Posted by Dr. Beth Steinhauer on March 18, 2005, at 21:34:06
In reply to Steinhauer: definition-BN or AN...mixed?, posted by B2chica on March 15, 2005, at 15:23:25
Dear b2c,
Lots of people with eating disorders have mixed symptoms. I think the formal classification is mostly helpful in terms of guiding treatment, and I tend to think in terms of which symptom is predominant at a given time, i.e. restricting or bingeing/purging. Many people with eating disorders describe periods of restictive eating alternating with periods of overeating or bingeing.A common misconception people have is that they must "diet" or restrict their eating following episodes of bingeing or overeating. In fact, most of us who work in this area know that restrictive eating almost inevitably leads to bingeing. Although it may sound counterintuitive, the best way to PREVENT bingeing (and implicitly, purging) is to ensure that you are eating 3 meals per day plus snacks, not going longer than 3-4 hours during the day without have something to eat or drink, and having a wide variety of healthy foods with adequate caloric content. Many people discover that when they eat too little during the day (perhaps intending to compensate for previous overeating), they end up feeling ravenous and out of control around food by late afternoon or evening. This is when they are most susceptible to bingeing +/- purging. It sounds as though this has been your pattern of late, though perhaps you did not realize that starving yourself during the day was precipitating bingeing.
I have previously mentioned Christopher Fairburn's book, Overcoming Binge Eating, which I think is an excellent and accessible self-help guide based on cognitive-behavioral principles. Peter Cooper also has a fine book making sense of Bulimia Nervosa. Your therapist, internist and/or nutritionist may also have good suggestions.
Best, ES
poster:Dr. Beth Steinhauer
thread:471380
URL: http://www.dr-bob.org/babble/eating/20050314/msgs/472666.html