A Guide to Recovery

25th Anniversary Edition

by Lindsey Hall and Leigh Cohn

Breaking the Binge-Purge Cycle

Excerpt from Bulimia: A Guide to Recovery 25th Anniversary Edition

Everybody has an opinion about how to eat. That’s why there are tens of thousands of books and millions of websites on eating, cooking, and dieting. Even experts in the eating disorders field don’t agree. Many advocate “legalizing” food and becoming an intuitive eater, others encourage abstinence from certain foods, like sugar or carbohydrates, and still others have their patients follow detailed food plans. I think different approaches work for different people—and there’s a path for everyone.

People have various kinds of hungers—physical, emotional, social, spiritual, and sexual, among others. If you have an eating disorder, you may have difficulty recognizing these different hungers because you are separated from your inner experience. So, in recovery, as you start to connect with yourself, you’ll also be learning to differentiate between your hungers and “feed” them appropriately.

Emotional hunger is the longing to be loved, have self-worth, be understood, and find meaning in life. It is the desire to find peace, be whole and happy, connect to other people, and do meaningful work. Bulimics are often oblivious to these hungers of the heart, and are instead preoccupied with their weight and feelings like self-loathing, loneliness, and shame. Emotional eating is a way to numb those painful feelings, and, for bulimics, all eating becomes emotional.

Emotional eaters are also oblivious to physical hunger, the body’s physiological craving for nourishment. Instead of recognizing what their body naturally needs, they try to control their appetite and waiver between a diet mentality and binge eating.

Bulimia is an addictive cycle on both physical and emotional levels. As you can see from the figure that follows, this sequence involves a self-sustaining series of events and predictable responses:

The Binge-Purge Cycle has no beginning or end, but for the purpose of this brief explanation, let’s start with DIET. If you believe losing weight will make you feel better about yourself, you control what you eat. Before long, you obviously experience physical HUNGER, which brings up anxiety (as in the tension between “I want to eat” and “I shouldn’t eat”). At some point, you finally EAT, but feel overwhelmed by guilt, shame, a sense of failure and insecurity, and other negative emotions. For bulimics, this translates into a BINGE that takes the focus off all these feelings, leaving a sense of numbness. But pressures build, and redemption is only a PURGE away. A “high” follows, along with the resolutions “never to do it again” and be a better dieter in the future. Then, the process repeats itself. In this way, the binge-purge cycle is not only about food and eating, it is also about painful emotions and using and abusing food to handle them.

You can break this cycle at any point by intervening on an emotional or physical level. Intervention can take many forms, for instance, you could refuse to purge after a binge, eat a dessert without guilt, or challenge the value of dieting. At the very least, begin to question. If you are hungry for food, acknowledge that your body usually knows what it wants because it is responding to biological needs, and ask, What is my body craving? What will give me feelings of satisfaction and fullness? What can I eat right now to nourish my body—without guilt? Before the binge begins, ask, “What would truly ease my hunger? What feelings need to be expressed? Is there a way of satisfying my emotional hungers directly instead of using food?” In the middle of a binge, ask, “Can I take back my power and stop right now?” These kinds of questions can help you begin to take steps towards distinguishing and feeding all your hungers—one of the biggest challenges of recovery.

A healthy pattern of eating excludes bingeing, purging, and dieting along with the negative emotions that accompany them. Here’s what the Healthy Eating Cycle looks like:

In this second scenario, natural HUNGER is followed by the anticipation of the next meal. For “normal” eaters, this is a period of excitement when they think about what foods they crave. When they EAT, it is with pleasure and enjoyment, leading to FULLNESSand feelings of satisfaction and nourishment. Instead of the turmoil of the bulimic, their physical and emotional hungers are fulfilled, and they feel energized and ready to get on with their lives until they feel hungry again.

Keep in mind that your body needs a combination of carbohydrates, proteins, fats, water, and minerals. If you have been purging or restricting for any period of time, both your body and your brain are probably starving for nutrients. You might not be able to think as clearly, respond as positively, or make as good decisions as you would if you were eating healthy food and keeping it down. This is why you must satisfy physical hungers by eating regular meals and snacks so you will be better able to incorporate the insights of recovery into everyday life.