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Bulimia: The Pleasure That Poisons

A disorder beyond pleasure or control.

Key points

  • Bulimia is characterized by an uncontrollable impulse toward food and a lack of control over the type and amount of food consumed.
  • The power of obsessive control for the purpose of weight loss has a paradoxical effect, essentially leading to a total loss of control.
  • Bulimia can often be resolved effectively through pleasure-based solutions.

Bulimia nervosa is an eating disorder whose name comes from the Greek for "the hunger of an ox." It is characterized by an uncontrollable impulse toward food and a feeling of having a lack of control over the type and amount of food consumed. Frequently, the condition is confused with vomiting syndrome (Gibson et al., 2022; Nardone, 2014).

A Pleasure That Poisons

Those who suffer from this disorder tend to eat out of proportion of what most consider appropriate. The life of a person with bulimia usually takes place between one binge and another. Their attempts to diet usually lead to massive binges. With this type of disorder, the patient continually falls foul of periods of uninterrupted control with periods of devastating bingeing, the effects of which can be dramatic.

Bulimia finds patients perpetually on diets but failing to maintain them, each time finding failure which compounds their lack of self-esteem, guilt, and self-loathing.

The most common pattern can be seen in patients who are able to maintain diets for a few months, successfully losing many kilograms only to find themselves collapsing inexorably into cycles of binge eating again, and in their binge eating, recovering all the weight lost as well as eventually gaining more than a few additional kilograms.

Just as it was with the mythological character Sisyphus, condemned to push a stone eternally up a hill, the bulimic heroically tries again and again to push their boulder made of pleasure and control up to the top of the hill, only to see it roll back to the bottom.

Despite many attempts by the person to control and push this stone up the hill, they eventually, totally, and completely surrender and often arrive at clinical obesity.

Why We Should Fear Dieting

While the modern world is obsessed with dieting, restriction, and control, a perfect storm has been created in which a problem can grow—not even thinking that we live in a pleasure food-rich environment or what we might call an obesogenic environment.

However, when we diet, we produce three dangerous effects that compound our failure over ourselves:

  1. The Rebellion Effect. When we diet, we begin to take a more rebellious approach to ourselves and life, and in our restriction, we begin to want to do what we want to do and therefore rebel against our desires and begin to eat the desired foods,
  2. The Transgression Effect. When we avoid, abstain, and control pleasure, we crave it more because we have now transformed what was once a mere bar or biscuit into a guilty and, therefore, increasingly pleasurable desire, thus ensuring the rapid and immediate collapse of a diet.
  3. The Submission Effect. This last effect is usually only experienced when we have finally tried all the above. Then we decide we can no longer do it, so we submit, and rather than restrict, we eat continually and without any boundaries, usually creating an obese outcome.

Diets Actually Increase Your Weight

The American Psychological Association published the results of a longitudinal study lasting 18 years and following tens of thousands of people, to monitor the effects of being on a diet or not. What was discovered should now come as no surprise: Over 80 percent of subjects on a diet were overweight, versus 70 percent of people who were not, being of normal weight. The inescapable conclusion is that dieting makes you fat.

The power of obsessive control for the purpose of weight loss has a paradoxical effect, essentially leading to a total loss of control. This is self-evident. When the rigid and stubborn formula of self-control is applied to food, the potential negative effects are devastating.

Along with this is the second problem posed by bulimia, which is the persistent overvaluation of the negative aesthetics of oneself and the positive aesthetics of others, especially thinner people. Their rigid perception adores everything that is thin and loathes all that is not, which can evolve into the patient seeking medical assistance with their looks (cosmetic surgery) rather than their perceptions (psychological therapy). This intervention rarely ends well and often fuels an ongoing obsession with surgery and correction even though there are poor rates of satisfaction after cosmetic surgery.

Solutions

Part of the treatment is surprising for patients: We request that they eat, and only eat, what they like best, but only in the three main meals of their day, and to eat without any limitation of quantity or quality. The effect of this intervention is that it often extinguishes binges, sometimes almost immediately. After a few weeks, they begin to decline the forbidden foods, and they even become less desired. Parallel to this, we will assist the person in creating daily activities—also important in these cases—by selecting an activity based on what they like most to do and not what seems best for weight loss.

With this, we achieve a lifestyle that’s not difficult to achieve because it is based on the expression of pleasure and not its repression. This treatment requires only a few months and shows great results.

As Oscar Wilde said, "The only way to manage temptation is to yield to it."

References

Gibson, P., Castlenuovo, G., Pietrabissa, G., Jackson, J., Manzoni, M. (2019). Therapy for Bulimia, Binge Eating; A Clinical Research Protocol.Frontiers in Psychology (10) 2019

Gibson, P. (2021). 12 Most Common Mental Traps. Strategic Science Books.

Gibson, P. (2022). The Persuasion Principle. Strategies for Effective Communication.

Milanes, R., Nardone, G. (2018) Prison Of Food, Routledge.

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About the Author

Padraic Gibson, D.Psych, is a Consultant Clinical Psychotherapist and is the Clinical Director of The OCD Clinic®, and director of Training and Organization Consultation at The Coaching Clinic®, Dublin. He is senior research associate at Dublin City University.

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The OCD Clinic