Topic Tuesday: Bulimia

“One Form of Many: How External Behaviors Reflect Internal Struggle” (By: Halley Corapi)

When I got the opportunity to write again on the topic of bulimia, I was initially hesitant to put forth my thoughts on this aspect of my eating disorder experience. The initial diagnosis I received at the age of 13 was anorexia nervosa, and I have clung to that label and that mode of behavior ever since.

That being said, I have also struggled with bulimia. And yes, it came much later. And yes, it lasted for “only” a year. And yes, I “conquered” the behavior. And no, I don’t tend to admit that anorexia has not been my sole form of disordered behavior.

My discomfort with writing on the topic of bulimia versus my openness in my first blog post very accurately reflects my respective relationships to bulimia and anorexia. I do not always feel adequately “experienced” enough to discuss the subject, but more than that—and this is difficult to admit—I have often felt significantly more ashamed of my struggles with bulimia than with anorexia.

A friend of mine who has also struggled with bulimia put it best when she said, “Bulimia is just one form of the many forms that my deeper problem has taken.” In my previous blog post, I explored the idea that the eating disorder can take on many roles. These roles include behaviors (such as restricting or the binge-purge cycle) as well as emotional roles that evolve through various different situations that come up in life.

When I was 19 years old and suffering an intense relapse into anorexic habits, I spent two months in an outpatient eating disorder treatment program. Another young woman in the program had been struggling with bulimia for most of her life, but recently she had begun to restrict more, and was exhibiting “anorexic” behaviors. She was very confused by this shift, because bulimia was her “thing,” so to speak. That’s all she had ever known, and that’s how she defined herself. She told us that she had envied anorexics in the past for what she thought of as a more sophisticated eating disorder with a higher level of control – something to be admired, even.

Bulimia, in her mind, was the “lower” or baser disease. Now that she was exhibiting anorexic behaviors without choosing to do so, she didn’t know how to feel about the eating disorder changing roles. She only knew that it meant something beyond the external routines, and she wanted to figure out what the transition said about how she was changing as a person.

Our group nutritionist told us that it’s not uncommon, as you get older and go through transitional periods of your life, for the eating disorder to change form as your life changes and you start to think of yourself and the world around you differently. The external behaviors and rituals of your eating disorder are very likely to also change to mirror what you might be going through at a given time. Some might fight the change; I know I certainly did, because I was very obstinate in maintaining my specific “mode” of disordered eating. Bingeing and purging seemed, to me, like a betrayal of my true “anorexic nature.”

But my life changed drastically in a number of external ways that began to reshape how I thought of my body and my entire identity. Something I could no longer deny was the simple fact that suddenly I was hungry all the time. I had suppressed my hunger instinct for so long that I forgot what it felt like to be hungry for food, and by extension to be hungry for anything else. But a lot happened at once, and I didn’t know what I was doing or what I wanted. I knew I wanted something, and I couldn’t ignore that anymore. Part of being a human is to have hungers and desires, but I did not see myself as a human being. I was very good at actively suppressing these instincts to the point of not being able to identify them. I felt that if I couldn’t identify what I wanted, I would not be in danger of going after anything. It was very safe in this way – limiting, yes, but safe.

Because I could never be disappointed. I could never experience the pain of wanting something, going for it, and then not getting it. The end of my first significant romantic relationship brought these issues home for me. All of a sudden I wanted again, and could not ignore it. Before, nothing was ever taken from me because I never had anything. I crafted it purposely for this very reason: to avoid loss. But I became hungry again, and this is where bulimia came in for me personally. I never got into the binging aspect of it, mostly because my anorexic tendencies were fighting tooth and nail with this newly realized hunger rather relentlessly. I was still restricting, but it was much harder than it had ever been. And at this point, I began purging anything that I did manage to eat.

Before, restriction was my way of life. And I suddenly realized, “This isn’t living, but I have to hold onto this somehow, because it’s the only thing I have. I have lost this relationship and I can’t lose this. I can’t lose anything ever again. And the only way to avoid losing is to never take.” I was terrified of losing myself, terrified of wanting things, and I couldn’t afford losing again. The only way to avoid losing something is to never have anything in the first place.

When I first began to struggle with bulimia, the two emotions I recall most strongly were shock and embarrassment. As I said before, my primary identity as an “eating disordered” person had been rooted resolutely in anorexia – restriction, control, denial. In terms of sharing with other people, the shame I experienced as an anorexic revolved around the feeling that I was never quite anorexic “enough”; the shame was centered a lot on the level of the problem, rather than the existence of the problem.

