The Obesity-Related Addiction That Isn’t Even Fun

People with bulimia have a lot going on. It’s not simply that they can’t see themselves accurately. Visual hallucinations are only one aspect of an entire array of sensual experiences. An anorexic person can eat a teaspoonful of rice and feel full. Looking bloated is not the worst nightmare; feeling bloated is.

Just like other types of enthusiasts, some folks who cherish and cultivate their eating disorders have favorite slogans that they live by. A person may be horrified by the concept of foreign matter being inside her or his body, even if that intrusive substance is food. They don’t like excess fat on their communication, either. Why say “Emptiness is freedom” when “Empty is free” conveys the message so eloquently?

The quest for emptiness becomes grotesque and horrifying. An 80-pound person wrote:

i purge for 45 mins to 2 hours flushing over and over again
i am bloated (not as bloated as i was before purging my binge), and i feel like things are still inside me
i never feel empty, even when i restrict or when i get hunger pains after my b/p session

Another appreciates precision in distinguishing similar but not identical phenomena: “I frequently get the hunger feeling after purging, but never the truly ’empty’ feeling. I consider those two distinct sensations.” But wait, it gets worse, in the next entry:

Well yes, I do get the empty feeling. I purge down to my morning weight or less… When I get to the point that I taste literally just bile and it burns coming up, I feel pretty empty… When I push [on my stomach], it feels like there’s nothing in there at all. It’s not every time because I just don’t have the willpower to stand there all night and push it all out, but it does happen.

In looking forward to the day when they can live in their own place and make up the rules, a person might fantasize about “keeping the refrigerator and cupboards empty, and free of food.” (There’s that “f” word again.) Again and again, respondents mention the adjectives light, fresh, thin, empty, and free. One person says,

I get so frustrated seeing my parents bring a bunch of junk into the house. It’s very triggering having it just there… When I’m on my own I finally won’t have to worry about binging… And no one will be there to pressure me to eat.

People with these feelings may not even be able to define exactly what the emptiness represents freedom from, or what it replicates — but isn’t part of the ideal of freedom, the concept of not needing to explain your dream or its conditions to others? Shouldn’t it be a basic rule of human conduct, that each person is allowed the leeway to chase their own particular definition of the ideal life? The philosophical ramifications are deep and wide.

If someone wants to be very skinny, why should they not be allowed to pursue their vision of fulfillment (which paradoxically, in this case, is emptiness) — just like the person who aspires to drive a race car or climb a mountain? Those are, after all, life-threatening modes of existence, and the lucky drivers and mountaineers who make it through might win piles of money and acclaim.

Okay, maybe this line of thought goes a bit too far into the territory of the absurd. But people who are mentally or emotionally disturbed do not know that. They may deeply believe in their right to self-destruct, borrowing the reasoning of patriots and freedom-lovers everywhere, to rationalize their lifestyle to themselves and justify it to others.

But the person who binges and purges, what do they get in return for all that risk? Disapproval, scorn, and possibly torture (unwanted treatment) in a place with locked doors. This quotation illustrates the common tendency to regard doctors and other medical personnel as the enemy:

I got out of hospital today for refeeding syndrome (ironically not ED related) I have physical issues that cause malnutrition but also some food body issues that no one really knows about other than I have low self esteem/can’t see myself as others do. They haven’t connected those two, luckily.

Other respondents are eager to share thoughts like these:

I also have no interest in gaining back to a healthy bmi…
I know I would feel that way no matter how low it went so it’s completely illogical and unsustainable…
I have felt more confident in myself since being underweight. Even if I’ll never feel beautiful or thin I can rationalise the thoughts… So in a way I have a peace of mind…
just feel sad and lost and stuck…

So many questions arise, like, when did bulimia become a “thing?” Do the afflicted people discover the behavior by themselves, or learn it from peers or older relatives? Did people binge and purge during the two world wars? Did the disorder even exist then? During the Depression? Did bulimics rejoice that cupboards were bare and no one had enough to eat? Did banquet guests in ancient Rome really vomit on purpose just so they could gobble down more food?

Currently, is binging and purging an American phenomenon, or does it span the globe? If not for the cultural trend toward fat-phobia and fat-hate, would people choose to live this way?

Your responses and feedback are welcome!
Source: “ED Support Forum, EDSsupportForum.com, 06/06/20
Source: “ED Support Forum,” EDSsupportForum.com, 02/24/17
Source: “ED Support Forum,” EDSsupportForum.com, 11/01/22
Image by Gerd Altmann/Pixabay

Why Am I Not Dead Yet

As previously suggested, the ED Support Forum and other websites of its kind might constitute either a blessing or a curse. We reviewed a few of the various suggestions offered to eating disorder sufferers involved with refeeding, and worse yet, with refeeding syndrome. That condition may lead to consequences as severe as seizures.

