A few months ago I vomited into my own ears. And they say dreams don"t come true. There I was, minding my own business and engaging in my traditional midday purge when suddenly - this is the part where you know you"ve hit just the right spot - I lost my balance from the force of my own retching. I flipped my head back and slung the rest of Monday"s mucus-meets-lunch right back into my own ears.
Gravity be damned. At this poignant (and amazing Ö kind of made me wish Real People was still on the air) moment, I realized two important things: (1) Q-tips are handy things to carry around in your purse and (2) my bulimia relapse had officially spiraled out of control. I"ve been bulimic since age 18. I"m barely 25 now. For seven years I"ve retched, lied, healed, relapsed and lived to retch another day. I"m fortunate for several reasons, not the least of which is an incredible circle of understanding and keenly observant family and friends. But I"m unfortunate in my own stupidity; I keep getting back on my knees. After this last relapse, though, I began to wonder if I wasn"t getting too old for this. I no longer tasted that familiar high - a metallic blend of after-puke and sulfur. Instead, I tasted something ominous and flat. A bitter taste, farther down in my throat than usual. A bitter ending to a silly story. And somehow, as I"m a wee bit older than the cautionary tale you"re usually handed about eating disorders, I don"t foresee any glossy, moving TV movies about me if I kick the bulimia-related bucket. (Author"s note: If I die and the producers come a-knocking, please see if you can score that Scarecrow and Mrs. King woman to play the concerned guidance counselor.) So why am I telling you this? Shouldn"t I be in a support group somewhere? Well, lately I"m hearing a little too much "rah-rah retching!" cheerleading from amateurs and young girls. At the risk of sounding preachy, piteous or melodramatic, I feel like somebody who"s been there needs to stand up and scream, "Wake the fuck up!" Despite the acquired talent for circus feats ("See Purgessa: The Girl Who Vomits Skyward!"), this disorder isn"t funny. Fighting it at 25 is even less funny. I"d go so far as to call it pathetic. I realize that after-school specials and student health pamphlets are a dime a dozen and that my words aren"t any sort of golden key. I"ve no illusions that spewing my own story forth (pun intended) will miraculously rescue some poor lonely girl hiding in a bathroom stall. Maybe, though, if you read this and you tell two friends (and she tells two friends and so on and so on Ö), well, perhaps you"ll reach somebody toying with the idea of "trying it." Maybe you"ll save someone a lot of the needless humiliation I"ve caused myself and the people around me. Or maybe you"ll simply recount the story about vomiting into my ears. To be frank, I kind of hope some version of my own story, ý la urban legend, eventually makes its way back to me so I can remind myself to stay calm, breathe and keep my ears clean. Tripping the blight fantastic First things first: What do I do, why do I do it and (the part everybody itches to know but feels tacky asking) how do I do it. When I"m actively purging, I tend to throw up my meals instead of binge-eating. Bizarrely enough, I also tend to try and keep my caloric intake low. I guess in case I become an ineffective vomit vehicle. When I was in college, I took the binge route on occasion - and when I am entirely strung out, I still do - but for the most part, when I set my mind to the task, I get right down to it. My after-dinner mint is my nightly run. I always run alone. I also always work out as late at night or as early each morning as possible. Even when I"m not tossing my proverbial cookies, I stick to my lone ranger run. It"s the part that"s hardest to shake. As for how I acquired these bizarre behaviors Ö well, if you happen to figure it out, I"d love to hear from you. It"s not that I love to gag; the vomiting is only the symptom, not the problem. I have an incredible family - and a normal, nurturing one at that. I wasn"t repressed, stifled, left to run wild, unduly pressured, abused in any way or ignored. In some ways, I am the poster girl of Bulimics Weekly. I was a high-achieving student, a creative thinker, a solid performer, a social gal. The class president. The witty sidekick. The confident leader. Never mind the vomit breath. True to stereotypes, I feel fleshy and gross most of the time. On down days, I might even deem myself ugly, despite the fact that I"ve always been complimented, supported and given every reason to feel attractive. I love my smile (which I risked ruining with stomach acids) and my legs (although the toilet-kneeling used to leave them purple) but all I saw in the mirror was the chubby sitcom neighbor. Never the interesting, sought-after vixen, but never the sweet-as-pie cheerleader either. The plain, lovable friend. See-sawing between a size 8 and a size 12, as I"ve done since college, I never believed that being thin would solve anything. I