I was flicking through Facebook the other day and I noticed that a good friend of mine had been teaching yoga to members of the eating disorder charity Beat. It started off a chain of thoughts in my head about eating disorders and in particular bulimia – the focus of this article. I’m not planning on going into great detail in this blog about what bulimia is and its diagnostic features. If you want to find out more, please check out the Beat website – https://www.beateatingdisorders.org.uk/

Now I’m a GP, as you know and I quite frequently see people who are having issues with bingeing and vomiting. Many of the people I see who are experiencing symptoms of bulimia have lost hope that they can get better. This is a real shame as I personally know of many people who have recovered. I wanted to share the story of Elle – a close friend of mine. She struggled with recurrent episodes of overeating and vomiting. The problem began in her teens and finally ended in her 30s. She’s given permission for me to share her story and our hope is that it inspires others to believe that they can recover.

“I starting having problems with food when I was around 15 years old. I remember the first time I overate and made myself sick and I couldn’t really have given you a concrete reason why I did it. Obviously I was a teenager and I was concerned about my appearance. I wanted to look right and looking back, I thought about my weight and what I was eating a lot. If I overate, it was bad day and if I managed to control my eating, it was a good day. It was quite split like that. I loved sweet things and eating was comforting and this behaviour was a way of overeating and not having the consequences. That was how I saw it at the time. I was pretty ashamed of the behaviour and went to great lengths to hide it from my family. I actually think it was a while before they found out. It was a dirty secret and I kind of pretended it wasn’t happening. I went to great lengths to be perfect at everything I did.

I didn’t like myself much. I wasn’t sure of my passions, what interested me or what kind of person I was. I was pretty cut off in the department. I’d realised pretty early on that I was bright academically and this was my saving grace. I put most of my energy into my work and learning and did extremely well. This kind of compensated for the rest of me (which I hated) and and so this split emerged. The more inadequate I felt socially, the more brilliant I became academically.

There had been a few things that had happened in the years running up to my “food symptoms” developing that had been difficult. As a teenager, I’d been on the receiving end of violence from a male relative in the household. He was a bully and I honestly felt that he might kill me on occasions. His outbursts were usually triggered by something trivial (which was blamed on me) when in reality he should have been able to control himself. Following this, I’d lost a parent and was unfortunate enough to be sexually assaulted by a NHS care worker. I didn’t tell anyone about this episode. I kept it to myself and got on with it.

I did really well in my A Levels and went onto university. There my symptoms got worse and I was vomiting 4-5 times a day. I was also diagnosed with depression and was taking tablets for this. I did on occasions open up to health care professionals about my eating issues. If I trusted them that was. The reality was I was hugely ashamed of my behaviour. It was completely at odds to the image that I was trying to portray to the world of this sorted academic who had it all together. The other thing that frustrated me was that the questions that doctors would ask me did not make sense. They would ask me what my “triggers” were and why I did what I did. The truth was that I didn’t know what triggered it. I would be fine one minute and then it was like somebody had flicked a switch and I would find myself with my head down the toilet. I also felt that my childhood had been “fine”. Yes, bad things had happened but I had no real feelings about these episodes one way or another.

I met my first boyfriend at university. He was controlling, and a bit of a git. I was raped on on a couple of occasions and I tolerated it because I didn’t want to lose him. Eventually the relationship ended and looking back on it now, that was a huge blessing. The eating behaviour escalated at this time and this was the first time I started to notice patterns. It was worse with stress and better when I was more comfortable. I like to see this time as the beginning of my recovery as I started to see the driving forces behind what was going on. This made it far less scary. It’s much easier to change if you can see what’s kind of going on underneath.

So that was the depressing part of my story. I wanted to tell it because it’s part of my journey and it feels more authentic to do so. I did seek help from the NHS and the tablets for depression probably helped a bit.  I had this burning desire to fix it once and for all. I’ve always been a bit of a bugger with getting stuff done. If I was a dog, I would be one of those snappy ones that is always around the ankles. I find it hard to let stuff go and I like a challenge.

The next big insight came around 15 years later. I’d started to drink too much and had finally managed to stop. A couple of days later, the bulimia symptoms came back and I started to get the urge to vomit. The eating problems had been “quiet” for a few years but now the alcohol was off the scene, the habit reasserted itself.

It was then that I had a lightbulb moment. It seemed very likely that the same problem was driving both these behaviour patterns – that of bulimia and the excessive drinking. If I could get to the “root cause” of both these issues, then I could heal myself.

This was a revelation to me. Before then, I had thought of my body as broken. These behaviours just happened to me and I felt I had no control over them. Now I could see patterns, and I could work with patterns. I just didn’t know how to.

My next breakthrough came through practicing mindfulness meditation. We were encouraged to observe thoughts and feelings without judgement. Thoughts I was familiar with but feelings? I realised then that I had quite a bit of difficulty identifying my feelings. I knew if I felt good or bad but that was about it. I remember buying a book from the Wellcome Library in London about emotions and it went on to say that we had a huge number of emotions. There was anger, fear shame, guilt, envy and it went on. I was very intellectual about things. I wrote gratitude lists and I knew intellectually that each item was something to be grateful about but I didn’t yet know how to feel grateful. I became very curious about this and the next time I wanted to act out with food, I started to pay attention to what was happening immediately prior to the urge.  I realised that I felt bad.  With a bit of practice, I realised that it was shame that I felt and each time I got the urge to act out, the feeling was always the same. Bingo!

This didn’t stop the bulimia immediately but I felt far more empowered. I started to feel proud of myself and this feeling built to more positive feelings and with more positive feelings, the less I acted out. With practice, my ability to name and feel my emotions got better and I started to feel more and act less. It took some time and I had some slip-ups along the way. If something was bothering me, identifying the emotion helped me to solve the problem in a more effective way. Perhaps I needed to talk to a friend, go for a walk, take a break. I learnt how to look after myself and I started to almost honour myself and be amazed at the complexity of how my body worked. It no longer made sense to treat it like dirt and so vomiting became less attractive and over time I developed better ways to cope. The tablets were stopped (thank God) and I started to live.

The other thing that happened which was quite painful was that I started to grieve the losses and the shitty things that had happened in the past. There was a lot of anger and for a time I saw potential abusers in everyone. Sometimes my intuition was right and I needed to move away from certain people in my life. Other times I was seeing their behaviour through the lens of the past and at the moment I’m still learning to tell the difference. Its a daily journey this life. Sometimes it’s painful but it’s always an adventure and there is learning in everything. We always have choice and if we choose, we have freedom.”

So if anyone reading this feels that they having a problem with eating, please seek help. Please visit your GP and we can offer help and support. The Beat website is also very informative for anyone whose life is affected by an eating disorder.

This aticle is designed for educational purposes only and is not intended to replace professional, personalised advice from your doctor. Please, if you feel ill and are unsure or concerned, seek advice from a qualified health professional which could be your GP or Accident or Emergency if you have a life threatening medical problem. If you unsure, NHS 111 – http://www.nhs.uk/NHSEngland/AboutNHSservices/Emergencyandurgentcareservices/Pages/NHS-111.aspx can help you decide.