One young woman reported in a post that she had suffered three of them, but told no one “because then they would find out about my ED, lol.” Laugh out loud, indeed. A paranoid mind might suspect that the forum exists, literally, to support eating disorders themselves, rather than the overcoming of them.

The contradictions and restrictions involved in maintaining binge eating disorder are exhausting. Keeping up with all the rules is like a full-time job, and the prospect of suffering the equally self-imposed penalties is dreaded.

A phrase seems to turn up frequently in the forum questions and answers about the hellscape known as disordered eating: “Why am I not dead yet” — without a question mark, which seems to remove it from the realm of the ordinary interrogatory. Put that way, the tone is not questioning, but resigned. Seemingly, the only thing a victim hates more than the eating disorder is the prospect of release from it.

That lying mirror

A peculiarity of pathologically emaciated individuals is the inability to actually see themselves in mirrors, photos, or the flesh. To themselves, they look repulsively fat, always. A forum participant known as Hiraeth_, a bulimia patient who accumulated more than 5,000 posts on the site, reminisced about the time when she had made herself so ill the question was legitimate — “Why am I not dead yet?” In one post, she named her ultimate goal as “being so […] thin that even I can see it.”

To maintain her “ideal” weight of 50 kilograms (110 pounds) she binged and purged almost every day, and took laxatives multiple times per day. A court ordered her into a hospital, where despite observation and strict rules, she still managed somehow to almost kill herself. That episode was followed by a year of being “in and out of hospital so many times I lost count, literally.” She writes,

After that horrible year, it surprisingly went better. I didn’t get hospitalized for 14 months. Until last week, lol. I hope this rollercoaster won’t start over again. Because this time, I bet I can’t be saved.

The gender factor

For whatever reasons, few eating disorder studies include males, but, surprise!

Despite the stereotype that eating disorders only occur in women, about one in three people struggling with an eating disorder is male, and subclinical disordered eating behaviors (including binge eating, purging, laxative abuse, and fasting for weight loss) are nearly as common among men as they are among women.

One might think that this refers to gay men, but one would be mistaken. Despite the shortage of reliable and wide-ranging statistics, it is suspected that males binge almost as often as females, although females are more likely to purge. Furthermore, it appears that women are more likely to purge in reaction to “normal” consumption patterns, and in the absence of binge eating.

Back to the ED Support Forum, one individual reported that she or he had been binging and purging for nearly five years, yet their blood work remained “completely normal,” which is “a bummer” because “I’m kinda hoping this kills me but it might take longer than I intended.”

The whole mess raises philosophical questions that can probably not be answered, such as: What does this have to do with the worldwide epidemic of childhood obesity? In a sense, it is almost as if the BP (binge and purge) people are some strange order of penitents doomed to suffer their ailment to compensate for all the planet-smothering obesity.

Like religious zealots who parade through the streets flogging themselves with whips, it is their destiny to take upon themselves the world’s sins of overindulgence, and somehow restore balance to the cosmic order. The one thing they cannot abide is the sin of obesity.

Your responses and feedback are welcome!

Source: “Search results for query: refeeding,” EDSupportForum.com, 2023
Source: “Bulimia Discussions,” EDSupportForum.com, June 2016
Source: “Eating Disorders in Men and Boys,” NationalEatingDisorders.org, undated
Source: “Bulimia Discussions,” EDSupportForum.com, 2016
Image by Gareth Williams/Attribution 2.0 Generic

Mutual Aid for Eating Disorders

One dangerous aspect of the World Wide Web is that young people can go there to be coached on exactly how to slim down in hazardous ways, by experts, i.e. other kids — or worse yet, adults — who are only too happy to indoctrinate them. The uninhibited spread of dangerous knowledge has been an ongoing problem ever since online forums were invented.

The one consulted here is ED Support Forum, a useful font of information on these topics, for better or worse. It apparently intends to help people escape from problem conditions, but in the course of helping, of course, readers will unavoidably find out a lot about how to acquire and maintain dangerous conditions.

The site is a huge resource, sorted into categories, where even those with unusual and arcane issues can find kindred souls. For instance, they ask each other about refeeding syndrome — a frequent consequence of malnutrition, whatever the cause, and not a challenge for amateurs to be handling on their own. Refeeding is the process of reconditioning the patient’s body to accept food without going all haywire from electrolyte imbalance and other complications. Refeeding syndrome is when it goes all haywire anyway.

