Tag Archives: Binge Eating Disorder

In Between Mental Illness and Wellness

I have often talked about recovery on this blog. Particularly, I have talked about recovery from my disordered eating habits and to a lesser degree self-injury. I wanted to get rid of my binge eating and stop self-injuring. Today, as I gave this some more thought, I took recovery one step further. So what if I stop bingeing and self-injuring? Would that then mean I’d be cured of my mental illness?

Of course, strictly speaking it wouldn’t. However, what if it did? What if I were cured of my mental illnness? After all, I exhibit far fewer destructive and aggressive behaviors than I did years ago. If I were to check mysel finto a mental hospital just as I am now, with no history of acute mental illness, the registrar would laugh at me. I wonder even if I’d be sick enough for outpatient mental health care if I presented with jut the symptoms I’ve been having lately. My overeating may or may not meet the criteria for binge eating disorder or eating disorder NOS. My self-harm does meet the criteria for non-suicidal self-injury, but then again these crteria are quite vague. My mood does not meet the criteria for a disorder. Heck, even when I was suicidal in 2007 and was clearly in need of acute psychiatric care, the only diagnosis the psychiatrist could come up with was adjustment disorder. Adjustment disorder is no longer covered by health insurance. In other words, under DSM-IV, which doesn’t include binge eating or self-injury as diagnoses, I would hardly if at all qualify for psychiatric care.

Of course, I do have borderline personality disorder and Asperger’s Syndrome – I still meet the criteria for these. However, no general practitioner would come up with the idea that I’d have these if I asked them to refer me to mental health services, and the vague referral letter my GP wrote in 2007 would not be enough now. So if I’m not sick enough at first sight for mental health care, am I then recovered? I don’t think so.

Mental health care has in recent years been more and more reduced to mere crisis intervention or other interventions directed at averting people becoming a pain in the neck. Now I won’t say I can’t be a pain in the neck, but a GP writing my referral letter from scratch now would not know. If you aren’t a danger to yourself or others, you most likely won’t get mental health services paid for through insurance. As such, mental health treatment is focused on curing the symptoms of severe mental illness (which is in most cases impossible), whereas recovery is more than that. Recovery, after all, is getting your life back on track.

As a long-term institution patient, I struggle with this. I am relatively well mentally speaking – probably not as well as I describe in the above paragraphs, but still -, but I don’t have a life. When I was admitted to the mental hospital in 2007, I was a university freshman in a new city. Now I’m nearly 30 and have little that could fulfill my life. I have my blog, but that’s about it. It makes me depressed. Not suicidal-type depressed (or should I say “adjustment-disordered”), but it does definitely make me slightly depressed. If I am not sick enough for mental health services and not well enough to get my life back on track without help, then where do I find help in recovering my life?

I hope that outpatient mental health services aren’t really as bad as I now think they are. I can only hope the recovery model still hasn’t been killed by the push for budget cuts. It however makes me sad to read in memoirs of mental health consumers about the recovery model and using mental health services to get your life back on track. After all, I’m afraid you can’t get mental health care for that now even if you’re severely mentally ill like myself.

Willpower

I am a member of a few general recovery groups on Facebook. Most of the members are addicts or alcoholics. I am not. I consider myself addicted to food in some ways, but it isn’t like I can just stop eating, like an addict can quit their substance of abuse. I’m not saying that’s easy either. That’s my point of this post.

Most recovery groups are based on some twelve-step model. As such, we see a lot of references to a higher power or God in the posts. One that I came across recently was that we have to redefine willpower. Willpower is the will to turn over the reigns of our life to God.

I like this statement. It doesn’t mean we don’t have to attempt abstinence (or in the case of an eating disorder, balance). We do still need to refrain from engaging in addictive behaviors. The difference is, God is guiding us on our journeys. If we turn over the reigns of our life to God, we are realizing that we need to follow His lead, not the road of addiction.

