This is part two of three. You can find part one of my story here. Bulimia is embarrassing if you think about the details of it: intentionally binging and then bending over a toilet to get rid of everything you just ate. In a way, my bulimic behavior crept up on me.
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In some ways the extreme exercise I was engaged prior to my anorexia diagnosis, could be considered a form of purging. When someone engages in extreme restriction of food intake and fasting, there is a shrinking that occurs with the stomach: a natural adaptation of a body in starvation-mode. So when I finally allowed myself to eat it had to be in small amounts. I feared gaining weight.
So I began to purge, small amounts at first. Secretively so no one would notice. Everyone could see if I was restricting or not, they could see if I was exercising excessively, but no one would know what I did behind a closed door. The lie was still there. Even though I wanted to change as evidenced by my recovery from anorexia I had not yet addressed the root issue. I came from a loving and supportive family. My parents were committed to raising kids with a sense of compassion, generosity and responsibility and they lived as an example of what they believed.
Instead it was the things unsaid: the things I thought other people were thinking of me. And when that becomes the obsession, what you think people think of you is really what you believe of yourself. So from a young age, I believed that my weight was not good enough. As I grew older that lie became more pervasive: I was not good enough.
So I did everything I could to be good enough. I was afraid of failure. I was afraid of disappointing. Fear is the great enslaver.
It paralyzes and traps. And so driven by a fear of being fat I continued to purge meals. And being fat is the ultimate fear, so the purge releases that fear and returns you to a sense of control. There is no thought to the physical harm you are doing to yourself and even if there is it takes a back-seat to the fear, because somehow as twisted as it seems the fear of becoming fat is greater than the fear of health complications.
Girls fight eating disorders together. Although the research appears interesting and promising, it falls more into the category of a pilot study, and the results should be viewed with caution, said Dr. Guido Frank, an associate professor of psychiatry and neuroscience and associate director of the eating disorder program at the University of Colorado School of Medicine. We know that stress triggers binge-eating episodes, and brain imaging can be a very useful tool," said Frank, who was not involved in the research.
Yet "the use of pictures is suboptimal, as it does not tell us anything about chemistry in the brain," he said of the study. Another issue with the study is its tiny sample size, Frank said. All in all, "this was really exciting, because it is hard to replicate findings in clinical samples in neuroimaging," Fischer said of the study. Call the National Eating Disorders Association helpline: That turned out to be a reality for Skylar Liberty Rose at a young age. Rose now finds solace in her writing, photography and mindfulness, as well as candles, classical music and chai tea -- but she said it wasn't always that way.
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Whenever the London native lacked control or felt stressed, she said, she would binge-eat whatever she wanted and then make herself sick and purge the food so that her body wouldn't take on extra pounds. She started doing so when she was 18, living in the city and working as an administrative assistant. It made her feel powerful, she said. Around the same time she flirted with bingeing and purging, Rose also smoked, socially drank a lot and "never really viewed myself as having an eating disorder," she said. She was never medically diagnosed with an eating disorder.
I would go stretches at a time without making myself sick, so I kind of normalized it," she said. Keaton: I was great at hiding my bulimia Even though it happened only on occasion, it happened, and that was enough for Rose to eventually realize that she was harming herself and needed to change. Between the time Rose was 18 and now, she has gotten married and divorced; was briefly hospitalized for pancreatitis; and traveled the world, "Eat Pray Love"-style, visiting Rome, India and Bali. Also, "over time, I began to feel less inclined to punish myself that way, because, for example, I couldn't go to a yoga class and be really immersed in a spiritual and physical activity and then come away from that and hurt myself," Rose said of bulimia.
So "I stopped physically punishing myself, but I still felt the need to control, and I still felt anxiety around not being in control of every area of my life," said Rose, who is now 42 and living in New York as a writer. Katie Couric reveals she battled bulimia Rose replaced bulimia as a stress-coping mechanism with more healthful approaches, such as yoga, mindfulness and writing, she said. In , she wrote about her experiences with bulimia in the Huffington Post.
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Though Rose no longer makes herself sick, she said, bulimia remains an ongoing battle. Without her new stress-coping tools in place, there could be a risk of relapsing. Making healthy food choices can be difficult for patients with bulimia; the other study published this week suggests that their brains respond differently to food rewards. The study involved 26 women with a history of bulimia and 22 women with no eating disorders, who had their brains scanned in MRI machines while they were given sugar water either after fasting for 16 hours or after eating a breakfast of bagels and cream cheese.
How bulimics' brains are different - CNN
The researchers then analyzed the brain images to determine differences in how the women responded to the water's sweet taste when hungry or full. The researchers found that the brains of women with no history of bulimia showed significantly more activity in the left putamen and amygdala when they were given sugar water after fasting, versus after they were fed.
Those parts of the brain are associated with evaluating rewards, such as how rewarding a taste is, said Alice Ely, a clinical psychologist at Christiana Care Health System in Delaware and lead author of the study. As for the women with a history of bulimia, there was no such difference, and their left amygdalas had greater activity when fed compared with the other women -- which may hold clues to the binge-eating aspects of bulimia, the study suggests.
Ely, who was involved in the study while at the University of California, San Diego, likened the findings to grocery shopping. Artist's sketches convey struggles of eating disorder. We tend to buy more highly palatable foods," Ely said. You don't get pulled and motivated in a big way by a reward," she said.
Limitations of the study include its small sample size, due to the high cost of brain imaging, and the fact that all of the participants with a history of bulimia were recovered or remitted from the disorder, Ely said. Additionally, "we looked specifically at sweet taste, and we know that highly palpable foods come in many forms," such as high-fat types, too. Still, no one knows whether bulimia causes such changes in the brain or whether such differences in the brain are associated with susceptibility to bulimia, Ely said.
Join the conversation. Walter Kaye, who led the study, hopes that that question could be answered as more research is conducted specifically on the brains of bulimics in the future. Clearly, stress and negative mood states are related to this. There's been this question about whether people restrict and get hungry and binge, or whether they just can't shut off eating once they start to eat," said Kaye, a professor and founder and director of the eating disorders program at the University of California, San Diego.
As researchers continue to search for a cause, Fitzgibbons, the Eating Recovery Center ambassador in Denver, emphasized that healing is no mystery.
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