereal and took it back to my bedroom. I sat up in bed, eating each bite slowly, wondering if I could die from overeating. What could happen to me? Could my stomach burst? Could my esophagus tear? Could I go into shock from too much sugar?

Surely what I'm. doing won't kill me,
I thought.
Will it?

Such questions always popped into my head after a binge, but I tried not to pay too much attention to them. I didn't want to think about what might happen. I also didn't want to think about how much weight I'd gained, about having to spend the entire next day at the gym to make up for my binge, and about going back to college. I only wanted to be full. I wanted to drift off to sleep feeling stuffed, sugar-drunk, and content.

The beginning of a binge always brought excitement, relief, and gratification, as if I were finally giving my body what it wanted, as if I were doing the right thing—even though part of me knew it was terribly wrong. However, the feelings of pleasure were all too fleeting. As I continued to binge, the good feelings gradually faded, leaving me wanting more and more to recapture them.

This will be the last time,
I thought.

It was not the last time. I binged again two days later, and again three days after that. Then I made a firm resolution to stop as we rang in the new millennium, which was the first of many New Year's resolutions to stop binge eating. That resolution lasted only until I binged again on January 3, three days before I was to drive back to school. I thought maybe I'd have better luck quitting once I got back to campus, once I no longer had to deal with the stress of living back at home, and once I had access to my therapist and nutritionist again. So, on January 3, I promised myself I would quit binge eating for good once I got back to the university.

DRIVING WHILE EATING

But here I was on January 6, lying on a disgusting old couch in a basement, feeling as full as I had on Christmas night. I wanted to rewind time and take back all I had eaten that day. My binge had begun that morning, about a quarter of the way into my four-hour drive. Even though I had eaten a meal before I left the house, I'd begun feeling the familiar urge to binge just an hour later.

I'd briefly tried to talk myself out of it but then quickly decided—since my promise to quit bingeing did not technically start until I was back on campus—that it was OK to eat in the car on the way. I reached into the backseat and blindly dug through my luggage for the large bag of Christmas M&M's that my mom had given me to share with my roommate. The M&M's were gone in minutes; then all my focus and energy turned to getting more food.

When I began to binge, it was as if I entered a trance where nothing else mattered—not driving, not listening to music, not my cell phone ringing, not making plans for next semester. All that mattered was where I would get the next sugary and fattening item for my binge. I knew it was wrong, disgusting, gluttonous, abnormal, costly, unhealthy, and irresponsible; but in the moment, I didn't care.

I took the next exit. I bought Doritos, Rice Krispies Treats, and honey buns at a gas station; and before getting back on the interstate, I pulled into a fast-food restaurant for a chocolate shake. I exited four more times to get more food before reaching my college town. Then I decided that I could squeeze in a few more stops before I was officially on campus. So instead of going straight to my dorm, I drove around town from one place to the next, avoiding the route to the university until I simply couldn't eat any more.

Finally, around 4:00 p.m., I took the two-lane road to my residence hall, going below the speed limit with a line of cars behind me.

I have to stop this,
I scolded myself as I pulled into the parking lot. I got out of the car feeling nauseous and dizzy, my stomach full and tight. I felt sick as I looked at the eight-story building in front of me. I wanted to like college. I wanted to make friends, go out, date; but my irrational and unrelenting desire to binge was getting in the way.

I was too uncomfortable to carry anything to my dorm room, so I left all my luggage, trash, and some uneaten food in the car. Opening the door to the building, I felt in a daze as I heard girls talking about the holidays, upcoming sorority events, and what classes they were taking this semester. I stared at the tile floor as I walked to the elevator, hoping I wouldn't see anyone I knew. My face was swollen, as it always was after prolonged binges; I was unsure whether I had gotten all the crumbs off of my face; and I certainly didn't want to talk to anyone.

Three girls boarded the elevator with me; one of them was telling her friend about gaining weight over the holidays because she had eaten so much. This was typical conversation in a college dorm, and it seemed I couldn't get away from talk about calories, weight, and working out. I hated the fact that other girls were so concerned about their weight, even though I was probably more concerned about mine than anyone. I thought that if that girl had only known what I'd eaten over the holidays, she wouldn't feel so bad.