I am a person who often turns over the reigns of her life to other people. I allow others to make decisions for me and in some ways, I’d like them to make the decision that I can’t have binge food, too. Staff won’t do this, as I’m an adult and responsible for my own recovery. My husband sometimes gets me a small bag of candy when I’d intended on eating a far larger quantity. This may lessen the physical effects of a binge, but it still means I engage in compulsive eating.

The first step of Overeaters Anonymous is to say we’re powerless over food. (The same statement is used in Alcoholics Anonymous and Narcotics Anonymous, with “alcohol” or “drugs” instead of “food”.) Therefore, we need to find a power greater than ourselves to help us recover from our addiction. Note that this higher power doesn’t necessarily have to be God: for atheists and agnostics, it can be the OA group they participate in. This signifies that, while no-one is taking responsibility for another’s choices, it is the guidance of our higher power, be it God or the group, that leads us into recovery. Even as believers, we believe that we have free will, but we can still turn the reigns of our life over to God. If we do this, we learn to rely on Him for paving the way for us into recovery. It isn’t that we are no longer ourselves in recovery or not, but we rely on God for facilitating our process of recovery.

I am nowhere near recovering, as regular readers of this blog know. My last binge was last Friday, and I was tempted to give in again today. I didn’t, which is a small win, and my thoughts on willpower contributed to that. I realized that God doesn’t want me to binge, and He gives me the means to resist the urge. Today, I was led to write this post instead of binge. It may sound like I don’t practise what I preach, as someone who’s still pretty deep in her eating disorder, but it personally helps me to preach recovery.

Disordered Eating: A Cry for Help

One day when I was probably in seventh grade, I read an audio magazine for blind teens. It was really a mixture of its own content with content from other teen magazines read aloud. One of the articles from another magazine was about an eating disorders unit. I just remembered this as I read a passage in J.J. Johnson’s Believarexic, in which Jennifer remembers learning about anorexia for the first time in fifth grade and wondering how the celebrity who died of it, got as skinny as she did. Later on, Jennifer learns about people being hospitalized for eating disorders. She envies them because of their size but also because of the attention they get.

This hit home with me. Back in seventh grade, I had already firmly embarked on the binge eating boat, but since I was at a healthy weight for my age and height, I didn’t notice my eating had spiraled out of control already. I remember once, probably in the same year, being confronted by my classmates about getting five candy bars out of the vending machine and eating them all in one sitting. However, I just got annoyed and didn’t realize that my classmates may have wanted to protect me from unhealthful choices.

We didn’t learn about binge eating disorder or compulsive overeating in health class. All we learned about eating disorders was about anorexia and bulimia. I even did one of my gifted program projects on these eating disorders. I didn’t tell anyone that, as I was writing the paper, I was trying to figure out how I could become anorexic.

No, I didn’t “want” anorexia, like some teens say they do. No-one consciously decides to develop an eating disorder. But I did want the perseverance that I perceived anorexics had. So I began keeping food diaries. This was before I had access to the Internet and I couldn’t read packaging, so I couldn’t check calories. In truth, as I look back at my food diaries of the time, they show a pretty typical overeater’s pattern. But I wanted to have some control over my food intake by keeping these diaries. Not that it worked, of course. Over the years, my binge eating got worse.

Back to the article about the eating disorders unit. For some reason, I felt compelled to be like these patients. I don’t know whether it was pure attention-seeking. I mean, I got plenty of attention from my parents and teachers. What I might’ve been missing was someone who saw how much I was struggling. Maybe, if I became anorexic, they’d see how miserable I was.

The other day, I had a meeting with my psychologist. She wa spushing me to take steps towards independence in preparation for my move in with my husband. I can’t remember whether she said so, but she gave me the impression that she felt I was doing better because I had much fewer meltdowns and emotional outbursts. In truth, I may be a little better, but I still have a pretty miserable life and feel pretty crap. Instead of becoming self-destructive or aggressive, I lie in bed or resort to overeating. A fair quality of life is not just not being a pain in the neck, but also being able to experience pleasure every once in a while. It isn’t that I never do, but it’s quite rare that I do things that bring me any sort of satisfaction. For example, I don’t craft nearly as much as I used to, because I can’t handle the noise and crowdedness at day activities.