just believed that leaving my looks to their own devices could only mean disaster. How I wanted to look and what I wanted to change was intangible. I couldn"t have explained to you, exactly, what was so wrong with me, my face, or my ample ass. I just knew something was wrong. To put it as plainly as possible, most days I just didn"t want to look like me. So I elected to attempt to control what I looked like in the only way I knew how: by controlling what I fed myself. Or what I denied myself. Bulimia is parasitic. It feeds off a need for control. And it is the suffocating fear of losing that control that undoes you every day. Every move you make is dictated by the frightful prospect of unleashing the monster under your bed so that it might wreak havoc on the way in which you have carefully presented yourself to the outside world. You do whatever it takes to conceal your own ugliness. It seems to me that, for whatever reason, bulimics (and anorexics and gamblers and druggies and compulsive adulterers, et cetera) feel from the word "go" that there is something voraciously ugly within and about them. They dare not show too much of themselves to the world for fear that the congenitally disfigured soul of theirs will appear and fuck up anything good they"ve ever achieved. Why these "users" feel they"ve something so awful to tuck away, I don"t know. My own ugliness is a mystery to me and I can only guess it"s just always been there. Luck (or un-luck) of the draw, I guess. Like being born with a knack for playing the sousaphone when no one else in your family can carry a tune in a bucket. Or always knowing, deep in your heart, that Kansas was the greatest rock band in the world even if your parents had great taste in music. Sometimes, I think, human beings victimize themselves for no particular reason. Sometimes reasonably bright human beings can"t even see what"s standing right in front of them. Despite the occasional ventures into starvation tactics, I can"t speak for the magazine picture of the stereotypical anorexic 16-year-old girl. The one who stares across the bathroom counter and sees a skewed image of a hefty giant when she actually weighs in at 72 pounds. When I study myself in the mirror, I assume what I see is accurate. I just don"t much care for it sometimes and I wonder - I obsess - whether or not other people might care for it. Or be able to bear it. As for other people I know or even see on the street, I never have the visceral reactions to their physical appearance that I have to my own. I"m told that I look just like my mom, who was the most beautiful woman I"ve ever seen. But I can"t see the resemblance. I wish I could. I see a wide variety of people walking around out there, looking a wide variety of ways, and most of them look great - mainly because they look happy. And they look like themselves. I can"t even begin to paint my own face with that kind of ease. Anyway, the last few years have convinced me that I"m much like any other addict. I engage in self-destructive, emotionally-ill escapades and will never be free of my pick of poison. The popular opinion among my therapy corps is that I came by my illness pretty honestly. My grandmother is a raging alkie like her mother before her; you will actually find a number of eating disorder sufferers who are potential carriers of the much-hyped alcoholic gene. The experience of some close Al-Anon friends is that some bulimics act like "dry drunks." How dry I am. But no one - not even Mr. Heredity - is to blame for my problems. It was my choice to cope with my predispositions as I did. That"s why I"m in therapy, right? To sort out all of the above and pin down why I decided to make myself a "Mia." Did I tell you that "my people" have a nickname? We like to call ourselves Mia. Pronounced "mee-yah," as in bulimia. Not like Rosemary"s Baby"s mama. What you"re chomping at the bit to hear, I know, is how I purge. I am quite the bulimic tri-athlete; while I specialize in the two fingers to the way-way back route, last year I debuted into the wild, wonderful world of laxatives. Two or three sickly sweet pink beauties at a time (OK, sometimes four) and I"m a go. Literally. Some people dig on Nytol, I dug on Correctol. I"d usually down the pills around 11 p.m. - fighting the urge to be sick right then and there from the simple, lurking knowledge of what was coming later. I"d then wake around 3 a.m. with incredible burning in my lower back and abdomen. I mean, BURNING. And there is nothing you can do to ease it; you don"t land on the toilet for at least another 90 minutes. On a good night, I"d feel like I had a raging fever and an ulcer the size of Calcutta. On a bad night, I"d curl up on the bathroom floor and vomit into a wadded up bathmat, usually sobbing and grasping at my ribs, hoping they were protruding just a wee bit more than the last night. Twice I was so disoriented and terrified, I picked up the phone to call 911 wondering if I"d finally gone one pink, coated step too far. As sick as I got, it was still an