I'm bulimic

What this looks like

You binge. You purge. Sometimes vomiting, sometimes laxatives, sometimes excessive exercise. The cycle has been running for years. The shame is bigger than the food. You hide it from everyone. You can’t tell your partner. You can’t tell your doctor. The cycle has its own time, its own places, its own rules.

The bulimia is doing something for you. It’s also been costing you in ways that compound.

A note on safety

Bulimia carries serious medical risks: electrolyte imbalances, esophageal damage, dental damage, heart problems. If you’ve been purging frequently, please get medical evaluation. Strategic therapy works alongside medical treatment for eating disorders, not as a replacement.

What you’ve already tried

• Inpatient or outpatient treatment
• A therapist who specialized in eating disorders
• An SSRI
• A meal plan to prevent the binge
• Removing the means of purging
• Telling yourself this was the last time
• Pretending you’ve stopped

The cycle keeps running.

What kind of eater are you?

Why the cycle is so hard to break

Bulimia is structurally a relief loop. The binge produces a state. The purge produces relief from the state. The relief reinforces the next purge, which becomes more available, which makes the next binge less consequential, which makes the next binge more likely. The cycle is self-reinforcing in both directions.

You very likely came up with a particular relationship to food and body that taught you neither was safe to occupy in the natural way. You may have grown up in a household where eating was monitored, weight was discussed, and you learned to manage food in private. You may have absorbed cultural messages about thinness that have made the binge intolerable, which has made the purge necessary, which has trained the cycle. You may have lived through a stretch when bulimia was the most reliable way to manage feelings you couldn’t manage otherwise.

For the related patterns, see I binge eat , I restrict food , or I’m an emotional eater . For the broader framework, see I have an eating problem .

The cycle is held together by its own logic. The logic can be addressed.

How we work with it

Strategic therapy works on both ends of the loop at once. We work with the binge as the predictable end of the day’s restriction or pressure, and we work with the purge as the relief mechanism that has been training itself to be more available each time. Medical care continues alongside the work. The cycle loses its grip because the conditions that produce the binge and the access that enables the purge both get addressed in the same hour.

The bathroom stops being part of the meal. The cycle that has been organizing your week starts losing its hold.