I was also telling my psychologist that I’m completely dependent on my treatment team. What I meant was close to the exact opposite: I have no control over what goals are set for me, but it is my sole responsibility to reach them.

In a sense, maybe this whole disordered eating thing is a way of showing peope I need help. It sounds so pathetic though: someone who’s nearly thirty-years-old needing to be taken care of like a little child. IN truth though, often I feel that vulnerable.

Fighting My Disordered Eating

“Fight” is one of the writing prompts from Mama’s Losin’ It for this week. The first thing that came to mind as I reflect on this word is my fight against my eating disorder tendencies. This fight has been on my mind a lot lately.

Last week, had a bad binge and then in the evening, a fellow patient gave us cake. A nurse was joking about all the calories in the cake, poking my tummy as she asked: “Do you want whipped cream on your cake?” This was extremely triggering to me. At first, I thought “screw you” and decided to indeed get whipped cream on my cake. As time went by and I ruminated on what had happened, the nurse’s words and actions took on a life of their own, causing me to doubt my will to recover from binge eating. Not that I didn’t want to lose weight, but my initial instinct was to move back in the direction of bulimia by starting to purge again.

I later told the nurse that what had happened had been immensely triggering and she assured me that she’d just been fooling around a bit. Usually, this nurse has quite good ideas for helping me recovr from my disordered eating tendencies, so I took no further offense.

This doesn’t mean the doubts about how to fight my obesity have gone. In fact, the only thing holding me back from starting to purge again is my chronic heartburn, for which I’m getting an upper GI endoscopy done to see what might be wrong. I don’t have that long of a history of purging, but that doesn’t mean that the purging I did do can’t have caused damage. It certainly won’t get better if I resort back to purging now.

However, eating disorders are not just about preserving one’s health. After all, they often do the exact opposite. There is this hierarchy in eating disorders where restrictive anorexics rank as most perseverant and stubborn, followed by binge/purge anorexics, bulimics depending on their weight and the biggest losers (no pun intended) are the compulsive overeaters. In other words, as someone who suffers from binge eating only, I’m a total failure of an eating disorder sufferer. Yet I am not just an eating disorder sufferer, I am a person who happens to have disordered eating tendencies and who wants to fight these tendencies.

This hierarchy of the eating disordered is, however, also reflected in how seriously I take myself and am taken by other people with regard to my disordered eating tendencies. When I still purged, my GP put in my file that I had bulimia. I didn’t – bulimia has very strict criteria that I didn’t meet -, but it was in my records nonetheless. Now that I probably do meet the criteria of binge eating disorder, I’m commonly seen as just a little overweight at best and as an unmotivated, lazy fatass at worst. It’s probably crazy that I’d rather be seen as sick than lazy.

Mama’s Losin’ It

A Letter to My Body

Dear body,

I am sorry. I have not been taking good care of you lately. I have not been exercising regularly, have been binge eating a lot and have slept at all the wrong moments and been awake at night.

Of course, I could blame my eating disorder and see it as something entirely separate from myself. I could blame the holiday season. I could blame the winter blues (or general blues, since I’m not sure if it’s seasonal at all) for my laziness regarding exercise, my increase in binge eating and my poor sleeping habits. Then again, that’d be avoiding my responsibility.

Sometimes, I feel as though you don’t deserve to be taken care of. I feel you’re ugly, fat and unheathy anyway. You’re fat, but at least my husband doesn’t consider you ugly and you could be a lot less healthy than you are.

Besides, right now I don’t have as poor an image of you as I had before. I like my skin feeling softer when I apply shower cream, then scrub it, then apply body butter. I particularly even like my belly, which is the part you seem to be storing most of your fat.

I want you to know there’s nothing you did to deserve me stuffing you with binge food and depriving you of the exercise and sleep you need. I’m stressed, but you didn’t cause me to be stressed. I’m slightly depressed, but you didn’t cause me to be depressed.