attractive option. While vomiting into sinks, toilets, my (former) purse and cups was a direct line to that "control high," with the laxatives, the hits kept on coming. It was usually a day or two before my appetite was back to normal and I could keep food down (or in, as the case may be). Never mind the sleep deprivation or exorbitant toilet paper bills. I saw results. I mean, I saw them once the distention faded. Predictably, I lost the most weight on this option, but like the rest of my weight loss successes, the results were short-lived. Have I gotten around to that part yet? That bulimia doesn"t actually help you lose "real" weight? Laxatives seem to knock off some serious water weight, but aside from killing your appetite, simply rushing your digestion is not the answer to thinner thighs. One thing for sure, bulimia skews your metabolism. Your body is so confused yet so astute that when you do feed it, it wants like hell to hang on to those calories and nutrients. It knows what it needs, so your body slows its own metabolism down, which can hinder healthy attempts at weight loss. The reason so many career bulimics can stay career bulimics without getting busted is because they maintain a healthy or normal-looking weight. I know Ö you"re thinking of the skeletal horror stories of anorexia (or anorexia dotted with bouts of bingeing and purging). But many bulimics don"t look skinny or malnourished. It doesn"t mean that they aren"t. So, the self-mutilation yields nothing of substance, aside from some ill-gotten weight loss, malnutrition and the perpetuated need to keep on purging. Think you"re sold on becoming a Mia NOW? Just wait! I haven"t even gotten to the best parts Ö The comprehensive bulimic benefits package I have no back teeth. Growing up in Appalachia as I did, maybe you"re not surprised. But I sure as hell was surprised when I spit half a molar out after biting into a Christmas cookie at a company party two years ago. Despite the fact that I love my smile and that a veteran Mia showed me all the tricks of the trade to help protect my teeth (or at least prevent getting busted by the dentist), I am now blessed with broken, missing and jagged back teeth. I still get blisters on my gums and the roof of my mouth. Twice last year, my neck grew so swollen and my mouth so infected that I was in bed for a week. And what my throat looks like, I don"t even want to know. I"ll let my acid reflux pills do their stuff and hope I don"t blow my career as a throat model Ö or a healthy, normal woman. Healthy. Normal. Neither applies when you wake up at night panting because you think - no, you"re certain - you"re going to have a heart attack. Let me rephrase: There is nothing healthy or normal about an active, non-smoking 25-year-old worrying daily that she could have a heart attack. Unfortunately, I"m told that my concern is neither silly nor unfounded, advice that was confirmed when a fellow Mia with whom I used to attend support group dropped dead when her heart stopped. Her "nasty little habit" had obliterated the sodium, potassium, calcium and magnesium levels in her blood. When these levels sink too low - when your electrolytes are so imbalanced - you can induce cardiac arrest. This is what happened to my comrade-in-stalls. She looked healthy the last time I saw her, only days before she collapsed from heart failure. She was 27. She was jogging when it happened. Alone. "They" warn you about Anas (short for "anorexic") having heart attacks Ö just dropping dead. But I was incensed; no Mia had ever warned me that tossing my cookies could kill me. This nullifies that fall-back line in which someone my age should be able to take comfort: At least I have my health. I don"t, exactly. And the worst part is, it is entirely my own fault. Liar, liar I"ve come now to the ugliest wart on bulimia"s nose. It turns you into the sleekest, most adept liar in the world. This silly, seemingly vain little disease blurs your perception. It blurs it to the point where getting caught standing on a public toilet and jamming Hostess cupcakes (not the creepy yellow kind, thank you) into your mouth is the worst case scenario. You end up telling everyone in your life half-truths about anything Ö everything Ö whatever you need to do to keep them at arm"s length and away from the bathroom door at inopportune moments. You cut your own hair so your hairdresser won"t see that it"s on the brink of falling out. You wear black clothes so no one sees the puke that splashes back at you in the stall at work. You"re jumpy. You forget things. You got as far as you did by being obsessive-compulsive but now it"s become your undoing. Well now, you certainly are the picture of success and perfection. Meanwhile, as you"re slinking around, dodging bulimic bullets, you are coming across as the shadiest character on Earth. You act more like you buried Hoffa than you threw up your General Tsao"s. Consider this scenario: Our heroine rounds the corner at work, having just come from her favorite bathroom stall (last one on the