Today I’ll wrap up the “Psycho Author” series with a discussion about the eating disorder Bulimia Nervosa. I might return later to tips about characterization based on psychopathology, particularly if I receive requests to cover different disorders. I’ll post links to the series on the right of my blog for authors to access.
Earlier I said that Anorexia Nervosa was the deadliest eating disorder, but there are increasing data that Bulimia Nervosa (BN) might be just as lethal. BN involves binge eating episodes (eating a significantly larger amount of food than most would consume in one setting plus feeling out of control) and purging (trying to get rid of calories through self-induced vomiting, laxatives, diuretics, overexercise, etc.) Purging can greatly disrupt one’s heart and electrolyte levels, as well as a host of other health risks.
Bulimia is Latin for “ox hunger”, referring to the intense hunger preceding a binge. Most eating disorders start with a diet, and BN is no different. We know that severe calorie restriction often leads to binge eating. A common pattern is to skip breakfast and/or lunch, believing that helps with weight loss, and then feeling so starved that dinner becomes a binge. Intense guilt and self-hatred follow. Those with Binge Eating Disorder stop there, but those with Bulimia Nervosa frantically try to compensate for the extra calories by purging.
Most people with BN are at an average or above-average weight because restricting followed by binge-eating and purging are not effective weight-loss strategies. Restricting slows down the metabolic fire, and dumping a lot of binge calories on a cold fire means they don’t burn well. Purging methods are often ineffective. One study showed that for individuals who binged and then immediately vomited, over 60% of the calories had been absorbed by their bodies. Laxatives work on a part of the digestive tract where over 95% of calories have been already absorbed. Diuretics only affect water weight and are the most dangerous of all purging methods.
Why do individuals continue to binge and purge despite knowing it doesn’t help them lose weight? For many it becomes an addiction. Sugar can affect the brain much like cocaine, raising dopamine levels and creating a “high”. Likewise, vomiting releases “vasopressin”, a hormone that mimics a heroin high. Laxatives and diuretics can create desired feelings of emptiness and a flat stomach.
A way out of the BN addiction is to work with a dietitian and a therapist, as well as a medical doctor. The dietitian can help the client follow a healthy meal plan, eating frequent small amounts, to reduce the risk of a binge. The therapist can help the client learn how to cope with negative feelings (like anxiety and anger) more effectively. Purging is often an angry, punishing act to the body, and there might be a trauma history to heal from as well.
I loved the movie Center Stage about the intense world of ballet. Actress Susan May Pratt played the role of Maureen, a ballerina who fell into BN.
What I loved about this role was that it showed the multiple causes of an eating disorder, like high anxiety, pressure to lose weight, pursuing somebody else’s dream (the loss of her “voice”), and low self-esteem.
Now it’s time for Meet an Author Monday Blog Hop, hosted by Lisa Sanchez.
We’re adding a new feature to the weekly Meet an Author Monday posts. The last Monday of each month will include a featured post along with the author hop. This month, participating authors will be sharing their favorite writing spot, and posting a photo of where the magic happens. Stay tuned!