In contrast, I was deeply ashamed of my bulimic tendencies because they existed at all. I remember opening up to a new friend several years back about my struggles with anorexia, and while he was sympathetic, he said, “At least you don’t have bulimia. Now that stuff scares the crap out of me.”

This is a reaction I’ve seen from enough people to believe that it is a fairly common perception of anorexia vs. bulimia. To many, people who deal with anorexia at least seem to possess a high degree of control, which is a valued trait in our society. Some people even see anorexia as an exemplary form of willpower. Conversely, many see bulimia as a much more violent form of behavior that stems primarily from utter loss of control.

These perceptions generalize and warp both anorexia and bulimia, and feed certain stereotypes that can make it very difficult for people struggling with any form of eating disorder to examine their own motivations or to seek treatment. When anorexia is held up as a “higher” form of eating disorder, or the behavior is validated and admired, people may feel they are receiving discouragement from receiving treatment or stopping the behavior; eating enough becomes even more an analogy for losing control or “giving in.”

This perception also completely overlooks the fact that anorexia is a very controlled and ordered response to completely out-of-control feelings, and over time the eating disorder comes to control the person who struggles – not the other way around. When bulimia is eschewed or feared as violent, crazy, or beyond reason, the side of bulimia that is just as much about ritual and control is overlooked in favor of viewing the disorder as only chaotic.

Having struggled with both anorexia and bulimia (and now technically falling under the “Eating Disorder Not Otherwise Specified” label), I have spent a lot of my time examining the different ways that control manifests in both modes of behavior. For me, anorexia was a preemptive strike, whereas bulimia was damage control. With anorexia, it’s all about preemptive control and denial. Food is either not taken in at all, or eaten in very specific, controlled amounts.

Bulimia, by contrast, is part of an attempt to undo something, to expel food that has already been taken in and by extension to expel something that is too “filling.” For me, bulimia came from a feeling of guilt for having done or consumed something I wanted, when I thought I should have suppressed the want and deprived myself of whatever it might be.

Of course, in truth, anorexia and bulimia are both reactive measures. No matter how hard an anorexic might convince himself or herself that they’re keeping something at bay, in honesty he or she is reacting just as much to guilt and shame as a bulimic. However, because of the external food rituals commonly associated with both disorders, bulimia is more often viewed as the uncontrollable disease.

Up to a certain point in my life, I was very careful in my life to be cautious, controlled, and restrained. I did everything in my power to remain a benign and neutral presence. Life happened to me, which meant I could restrict and avoid and deny what I saw as dangerous or threatening. As long I denied myself, damage control was never necessary. It all happened to me; I never made it happen myself. Therefore my guilt was primarily focused on wanting things, which I then denied myself to appease the guilt, as opposed to having taken or indulged in what I wanted – because I never did. Some part of me knew that if I did, everything could unravel. I certainly wasn’t in an emotionally healthy enough place to take what I wanted and not feel guilty or ashamed; I knew if I ever did acknowledge my desires and needs, I would have to find a way to punish myself and reject what I had taken.

Until college, I denied myself romantic relationships, denied even wanting them — much like food. Once I did tentatively start to engage in those relationships (always at another’s instigation, of course), it also mirrored my eating habits at that time: food was being ingested, but in very small and controlled amounts, at very specific times and in very particular ways. If anything threatened that ritual, I retreated.

It was the same with people and relationships. I never took anything. If something was “offered” to me, I would either refuse it, or very tentatively take very small pieces and even still hold them at arm’s length. All of this – whether with food, men, alcohol, social activity – was very centered around anorexia. Denial, restriction, control, distance, passivity, and a constant state of guilt and fear, knowing I might want something for real — and I couldn’t acknowledge that or honor it.

I think at this point more than any other, I felt true resentment toward men, toward my family, and toward anyone — even including female friends, who before had proven to be the least “invasive” toward my eating disorder — that in my mind had all threatened me, my eating disorder, my control. I felt that if they had all just left me alone, not touched me in any way, I would be safe.

My greatest fear was not criticism, not rejection or lack of love, not even failure — it was disorder. To me, anorexia was order. Everything else was chaos. The eating disorder was the most orderly thing I had.