So I want to thank you for being relatively healthy while I don’t take as good care of you as I should. All your major functions (except for vision of course) are intact. You keep your vitamin and mineral levels okay. You haven’t developed diseases like diabetes or heart disease in spite of your obesity, caused by my lack of proper care. You are okay.

As I said, I could look at your negative attributes: your not being as fit as I’d like you to be, your causing me acid reflux, irritable bowel syndrome and random pains and aches. Then again, whether it’s you causing me these problems or me causing you these problems, could be debated. The thing is, I can’t change your functions without taking better care of you first.

As dialectical behavior therapy also teaches, I can’t change you witout accepting you as you are first. You are okay as you are. Now I can work on improving you.

Yours,
Astrid

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Mom's Small Victories

Prayer and Reflection: Jesus Helps Me Through My Eating Disorder

I have had quite the urge to engage in eating disorder behaviors today. It’s raining, so I can’t go out to the town store to get some candy. Besides, it’d not be right in the long run. After all, I’d not be caring for myself well by indulging in the urge to binge.

So I paged through Journaling in Eating Disorder Recovery. The book is explicitly Christian. Since I am a Jesus follower too, I have felt very much touched by the questions and suggestions in the book. At several points, the author encourages the reader to find Bible verses or other inspirational material that will help them through their recovery journey. So I looked online for some Bible verses that help me strengthen my willpower to overcome this urge, at least for now.

“For this reason he had to be made like them, fully human in every way, in order that he might become a merciful and faithful high priest in service to God, and that he might make atonement for the
sins of the people. Because he himself suffered when he was tempted, he is able to help those who are being tempted.” (Hebrews 2:17-18 NIV)

This is so powerful. Jesus was human himself, suffering all the usual temptations us humans face on a daily basis. Jesus did not have an eating disorder, but He was undoubtedly tempted to indulge overeating every once in a while. After all, everyone is tempted ot overeat at times. Yet Jesus overcame this temptation. We could say He did so because he is God, too. That would be disempowering ourselves, because we are saying: “I coud never resist temptation like Jesus did, because I’m not God.”

What this Bible verse says, however, is that Jesus is able to empathize with us and thereby help us. We may not have the Godly powers Jesus has, but we can lean on Him, and He will care. After all He knows what it is like to be fully human. He cannot just sympathize, but truly empathize.

As a mental health sufferer, I tend to look to people who have a lot in common with me for guidance and support. I look to people who have had the same experiences and struggles I face. I look to people who cannot just sympathize, but empathize.

How wonderful is it that God HImself, through His son Jesus Christ, can empathize with all of us! He knows what it is like to be tempted, so He is willing and able to help us through.

God, help me through the urge to binge for just one day. Help me face the reality that, in the long run, bingeing will be bad for my body, and I need to take good care of my body. Help me realize that, through your son Jesus Christ, who suffered human temptation, I am able to overcome this same temptation. Amen.

After Recovery

This week, the One Word blog linkup has “after” or “pretend” as the choices of words. I could write a post inspired by both of these words, but I need to choose one. When I found out about this week’s words, immediately an idea popped up in my mind, inspired also by my eating disorder recovery journaling project. What would my long-term goals for recovery be, and what would my life look like after I fully recover?

The answer to this question of course depends on the question: recover from what? Just my eating disorder or mental illness in general. In the latter case, I need to note that recovery is not the same as cure. Recovery means living beyond the illness, not necessarily without it. In Dutch, the word for “beyond” is “voorbij”, which in most cases connotes the thing we go beyond has passed. In English, the word “beyond” does not have such a connotation.

First, let’s pretend (ha, the other word sneaked in!)j that I can be fully cured of my eating disorder. This is in fact not just pretend, as people do live past their eating disorders. What would this look like?


  • I would be able to snack without losing control.

  • I would not feel guilty (most of the time) after eating.

  • I would no longer compensate for (over)eating in an unhealthy way, such as by purging.