The looming hazard posed by refeeding syndrome is a major reason for wanting to make sure that misguided young people do not become involved with any of the pathological and often grotesque efforts to lose weight in unsafe ways. Asking advice from people in the same boat is not a great choice but it’s as far as many people will go. They’re giving each other advice about how to manage refeeding syndrome at home, on their own. One poster asks,

Has anyone ever been thru refeeding at home? Went 8 days fasting with very little liquid. Then tried consuming the last 3 days. Every time I try, I break out in sweats head to toe. Then nausea. My lower legs and feet and ankles are swollen and even after hours of elevation don’t go down much. I have passed out a few times. My blood pressure is low. Last check was 86/58.

This person goes on to say that they have social anxiety, and rarely leave home, so of course going to a hospital “isn’t an option.” So they request not to be offered any advice like calling 911 or visiting a doctor or the emergency room. But then their next post says they “did end up at ER sunday.” The poster wrote:

Because of malnutrition/starvation/dehydration my body is trying to hold on to fluid nutrients or whatever it can. Fluid in chest/abdominal wall is what is causing the pain… I’m weaker now than I was Sunday. Still swollen. Wt up 8 lbs from swelling. My stomach has been removed and I’ve had 3 bowel resections.

This really sounds like hell on earth, and another member of the forum confirms that “refeed edema is super painful… Stick to whole foods, avoid processed since processed has high levels of sodium,” and goes on to give other advice gleaned from research papers. Another amateur counselor notes that the mental health toll an eating disorder imposes can be devastating. Implementing “damage control” is exhaustingly time-consuming, and the whole process is something “you can really beat yourself up over.” They write,

You will have to challenge your perfectionism which the ED is tightly bound around, so that’ll freak it out. Unfortunately, challenging perfectionism a little might be what keeps you mentally and physically safer during your ED.

Another person, and just for ease of communication we’re going to assume this is a female, confides that her “ED brain” looks in the mirror and sees a big, fat blob that absolutely needs to continue losing weight. Even if her calorie count is tiny, the ED brain gets angry. When the number on the scale goes up by even one pound, the ED brain tells her she is a failure, and is only happy when the number decreases. The person writes:

Then my little bit of sanity I have left sees the real me in the mirror and thinks I look disgusting… That this is the one body I’ll ever get and I’m ruining it… Also stop losing before I get put in forced recovery.

“Dark Seas” contributes information about how prickly and defensive her ED brain is, because when someone advises her not to vomit, or offers some other helpful advice, the ED brain hisses, “Of course they’d say that, because they don’t want me to be skinny.” So even a helpfully-intended intervention is received as an insult and a challenge.

Your responses and feedback are welcome!

Source: “Refeeding at Home,” EdSupportForum.com, 05/22/24
Source: “How to avoid/lessen binging,” EdSupportForum.com, 01/25/24
Source: “ed brain vs rational mind,” EdSupportForum.com, 06/11/22
Source: “ED Brain,” EdSupportForum.com, 03/08/22
Image by Edvard Munch/CC BY 4.0 rawpixel.com

Oprah Through the Years, Part 21

Courtesy of the Oprah Winfrey Network, March of 2011 brought the TV audience a new reality show, “Addicted to Food.” It was recorded on location at the Shades of Hope Treatment Center, a facility specializing in eating disorders and addiction. Shades of Hope founder and CEO Tennie McCarty has found that addicts come from homes affected by dysfunction, abuse, addiction, or some combination of all three. The work that must be done is “to delve deep within and confront not only the outward behaviors of addiction, but also the secrets, pain, self-loathing, and blame that lie beneath.”

How long does that take? At minimum, 42 days, which is the length of the Intensive Residential Program. This has been shown to be enough time to dig into the psychological issues, learn the tools of recovery, and achieve a solid state of abstinence. The process is not easy, and the rules are strict, for good reason. No alcohol, no smoking, no other types of addictive substances are allowed, because to run a program meant to end one sort of addiction while allowing other addictive substance to be used is just plain silly.

While a client’s weight may be tracked, it is not revealed. The point is to get away from the idea that “it is always about the numbers and the connection of worth/control/success to the number on the scale.”

And that’s not all…

Oh — and no TV, or books or magazines are allowed either, because people need to be thinking about their own issues, not about the larger world or some imaginary characters. McCarty explains that the goal is to allow all the negative feelings to emerge and “slap the client in the face.” Hopefully, that blow will metaphorically knock the mask right off, exposing the anger and all the other stuff. When this happens, the client is said to be “showing up.”

