Bulimia: A True Frenemy
Bulimia, as many clients have agreed, is like living with a frenemy – it pretends to have your best interests at heart - telling you how good you look and how smart you are - before dragging you into a spiral of self-doubt and shame. You then relive the same exhausting pattern over and over—like a horrific version of the 1990s film, Groundhog Day.
Understanding the Cycle of Bulimia: A Miserable Version of “Groundhog Day”
Bulimia’s cycle is deceptively simple and deeply destructive. It often begins with attempts to restrict eating through severe dieting or skipping meals. These behaviours set the stage for a powerful biological and emotional hunger that eventually leads to a binge - where you consume an excessive amount of food in a short period of time. This is often followed by intense feelings of guilt, shame - and a desperate need to undo the binge, leading to purging through vomiting, laxatives, or extreme exercise. And so, the cycle starts again.
The repetitive nature of this cycle is what makes bulimia feel like a horrific Groundhog Day. The more it repeats, the harder it is to break free, leaving us feeling trapped, ashamed, and increasingly worn down.
The Dangers of Bulimia
The cycle of bulimia carries significant dangers:
Physical Consequences: Chronic purging leads to dehydration, electrolyte imbalances, and damage to the digestive system. Over time, this can result in life-threatening conditions, such as cardiac arrhythmias and kidney failure. It can also lead to severe dental problems.
Emotional and Mental Health: The ongoing struggle creates a vicious cycle of low self-esteem, anxiety, shame and depression. The act of bingeing and purging becomes an addiction, driven by the temporary relief it offers.
Understanding these dangers is essential for anyone trapped in this cycle. As Glen Waller, a clinical psychologist specialising in treatment of bulimia emphasises, the first steps towards recovery involves addressing these behaviours head-on, breaking the harmful loop.
Step One: Stop Purging
Much as this can sound both terrifying and horrific – with a fear that we’ll “balloon” if we do it - the first critical step in breaking free from bulimia is to stop purging. This is essential to halt the immediate reinforcement of the cycle. Purging provides a false sense of relief that strengthens the behaviour, trapping us in an endless loop. It also:
Breaks the Cycle of Immediate Reward: Without purging, the cycle loses some of its power. This step forces us to confront our discomfort and work through it without relying on harmful habits.
Lays the Foundation for Change: By addressing purging first, wecreate a space to start focusing on the root causes and triggers of binge eating.
Step Two: Eat Regular, Balanced Meals
The next phase involves developing a consistent eating schedule. One of the driving forces behind bulimia is under-eating or missing meals. When our bodies experience prolonged deprivation, they respond with an overpowering biological urge to binge. This is not a failure of willpower - it’s a natural response to starvation. Regular meals help regulate hunger signals, making it easier to resist the compulsion to binge. Establishing this routine is a cornerstone of recovery, because it stabilises blood sugar levels and reinforces the body’s natural hunger and fullness cues.
Step Three: Challenge Your Thinking
Bulimia is, essentially, an addiction. It thrives on strict rules and black-and-white thinking, driven by statements such as “I can’t change” or “I must exercise or purge after eating” or “If I eat breakfast then I’ll gain 3kg”. These fixed-rule statements maintain the problem. When even a small backward step occurs, it triggers feelings of failure that can lead to a binge-purge episode. The negative beliefs that underpin bulimia and:
Creates a Fragile Mindset: Living by rigid rules makes individuals feel like they are only one misstep away from disaster.
Reinforces All-or-Nothing Thinking: This mindset prevents balanced approaches to eating and self-care, fostering guilt and shame.
How Therapy Can Help
Therapy plays a central role in dismantling the false support system that bulimia provides. It offers structured approaches to help individuals recognise harmful thought patterns and behaviours while building healthier coping mechanisms.
Enhanced Cognitive Behavioral Therapy (CBT-E) is one of the most effective treatments for bulimia. It focuses on:
Establishing clear behavioural patterns, that can be maintained.
Identifying and challenging rigid beliefs and unhelpful thought patterns.
Teaching practical coping strategies for dealing with the emotional triggers that lead to bingeing and purging.
Encouraging gradual changes in thinking to promote a flexible, more forgiving approach to eating and body image.
Nutritional counselling creates meal plans that support regular eating patterns. This step reduces the physical triggers that lead to bingeing and helps restore the body’s natural balance.
Embracing Setbacks as Part of Recovery
Waller and other experts stress that recovery from bulimia isn’t a linear path. Setbacks are a natural part of the healing journey and do not signify failure. Viewing setbacks as learning opportunities, instead of defeats, allows individuals to build resilience and adapt their strategies. To handle setbacks, we need to:
Practice Self-Compassion: Normalise backward steps and see them as part of progress. Speak to yourself with the kindness you would offer a friend.
Learn and Adapt: Reflect on what triggered the setback and how you can respond differently next time.
Use your support network: Whether it’s a therapist, a support group, or close friends, they help you to stay motivated.
Conclusion
Bulimia is a frenemy, initially charming and enticing, before becoming a force that grinds down your physical and mental health, leaving you stuck in a relentless, miserable version of Groundhog Day. By seeing it as an addiction that can be overcome and engaging in therapy, you can start to break free. Whilst recovery can have its ups and downs, falling off the wagon doesn’t mean you can’t get better—it means you’re human. The path to being free from bulimia is possible: it starts with understanding that true friends help you grow and heal, they don’t keep you trapped in the harmful cycle of an abusive relationship.