5 Top Tips For Dealing With Bulimia Nervosaby Dr Emma Gray - 11th September, 2014
1. Develop a regular pattern of eating
If you are bingeing developing a regular pattern of eating is an essential first step. One of the main triggers for bingeing is hunger or low blood sugar. Regulating your blood sugar and ensuring that you are never too hungry will significantly reduce the likelihood of a binge being triggered. Aim for 3 meals and 2-3 snacks per day and ensure that these consist of a balance of complex carbohydrates, protein and vegetables. If you are trying to lose weight you will need to put this to one side until you have resolved your eating disorder as dieting deprives the body of calories which, if you are prone to bingeing, will exacerbate the problem. Whilst working to overcome your eating disorder you should aim for 1800-2,000 calories per day. If you are bingeing, this amount of calories spread in a balanced way across the day will not only reduce the frequency of binges but will amount to a far lower overall calorie intake than dieting/restricting and the consequence high levels of bingeing that this way of eating results in .
2. Regulate your mood
The other key trigger for bingeing is high and intolerable emotions (both negative and positive in some cases). Common triggering emotions of bingeing include anger, depression, loneliness and anxiety. Keep a diary to monitor the emotion that most often results in a binge and then try to identify its cause. Our emotions are most often triggered by thoughts so identify the thought that preceded the binge triggering emotion and then look at how accurate that thought is and how helpful it is. Now try to substitute the thought with a more accurate helpful alternative.
Another way to regulate your mood is to identify the particular emotion that you are feeling pre-binge and then identify the opposite emotion (e.g. depression-happiness, anxiety-calm, anger – chilled). Now identify the activities that usually result in you feeling the identified opposite emotion and engage in those activities.
3. Change the way you eat and shop
Make sure that your environment is binge-free friendly. In the early stages of trying to resolve your eating disorder write a shopping list and stick to it. Shop on a daily or bi-daily basis, avoiding a weekly shop so that food outside of you regular eating plan is not readily available. Always eat at the table without other distractions, when we binge we tend to dissociate so being mindful during meals times reduces the likelihood of a meal turning into a binge. Eat slowly to allow your body to register when it is full and to build your experience of eating in a non frenetic way (i.e. a non bingeing way).
Both bingeing and purging are impulsive behaviours. This means that there is little if any conscious thought which precedes them, our minds switch into auto pilot which makes it very hard to stop the behaviour. By pausing or delaying your binge and purge you can reintroduce conscious thought which over time brings a real choice back into the process. Some examples of pausing or delaying bingeing and purging include:
· changing the shop where you buy your ‘binge food’ to one that is further away
· introducing a pre-binge/purge activity e.g. walking round the block, count to 100, do a crossword, listen to a piece of music
· identify the trigger to your binge/purge urge (i.e. thoughts and associated feelings)
5. Improve your self esteem
Bulimia Nervosa is ultimately a result of chronic and severe low self esteem. Bulimia nervosa enables the sufferer to feel as if they have a solution to feeling ‘not good enough’, although that solution creates more problems than it solves over the longer term. So eventually to achieve long term relief from an eating disorder like bulimia nervosa you will need to build your self esteem. The most effective way of doing this is through therapy, ideally Cognitive Behavioural Therapy (CBT) with a trained mental health professional (e.g. a doctor of Clinical Psychology or Counselling Psychology).