left). Her eyes are pulsating from the head rush; if she didn"t know better, she"d swear everyone could see her pupils dancing and bulging. Her eyes are rimmed, drippy and to top it all off, she"s sniffling. But our heroine"s got a huge smile on her face, which isn"t even disingenuous, because she feels fantastic and on top of her game Ö for a second. But a co-worker notices the sniffle and asks, in all innocence, "You OK?" Suddenly, our heroine panics, smiles, answers, "I"M FINE!" with a wee bit too much enthusiasm and takes off. H"mmm, the co-worker thinks. She acts so strange and secretive sometimes. Hey! She was sniffling. Maybe she"s on coke. So, you see, you can"t blame your friends and family when they assume that you"re covering something that - in your mind - is much worse than what you are covering. And when they realize how much you have been lying to them, your credibility is worth about as much as your back teeth. It"s gone. You ARE the Bulimic Who Cried Wolf and there"s little you can do to repair the damage you"ve done to your relationships. If you"re incredibly lucky, some people will give you a second - and third - chance. But don"t relax yet. I"ll bet my carefully hidden Correctol that if you"ve been bulimic for even a few months you have already ruined two or three key relationships. Take it from me. I am a number of dear friends-the-fewer since my last relapse. And I don"t blame them for being too exhausted and fed up to put up with my constant deceit. Please hear me on this if you hear me on nothing else: The lying that you will have to do to perpetuate this disease will destroy your relationships. Friends will have no reason to trust anything that comes out of your mouth, because as deftly as you may duck and dodge, your friends aren"t stupid. They sense dishonesty and it will soon be reasonable to assume that your dishonesty is far-reaching, right or wrong. Blow your chunks, blow your friendships. "What? No snacks?!" Interestingly enough, I didn"t socialize much with other bulimics until just a few months ago. I suppose it"s because, as we learned on the playground, it takes one to know one. Who wants to hang out with someone who can blow your cover? But this summer, as I tried to pull myself up off the floor after the last relapse, my therapist had an interesting idea. Why not attend a support group of younger girls where I could act as a mentor and, maybe, renew my grip on reality, which expired about as long ago as my "license to ill." You may be surprised to hear that I"m actually pretty good with people - seeing as I typically try to avoid vomiting on them until much later in the relationship - so I considered the mentorship as a chance to do what I do well and start feeling a little better about myself. I"ll lead them to the Promised Land! If there"s one thing bulimics are good at, it"s organization and leadership. You don"t necessarily want us to plan your buffet, but let us plan your next corporate retreat! I will OWN this support group, I thought. Sometimes I am just incredibly naÔve. The first three weeks of the new group were uncomfortable, awkward and miserable. In front of a circle of girls as much as 10 years younger than me, I had to, from start to finish, recount every jab, every mistake, every lie, every humiliation. Like the time in college when I sucked back a box of expired allergy medicine to try and throw up the cafeteria savory beef brisket. My roommate found me, out cold, at the foot of my bed. She and my friends thought I was trying to kill myself. Trust me, there"s nothing quite like leaping up in front of friends and shouting, "Worry not, kids! I"m not suicidal! I"m just a bulimic freak!" I swear, these therapy sessions made me feel like I was sitting atop a carnival dunk tank wearing a dunce cap and a mullet, to boot. I didn"t feel better about myself at all. In fact, this therapeutic experience had the most bite of any I"d been through. Nothing (I mean, besides me) had ever made me feel so shitty, so low, so ridiculous or so Ö able to heal. This, I think, is why they call it therapy. My only lingering complaint is that eating disorder support group meetings are woefully devoid of snacks. When I was done telling my horror stories, it gave me a chance to hear from some very frightened yet highly capable young women. In every other arena of their lives they could be sensitive, competent, bright and reasonable. When the gloves came down and they had to deal with themselves and their bodies, though, they said unbelievable things. "But throwing it up means I could still eat and not get Ö you know." Or, "I think I"ll be fine in just 30 more pounds. Hey, at least I eat SOMETHING." I had said the same things so many times. But sometimes you have to swim a few laps - or just float - in the deceptively warm waters of the absurdity of your own illness before you recognize the undertow. Keeping it down Soon after falling apart this last time, I set about really committing to placing my health and the success of my escape from bulimic