And then my experience with bulimia completely turned this perspective on its head. When I made myself throw up, the feelings that preceded it and the emotional reactions afterward made me feel anything but controlled. I would feel a very brief, almost spiritual high immediately after throwing up. In this small moment, I would feel empty and giddy and entirely above my body, my home, the people around me, even the entire earth. I felt like I had transcended every limitation.

But these post-purge moments were always followed by an incredible emotional crash. My brain was a scrambled mess of voices trying to out-shout the others:

“Good for you, you got rid of everything. Now you’re empty again.”

“How could you do that? You completely lost control!”

“This isn’t what you do. You are an anorexic.”

“This isn’t who you are. Neither is anorexia. Stop messing with your body.”

Each time, the message that always struck me the hardest was:

“If you keep doing this, you will have nothing left. No one will be able to touch you. That’s just the truth. The question is whether you want that to happen or not.”

I think I always responded more to the non-emotional, neutral voice in my head in times like these. The negative voices were familiar and controlling, but were starting to lose their impact because I had grown too aware to fully believe them. The positive voices were undoubtedly important, but I wasn’t at a place to just accept what they were saying as my own viewpoint without arriving at these beliefs myself. At the end of the day, both the negative and positive voices were telling me how I should feel. But when I assessed myself and the situation from a distance, it actually gave me the opportunity to figure out how I felt on my own. Though this did not kick my eating disorder to the curb, it did help me get a handle on my bulimic behavior, and it certainly opened my mind to what I might be able to do in the future to navigate what I was dealing with.

I started cultivating this calm, neutral inner voice as best as I could. It would say to me, “These are the facts. This is what’s happening. You didn’t eat yesterday, and today you made yourself throw up. How you feel about these things and what you do or do not want to take from this will dictate your next move.”

In this way I began to move inch by agonizing inch toward a clearer understanding of my hunger and my motivations for fighting it. I also gained some insight into how and why an eating disorder might shift roles and manifestations.

In an unexpected way, my struggle with bulimia was one of the most significant periods of my life in terms of understanding my eating disorder as a whole. The shift from anorexia to bulimia revealed to me the desperation and hunger that was lurking behind the structured way of life that was no longer working for me. While it’s taken me quite a lot of time and effort since, without that shift, I probably would have continued to lie to myself well into my 20s — perhaps even longer — and the inevitable crash would have been all the more painful for having repressed my own life to that extent.

I’m still in the process of uncovering new and healthy ways to acknowledge my desires and to feed myself. I have to be honest: the compulsions to restrict and to reject still run deep and strong, even as I navigate a new world of possibilities and opportunities that were unavailable to me before I made the commitment to recover. But I’ve learned to process these compulsions and view them as signals rather than directives. When I feel the need to restrict, it’s a signal to interrogate myself and uncover what I’m afraid of consuming. When I feel the need to purge, it’s a signal to examine what I am truly longing to undo or give up.

In this way I can begin to separate my emotions around food from the deeper issues shaping my outlook and driving my behaviors. It may be a long open road from there, but the key word is open.

I want to encourage everyone struggling with an eating disorder – whether you identify yourself as “in recovery,” whether you define yourself as anorexic, bulimic, something in between or beyond – to be as open and honest with yourself, first and foremost.  I know that relationships are a significant part of life, and that sometimes you may feel like you owe your health and recovery to other people. But if you’re doing it for anyone but yourself, it’s not going to stick; that’s just another form of denying yourself in favor of living by someone or something else. You will be able to contribute the most to your relationships once you get to a place where you can honor and nourish your own self. I tried for a very long time to fix myself by putting others before me, and in the end, no one benefited.

Cultivate and listen to a part of you that can say, “For whatever reason, this has been my struggle. It may not seem fair, but this is part of my life. Denying myself – no matter in what form – is self-harm. No matter how I proceed from this point, I will not lie to myself.”

As a good friend recently said to me: “If it’s hard – let it be hard.” Own your struggle, acknowledge the pain, and in the process, learn to access your potential to move beyond an identity that is not true to you. And most importantly, do it for you. If you owe anyone anything, you owe this to yourself.

About the Author

Halley Corapi lives in East Nashville and works as a producer for a messaging firm focused on advocacy and political campaigns around the country. She interned for Renewed in 2015, and has spoken to students on the organization’s behalf about eating disorder awareness and education. She loves language, and is always looking for new ways to communicate the complexity of mental health and recovery.