  • I would feel okay about my body. This does not necessarily mean I’m at a healthy weight, as weight loss is a completely different journey from eating disorder recovery even if your main behavior is bingeing. It would simply mean I’d no longer hate my body.

  • I would have and use healthy ways of coping with stress.

This is where recovery form mental illness in general, in my case borderline personality disorder, comes in. After all, one of my primary goals in recovery is to develop healthy coping mechanisms.

Suppose I developed those healthy coping mechanisms. What else would I want to have accomplished after recovery? First, I’d like to feel mostly stable. I’d still have down days and up days, would still get angry at times, because that is human. I would, however, no longer experience those intense states of hopelessness which usually lead to destructive coping mechanisms or feel chronically empty.

Another way of looking at recovery, however, is to look at what I want my life to be like beyond my illness. In other words, what would I like to achieve in life in spite of my mental health problems. Here goes:


  • Live with my husband.

  • Be able to do a volunteer job>

  • Be able to spend enough time on my hobbies not to get bored, but not so much that I get overwhelmed.

  • Be grateful for the smaller and larger joys of life without immediately second-guessing myself.


Lastly, this is somewhat unrelated to recovery. It is more a general life goal. I’d love to write my autobiography.

Physical Effects of My Eating Disorder

The first journaling question in Journaling in Eating Disorder Recovery is about body image. The author asks you to journal about what your eating disorder is doing to your body. She also asks you to contemplate whether your body image is worth these effects.

My eating disorder mostly involves bingeing, which is good for neither my body nor my body image. After all, it not only causes me to be nauseated after a binge and get acid reflux (I believe this is also triggered by bingeing and not just by purging), but above all it has caused me to gain about 40lbs in a two-year period. As a result, I am now about 30lbs overweight. This of course results in poor body image, because, you know, I don’t just think I am fat.

I just googled the physical effects of bulimia, and some I find are related to bingeing. For example, people who binge get a bloated stomach and stomach pains. The bloated stomach causes it to take longer before you feel full. A severe binge can even lead to a ruptured stomach.

I also purge on a semi-regular basis. While I don’t purge nearly as often as some bulimics, I do vomit significantly more than people who are sick every now and again with a stomach bug. Purging can have the following effects:


  • Tooth decay.

  • Erosion of dental enamel.

  • Dehydration.

  • Irritation of the esophagus.

  • Sore throat.

  • Acid reflux.


I have many of these symptoms.

Of some symptoms I found, it isn’t stated whether bingeing, purging or laxative use causes them, but I have them whichever is the cause. For example, one source listed acne as a possible effect. I use to think I’m too old for acne, but nonetheless I do get an eruption when my eating disorder is particularly severe.

Effects that aren’t mentioned, are the long-term consequences of obesity. Think, for example, type 2 diabetes. I don’t know where he found this so can’t check the source, but my husband says that eating lots of sweets is now thought to actually lead to type 2 diabetes because of leading to a chronically elevated blood glucose level.

Is my body image worth these consequences? Of course, my body image is damaged by my being obese, but what if purging actually causes weight loss? Note in this sense that in my case it hasn’t led to weight loss, but just suppose it did. Then, still, I would have to say that health is more important than outer beauty.

I do, however, sometimes believe that purging can’t hurt while obesity can. In this sense, I weigh the health risks rather than the effects on my body image. Or do I?

After all, people’s encouraging obese people to lose weight for health reasons is generally coupled with a lot of shaming of people’s fat status. Even if other people don’t say so, I tend to think that I need to lose weight to be good enough. I still tend to think my husband doesn’t find me attractive even though he’s stated a few times that his reason for encouraging me to lose weight is my health. Other people, like some staff, do more clearly fat-shame. For example, we get metabolic screenings, including waist measurements, every six months to a year. At my last screening, the nurse took my measurements and then commented I really need to lose weight. So far it could still be interpreted as pure concern for my health, but another patient was next. She took this woman’s measurements and then commented to me: “See, it can get worse.” That really was an unnecessary comment that instilled shame rather than motivation to get healthy.

