Bulimia and Starvation: How Restriction Perpetuates the Binge-Purge Cycle
Contributor: Jennifer Rollin, MSW, LGSW, writer for Eating Disorder Hope
Bulimia Nervosa is an eating disorder that is characterized by “a cycle of bingeing and compensatory behaviors such as self-induced vomiting designed to undo or compensate for the effects of binge eating.”
According to The National Eating Disorders Collaboration, the two key features of a binge episode include, “eating a very large amount of food within a relatively short period of time and feeling a sense of a loss of control while eating.” For an individual with bulimia nervosa, there is often extreme guilt following a binge episode-which causes the person to engage in unhealthy compensatory behaviors.
A Key Element
I would argue that there is one key element, which is often overlooked that serves to perpetuate the cycle of binging and purging. Actual physical starvation or deprivation, or the threat of deprivation is one major component that maintains this dangerous cycle.
Dieting and food restriction often naturally leads to binge or emotional overeating. From an evolutionary standpoint, it makes sense that starvation or the threat of future starvation would trigger us instinctively to binge eat. Lauren Muhlheim, PsyD, CEDS, director of Eating Disorder Therapy LA, exemplified this point when she stated,
“Our bodies evolved in an environment in which food was relatively scarce. To survive in such an environment, our bodies had to prioritize the consumption of food above other activities. If our food supply was less secure, we learned to stock up on food when we could.
It is a behavior that ensured our species’ survival. Bingeing was not a matter of poor willpower, but a perfectly normal and healthy body response to starvation.”
Further, a groundbreaking study on the effects of physical starvation that was conducted in 1944, helped to demonstrate that “many of the symptoms that might have been thought to be specific to anorexia nervosa and bulimia nervosa are actually the result of starvation. These are not limited to food and weight, but extend to virtually all areas of psychological and social functioning.”
The Minnesota Starvation Study
The Minnesota Starvation Study involved a sample of 36 young, healthy, men whose caloric intake was restricted for a 6 months period. “More than 100 men volunteered for the study as an alternative to military service; the 36 selected had the highest levels of physical and psychological health.”
“During the first 3 months of the semi-starvation experiment, the volunteers ate normally while their behavior, personality, and eating patterns were studied in detail. During the next 6 months, the men were restricted to approximately half of their former food intake. This was followed by 3 months of rehabilitation, during which the men were gradually refed.”
Interestingly, many of the symptoms that are associated with clinical eating disorders became apparent in the men who participated in the study. Many of the men in the study became obsessed with food, collected recipes, hoarded kitchen utensils, daydreamed about food, and engaged in strange food rituals.
Further, “Despite little interest in culinary matters prior to the experiment, almost 40% of the men mentioned cooking as part of their post experiment plans. For some, the fascination was so great that they actually changed occupations after the experiment; three became chefs, and one went into agriculture.”
“During the restrictive dieting phase of the experiment, all of the volunteers reported increased hunger. Some appeared able to tolerate the experience fairly well, but for others it created intense concern and led to a complete breakdown in control.”
A few of the men broke the rules of the study and binged on large quantities of food. One study participant binged and purged. Additionally, the men experienced psychological changes, such as a decrease in sex drive, and an increase in depression and anxiety.
The Minnesota Starvation Study helps to explain some of the behavioral and cognitive symptoms that individuals with bulimia nervosa may experience as a direct result of their attempts to restrict food.
Individuals with bulimia nervosa often feeling guilt and shame following an episode of binge eating and this may trigger them to restrict food-thus perpetuating the cycle of binging and purging. Even if the person does not physically restrict food, they may be emotionally restricting food.
Emotional deprivation is the concept of allowing yourself to eat a certain food, but continuing to feel shame and guilt around your food choices. Emotional deprivation can perpetuate the binge-purge cycle, as the thought behind it is often, “I am eating this now, but I won’t allow myself to eat it tomorrow.” This mindset may trigger binge eating, as it is the perceived threat of starvation or deprivation.
If you are struggling with bulimia, it is important that you consider reaching out to a treatment professional for help. They can help you to challenge your food rules and “all or nothing” thinking towards food, which may help you to stop engaging in the binge/purge cycle.
It is particularly helpful to look for treatment professionals who utilize a health at every size approach and who are knowledgeable about the concept of intuitive eating.
A licensed professional can also help you to examine the underlying emotions and stressors that might be contributing to your use of maladaptive coping skills. It is likely that you binge and purge because you are trying to help yourself to feel better.
However, this strategy is harmful to your emotional and physical well being, and doesn’t do anything to solve the underlying issues. It is important to note that you are not choosing to feel and behave this way. No one would choose to have an eating disorder, however it is never too late to choose to work towards recovery.
Community Discussion – Share your thoughts here!!
What types of treatment have you or your loved one found successful in obtaining recovery from Bulimia Nervosa? What hope do you have to share?
Jennifer Rollin, MSW, LGSW, writer for Eating Disorder Hope
The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.
We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.
Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on November 11, 2015
Published on EatingDisorderHope.com