An RD Confesses: "I Had Bulimia"

The Breaking Point

My friends, who were unaware of my late-night bingeing and purging, continually praised me for all this hard work. But as the months and years went by, throwing up felt less and less like an easy (albeit shameful) solution. Now it just felt gross, emotionally agonizing -- like an obligation. I knew it was bizarre and abnormal; I knew the sensible way to lose weight would be simply to eat less in the first place. Still, I just couldn't stop.

Based on what I now know about the disorder, it makes sense: Some experts suspect that dysfunctional eating behaviors actually "help" a stressed-out brain relax. Bingeing, starving, exercising, vomiting -- they all affect brain chemistry as powerfully as drugs. As with an addict who promises to quit, when the next stressor hits, the behavior returns. Instead of quitting, I just worked harder and harder to keep my habit hidden. Secrecy was crucial.

One day during the summer after I graduated from college, my mother confronted me. We had gone out to eat at a Chinese buffet; starved after a day of fasting, I had gorged myself, then run to the bathroom to vomit. When I returned to the table-hair disheveled, eyes watery-my mother asked, "Did you make yourself throw up?" I lied and said, "How could you even think that?" She dropped it, but the conversation jolted me into reality. Keeping food out of my stomach felt good; Mom noticing felt bad. (I found out later that she herself had frequently purged as a child, after her mother force-fed her a full breakfast before rushing her off to the school bus. Maybe that's how she recognized the signs.)

When people ask me whether it's smart to confront someone with a suspected eating disorder, I tell them to handle it the same way they would if they thought their friend was drinking and driving. Regardless of how she acts in the moment -- with denial, anger or a promise to change -- the most important thing is that she now knows you care and will stick by her. And that might be what saves her life.