habits above my weight. It is unbelievably hard. I miss the high. I hate my gut. But I"ve kept my toilet remarkably clean lately. I"ve even been able to tell my beloved dad - and sister and friends and aunt - that I haven"t thrown up this month Ö and mean it. I credit my family, I credit therapy, I credit my friends, I credit my mom (we lost her in June after a long, long battle and I miss her every minute) Ö and I"m starting to credit myself. But I know that I will always be sensitive to my favorite triggers (job stress, loss of a loved one, rejection, especially relevant Perfect Strangers re-runs) and I can only hope that the next time I can withstand the pitfalls and hang onto my cheese fries. "Hang onto your cheese fries, folks!" is now available, by the way, for incorporation as your band or business" slogan. See NUVO for details. Bulimic or not, a girl"s got to cultivate her entrepreneurial spirit. Cleansing the palate That is about as far as I can go (this from a woman who can fit four fingers into her throat). I fear that if I share much more detail I will be offering Bulimia for Dummies instead of a cautionary tale. Reading this, I hope you don"t pity me or think of me in any heroic, victimized or martyred terms. As much as I hate to say this - because I want my fellow Mias out there to know that I support and believe in you - I kind of hope you"re disgusted by me. Well, maybe not by me, exactly, but by my choices. And after you forget all about my story, I hope you stay disgusted Ö and that maybe, if you"ve ever thought about "trying it," that disgust will creep into your mouth one day, replacing your fingers. Maybe it will convince you to pick up the phone and ask for help if you ever feel the urge to purge. It"s just not worth it, because even the first time - with its revolting sweetness - can convince you that you can handle yourself and stop whenever you want, whenever you start to feel better about yourself. You can"t. You won"t. Don"t even try it. Trust me. And if you can"t trust a woman who can vomit into her own ears, whom can you trust?
Did you know?*
It is estimated that 8,000,000 Americans suffer from a clinical eating disorder. Approximately 5 percent of adolescent and adult women and 1 percent of men have anorexia nervosa, bulimia nervosa or binge eating disorder. Bulimia affects 1-3 percent of females aged 13-30. While the bulk of reported cases were once in the 14-20 age range, more and more cases are being reported among women in their late 20s to early 40s. There has also been a significant increase in reports of sufferers between the ages of 8 and 11. Fifteen percent of young women have substantially disordered eating attitudes and behaviors; many bulimics first experience symptoms during adolescence. Some bulimics (about 30 percent) also suffer from depression, anxiety, obsessive-compulsive disorder, substance abuse or personality disorders. Research suggests that some disorders, such as substance abuse and perfectionism, result from the onset of an eating disorder. According to the National Association of Anorexia Nervosa and Associated Disorders, bulimia can be tied to a fear of independence or growing up; insecurity and low self-esteem; feelings of, or real lack of, control over one"s life; sexual trauma and/or abuse; the need to relieve anxiety and stress in one"s life; major life changes or crises (i.e. puberty, death of a significant other, location changes, etc.); peer pressure/media encouragement. It is estimated that 6 percent of serious eating disorder cases are fatal. -MM *according to the National Association of Anorexia Nervosa and Associated Disorders (http://www.anad.org/index2.htm), the Houghton College study on bulimia nervosa, and the National Mental Health Institute in Canada
National Association of Anorexia Nervosa and Associated Disorders (ANAD) P.O. Box 7, Highland Park, IL 60035 (847) 831-3438 www.anad.org National Eating Disorder Hotline and Referral Service 1 (800) 931-2237, www.edap.org Eating Disorder Center of Indiana 3945 Eagle Creek Parkway, Suite C, Indianapolis, IN 46254 (317) 329-7071 www.edci.net/ Some interesting books: Surviving an Eating Disorder: Strategies for Family and Friends by Michelle Siegel, et al Bulimia: A Guide for Family and Friends (Psychology Series) by Roberta Trattner Sherman, Ron A. Thompson Bulimia Nervosa & Binge-Eating: A Guide to Recovery by Peter J. Cooper When Your Child Has an Eating Disorder: A Step-By-Step Workbook for Parents and Other Caregivers by Abigail H. Natenshon The Eating Disorder Sourcebook : A Comprehensive Guide to the Causes, Treatments and Prevention of Eating Disorders by Carolyn Costin Hope, Help and Healing for Eating Disorders: A New Approach to Treating Anorexia, Bulimia and Overeating by Gregory L. Jantz Dying to Be Thin: Understanding and Defeating Anorexia Nervosa and Bulimia - A Practical, Lifesaving Guide by Ira M., M.D. Sacker, Marc A., Ph.D. Zimmer The Body Betrayed: A Deeper Understanding of Women, Eating Disorders and Treatment by Kathryn J. Zerbe -MM