I was still the thinnest one on the elevator, but I was gaining weight by the day. At 5'4", I'd weighed 92 pounds when I began college in August 1999; by January 6, I was 107. The girls in that elevator probably weighed between 120 and 130, and they looked healthy and beautiful to me. I thought of how wonderful it would be to be like one of them—to be of average weight, not starving, not stuffed, and only concerned with eating a few extra calories during the holidays. Instead, I was concerned about eating over 7,000 calories in the car ... and wondering why I still wanted more.

The three girls got off the elevator on the third floor, and the door closed behind them. My dorm room was two floors higher, but as the elevator ascended and the number 5 lit up, I didn't move. I watched the door open and close.

What's the point of trying anymore?
I stepped forward and pressed the B button.

LOW

Downstairs, I walked the empty hallway—past the basement lobby, past the laundry room, and into a small room with vending machines. I bought a bag of chips, a candy bar, a Pop-Tart, and a bottle of Diet Sprite; then it was back to the basement lobby to sit on the old, disgusting couch. The food was no longer enjoyable, and I felt sick, but as long as I kept eating, I didn't have to think about anything else—I only had to chew and swallow. I felt completely numb.

It wasn't until I had eaten the last bite of Pop-Tart that I started to feel uneasy. As I slowly returned to my senses, what I'd done that day became very real to me. The shame, guilt, and self-hatred set in. What made it worse was that I hadn't even been back on campus for fifteen minutes, and I'd already broken my promise to myself.

I began to panic. I knew I had to do something to fix this. I had track practice in two days, and I felt too fat to walk, much less run. I feared that everyone on the team would stare at me, wondering why I was gaining so much weight. I felt that I could not live with myself if I gained any more weight in this horrible and disgusting way. I got up from the couch, walked to the trash can, and tried to vomit.

This was not my first time trying. I had begun trying to make myself throw up after binges several months before, but no matter how hard I'd tried, it hadn't worked. Sometimes I felt content after binges—like the one on Christmas night—and I'd go right to sleep; but other times, I felt desperate to get rid of the food. This time I was desperate. I gagged so hard, my face burned and my eyes watered, but nothing came up. I gave up after fifteen minutes.

I collapsed in tears on the couch. If I could just make myself throw up, it seemed to me, all my problems would be solved. Then I'd be able to binge—which was all I seemed to want to do and which seemed impossible not to do—without suffering the consequences. Inside myself, I knew that throwing up would only make things worse, but at the time, it seemed like an easier solution than my usual one: exercising the entire next day.

I was so exhausted at this point that I couldn't even think about working out. I felt too tired and sick to even make it back upstairs to my room. I only wanted to sleep. I curled up on my side on the couch and drank my Diet Sprite, thinking how ironic and ridiculous it was that I often ended my several-thousand-calorie binges with a
diet
drink. The carbonation made my stomach feel a little better, and the warmth of the basement made my eyes heavy.

THE LAST WRAPPER

I woke up near midnight, with that dampness on my shirt and with the usual aftereffects of a binge: swollen stomach, puffy face and hands, acid reflux, a sore throat, and a horrible taste in my mouth. All I could think about was how fat I felt and how much of a failure I was. In the darkness of the basement—among the shadows of a few boxes, some folding chairs, a splintered table, and an old piano—it all felt like a bad dream.

I picked up the soda bottle and Pop-Tart wrapper from the couch and made my way back toward the elevator.
I can't bear another semester like last one,
I thought, and this was already shaping up to be worse. I recalled the last several days of the previous semester, the worst week of my bingeing thus far. I had binged on Monday, Tuesday, Wednesday, Friday, and Sunday. I was up all night eating on Sunday even though I had a chemistry final the next morning. After my exam, I felt so fat that I decided to keep eating. There were free doughnuts in my dorm's lobby during exam week, so I downed eleven of them, plus two cartons of chocolate milk.

Now the dorm was quiet. There was no end-of-semester hustle and bustle, no doughnut table. It was a new start. But I felt the same—miserable and bloated. I boarded the elevator, rode up to the fifth floor, opened the door to my dorm room, and looked around the tiny, dark space, feeling sick and hopeless.