The Intensive period includes Family Week, and then another week in which to process whatever transpired during that time, and to figure out what’s next — which might be a transitional period, either still at the Shades of Hope, or at another facility. Or perhaps it is time to return home, and get back to school, work, or whatever.

But… and this is a big but…

None of these stages can be regarded as an end point, because this is not a race where a person breaks through a ribbon at the end of the course. Nope, says McCarty. It’s all about a lifelong commitment, during which the individual must be constantly on guard because that inner void still cries out to be filled, and “switching” addictions is definitely a real possibility, to be avoided at all costs. Day by day and minute by minute, the commitment — to use new attitudes and new tools to change old patterns — must be scrupulously kept.

McCarty offers five helpful “tips” for recovery, more thoroughly described on her page, and worth looking into:

1. Be conscious of what you eat.
2. Eat with intention.
3. Maintain a healthy meal plan.
4. Eat by the clock.
5. Recovery is not a diet, but a way of life.

The show made at this “extremely difficult rehab center” involved eight clients, and it must have been edifying for Oprah to recognize which one (or ones) she most closely identified with. Seven years later, InTouchWeekly.com made an attempt to follow up on the participants, which proved to be rather half-hearted and largely unsuccessful. But their website also contains the trailer for the original show, which is pretty interesting. SocialWorkersSpeak.org also took note of the series and made some comments.

In the next chapter of Oprah Winfrey’s life of up-and-down weight shifts, we will see things take off in a whole different direction.

Your responses and feedback are welcome!

Source: “Addicted to Food Q&A: Tennie McCarty and Tough Love,” Oprah.com Source: “Remember Oprah’s Reality Show ‘Addicted to Food’? Here’s What the Cast Is up to in 2018,” InTouchWeekly.com, 03/01/18
Source: “Oprah Winfrey Network’s ‘Addicted to Food’ Tackles Emotions Behind Eating Disorders,” SocialWorkersSpeak.org, 05/12/11
Image by Pat Hartman

Oprah Through the Years, Part 20

We left off last time by mentioning how the rules change. This is one of life’s little jokes. As soon as you get used to one condition or set of circumstances, it will probably be necessary, before too long, to readjust to something else. For humans, the primary survival trait is adaptability, and the young are better at it. This is one reason why, when correctly applied, being like a little child is a very desirable state.

Youth is when many people are easily able to swallow and assimilate anything without suffering a physical penalty. As the body ages, it becomes less tolerant and… the rules change. When something else is going on at the same time, this fact might be easy to ignore. In the case of Oprah Winfrey, trainer and friend Bob Greene pointed out that her thyroid issue was an easy excuse to fall back on, and that she had “absolutely” done so on more than one occasion.

People are usually pretty good at generating excuses for not achieving their dreams. Just like a regular human, the global influencer and star had a particular and individual issue to deal with. In her case, it was a medical condition that required expert management, as well as patient compliance.

At the same time, like billions of regular people, Oprah was getting older every minute. As time goes on, and even with dedicated effort, it becomes more and more difficult to stave off weight gain.

In human history, this has rarely been the case. For obesity to become a significant problem, a society has to reach the stage of having food surplus to its needs. The civilization advances to where it can afford to have some members unable to defend themselves, and dependent on others for their continued well-being. When the society has abundant food, and physical fitness is not a priority requirement, people can become obese.

The Bob Greene worldview

Greene theorized that no one, be they an anonymous teenager or a world-famous star, would ever be able to completely overcome food addiction; that the problem would never completely disappear, and would always need conscious and diligent management. He also suggested that no one could properly start the recovery journey without squarely facing five crucial questions:

What are you hungry for?
Why are you overweight?
Why have you been unable to maintain weight loss in the past?
What in your life is not working?
Why do you want to lose weight?

The last query is a particular challenge, because the seeker is quite likely to come up with the wrong answer. “Then I’ll be happy” is not the right one, because it encompasses only two possible outcomes, neither of which can satisfy, as Greene explains:

You never reach that size or weight and you’re never happy. And even worse, you reach that size and weight and realize it has nothing to do with your happiness.

The following year, 2010, was when Oprah famously stated for publication that she was not fond of the term “food addict,” but…

I realize that I really have been one. And believe me, I — like so many of you — have punished myself for that. But I know that I’m not alone, and I know that the battle hasn’t ended.

This admission seems to cover two bases: First, it pleads guilty to the same fat-hate that dwells in the heart of even the most compassionate person. Also, it appears to confirm that the last person anyone is ever able to forgive is their own self.

Your responses and feedback are welcome!

Source: “Oprah’s Weight Loss Confession,” Oprah.com, undated
Image by Oprah.com/Fair Use