Brilliant blog posts on HonestMum.com

Pros and Cons of My Eating Disorder

I have truly been relapsing in the eating disorder department lately. I don’t really know why, other than the fact that I’m quite irritable lately. This, though, seems to be a vicious cycle: I go from irritability to thinking about bingeing or purging to actually bingeing or purging and back to irritability.

In order to help myslef think clearer about my disordered eating habits, I bought the eBook Journaling in Eating Disorder Recovery by Laurie Glass. The book contains a multitude of suggestions for journaling yourself into recovery. One of the suggestions is to make lists, for example of feelings or thoughts. I really love list-making.

The book also contains journaling questions. I don’t know whether a pro/con list for your eating disorder is in them, but I made one recently. I made it for a pro-eating disorder site that I used to go to, but I left it. I might still be a member but don’t want to trigger myself by checking the list there. Let me make a new one.

Pros of my eating disorder:


  • Relieving stress.

  • Feeling something in my body rather than in my mind.

  • Being able to eat as much as I want of the foods I love. This one isn’t really true, as I’m not sure I want to eat till I’m nauseated. I however have the thought that if I recover, I need to adhere to a strict diet and can never have candy or pizza again.

  • Avoiding the physical and mental sensations of hunger.

  • Expressing that I’m not feeling well. This may be in the sense that eating disorder behaviors are a cry for attention, but also that they impress the reality of my struggles upon myself.

  • Avoiding pressures such as college or work or independent living.

Cons of my eating disorder:


  • Weight gain and the resulting obesity.

  • Acid reflux from purging. Possible esophagus damage as a result.

  • Not being able to engage in healthy social interactions because of having food on my mind all the time.

As you can see, I find I can think of far more pros for my eating disorder than cons. However, ultimately, these pros are based on the idea that I do not cycle from irritability to thoughts about disordered eating habits to eating disorder behaviors and back to irritability. In reality, the stress relief, for example, is very short-lived. For instance, I just binged terribly about an hour ago and have been feeling guilty and angry for the past thirty minutes at least.

Where I Am on My Eating Disorder Journey Right Now

I had a particularly bad week in the eating disorder department. I joined a (not too bad) American pro-ana site and considered joining the bad pro-ana sites that the Netherlands is rife with but was held back by their requirement that I post my weight. I had two binge episodes (Wednesday and today) and am currently fighting off the urge to purge.

In order to motivate myself for recovery or, if that doesn’t work, at least to distract myself from the disordered thoughts, I searched for recovery challenges agian. I remember starting one last year but never completing it. I have no intention of really completing this one either, but I thought I’d answer the first question, which asks you to assess where you are in recovery.

First, here are my stats:


  • Height: 1.53m or 5.0ft.

  • Weight: 74kg or 163lb or 11st 9lb.

  • BMI: 31.6.


Since becoming a psychiatric inpatient in 2007, I’ve gained 20kg, most of which I gained over the past three years.

It would be tempting to say I’m at my lowerst point ever in terms of recovery. After all, I’m one kilogram from my highest weight ever and to be honest I didn’t weigh myself just now but am taking my weight from a few weeks back here. For this reason, chances are I’m currently a bit over that 75kg mark.

If I’m truly honest, I must say I’ve never been truly recovering from my eating disorder. My eating disorder has changed, but some behavioral manifestations were always there. I’ve been overeating for fifteen years, probably binge eating to some extent even for all those years, although I didn’t recognize that what I was doing was more than just overeating until a few years ago. I purged for a while too.

On said American pro-ana site, I defined my eating disorder as in the middle between bulimia and binge eating disorder. In fact, however, I’ve not purged in months so am actually suffering with pure BED (I’ve never engaged in other compensatory behaviors). My staff see it as simple overeating so I’ve not been formally diagnosed with an eating disorder. I guess they’d rather see me as one of their so many obese patients who refuses to lose weight than deal with the underlying problem. I don’t know honestly whether I’m motivated either. Not having had any therapy that worked for any of my issues except a bit of guidance for my autism in 2007, I’m uncertain that I’m fit to ever recover.

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