-Notes on binge/purge-

ok i’m gonna try to explain in condensed form. Ive got anorexia nervosa binge/purge subtype (no bingeing for the last 2+ years). I developed bingeing behaviour as after prolonged period of starvation when i was in my teens, having previously never struggled with overeating. My case is not an anomaly but exemplary of statistical variance in ED populations – we don’t know exactly why the hormonal changes caused by starvation cause bingeing behaviour in some sufferers but not others, but we know that it’s the case. presumably it’s a highly individualized combination of genetic and environmental factors at play in each individual instance and at different moments in the history of psychiatry different explanations were privileged. What we do know nonetheless is that bingeing is not just a straightforward case of bad choice of coping mechanism. Post war large scale studies of hunger and behaviour like the Minnesota starvation experiment have given us a statistical sense of how starvation affects a sample population (i.e. the probability of an individual developing bingeing behaviours for the first time after a period of starvation is higher than bias allows us to imagine). Ultimately bingeing is a pathological response to stress that has a compulsive character, similar but not identical to substance abuse, i.e. people keep doing it although they know it’s bad for them generally, or even if there is always a ‘come down’ period after the initial high/relief. When I had a hardcore bingeing problem I was immensely more distressed than I am today (restriction only) because every binge episode was followed up by a period of increasingly unmanageable guilt, shame, self-hatred and sometimes suicidal ideation (including one attempt). I felt trapped and reduced to doing things that to my anorexic mind were unspeakable (almost like a perverse act of self harm).
In this light consider the logic of restriction again and note the parallels between two seemingly opposite styles of ED suffering – whatever the sufferer thinks denying themselves food will achieve in positive terms is inevitably outweighed by the negative reality of being an ED sufferer/patient. Restriction is often the cause of social isolation, depression, sleep issues, paranoia, obsessive/compulsive behaviours, distorted thinking esp re self-image and generally a more circumscribed lifestyle (to say nothing of the physical risks). You don’t choose to restrict so much as you feel like you have to. Eating disorders have a choke-hold on the disoriented, distressed person grasping for ways to stabilize their life and cope.. they promise certainty *if* a number of exponentially steeper conditions is fulfilled & the sufferer doesn’t notice the goalposts keep shifting until it’s too late. Anorexia always pushes me to give up more, to make myself want less, to punish myself harder for transgressions, to lie to ever more people because it tells me nobody can be trusted, they just want to make you fat. Anorexia makes me feel like it is the only thing I can rely on, the only thing that is truly mine and truly satisfactory. In the final instance that narrative is a lie of course, but if seeing the number on the scale go down didn’t make me feel truly ecstatic i would probably be free of it by now. Same with bingeing – it’s an extremely effective coping mechanism that comes with an ever-higher price; often the only way to cope with the lows of bingeing is to binge (and purge) more, sinking deeper and deeper into the cycle.
Final thing to note is that while starvation (although not the starving woman per se) is valorized in western christianized society. Self-denial might have an addictive logic but culturally it is still understood as an honorable if slightly extreme expression of willpower and spiritual purity. In other words, it’s easier to confess to starving than to bingeing, as in the popular imaginary bingeing registers as weakness of the will and an act of surrender to low and sinful desires of the flesh. The incentive to hide any ED behaviour is already significant. For many of us, the ED is the only thing we feel like is truly our own, the only aspect of our lives we can still control; the ‘wrong’ people knowing increases the risk of a (forced) intervention. With bingeing, medics w the possible exception of specialists only monitor the most obvious factors like BMI and vital signs. Someone w bingeing issues, esp if that someone is driven by an obsession with thinness easily can slip under the medical radar for too long (ie until an easily observable/highly dangerous pathology emerges like electrolyte and heart issues), becoming ever more addicted to the bingeing in the process.

#binge #purge #bulimia #ontology

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