Diets-Metabolism   [back to the Category]

Bulimia   [read the french version]

Author :   Dr Paule Nathan

The word bulimia comes from the Greek meaning "ox blood". Bulimia is an eating behaviour disorder that leads to "gorging" great quantities of food. It is generally the result of a build up of anxiety that the sufferer is unable to express.

Bulimia attacks often follow the same pattern. Hunger, urgent to the point where it can no longer be resisted, results in a frantic search for great quantities of food whilst sufferers try to fill themselves up in a very short period of time. They have an urgent need to fill a space quickly and without stopping but it is like a bottomless pit. They swallow everything they can lay their hands on, often foods with high calorific values which are not always good for them; the important thing being to eat their fill. Bulimia sufferers secretly stuff themselves, swallowing more than they chew, whilst feeling ashamed and helpless.
The end of the attack is marked by stomach pains, sometimes with spontaneous or provoked vomiting. Sufferers will sometimes sleep afterwards like a baby with a full stomach. But they always feel guilty for having eaten so much.

Between attacks, sufferers have a feeling of not being in control. They are aware that their feelings created by this disorder are not normal and they are constantly worried about another attack, afraid that they will not voluntarily be able to stop eating. They are also afraid of putting on too much weight. Their behaviour and their body no longer belong to them. It is difficult to live with, sufferers are constantly preoccupied with their weight and their body image. This bad self-image, often leads to an autistic withdrawal; they refuse to take part in meal festivities with family and friends. They no longer care about other people or anything that is not connected with their food and their figure. They take no interest in sorting out their problems, their daily worries. They are obsessed by the fear of a new attack; what will it be like? will they be able to resist it? The attacks govern their life. Those suffering from bulimia are very lonely people and yet, they need someone to help and listen to them.

Close friends and family, parents, brothers and sisters, are usually the last to spot the disorder. Those suffering from bulimia are alone with their illness. It is currently spoken about more in newspapers and on the television, we are, as well, managing to help those who suffer from it.

If the attacks continue, their health can be affected: mineral losses caused by vomiting, receding gums, enlarged parotid glands, the two salivary glands located on each side of the maxillae, giving sufferers a hamster-like appearance. Bloating of the stomach can also occur.

Why do people become bulimic?
Attacks are often triggered by repeated attempts to lose weight using very restrictive diets. Sufferers try, at all costs, to slim because they do not like themselves. This is why, we stress the fact that children and teenagers who do not need nor want it, must not be put on diets. It is very important that parents do not criticize their children's eating behaviour as this will only reinforce or trigger disorders. Do not hesitate to seek advice from a paediatrician or a doctor specialized in nutrition. It is perfectly normal for a child to want to eat and nibble at food, it is all a question of proportion. Bulimia is a kind of valve against excessive restriction. Sufferers restrict themselves, then, stuff themselves and their weight goes up and down like a yo-yo.

What is the cure?
Sufferers must talk to their parents, then, to a doctor; sessions of psychotherapy are often recommended. These consist of sufferers talking about themselves to an adult who is neutral, there to listen to and help them without judging. The road to recovery consists of becoming aware of the factors that triggered the attacks; anxiety, family or love life problems, difficulties at school, questions about life, etc. We often advise sufferers to keep a food diary and write everything down, what they eat as well as everything that goes through their mind. Dialogue is important because bulimic attacks are a reflection of difficulties in solving conflicts, in accepting changes to the body during puberty, in become autonomous and in creating new relationships with close friends and family. It is an interesting road to take and sufferers should not be afraid of undergoing psychotherapy sessions because they come through the other side a stronger person. They leave childhood behind and begin the life of an adult, they discover the world with its joys and, also, its contradictions. They learn to express themselves, to be themselves, to discover themselves and to find their place in the world. If all this is smothered, it will be expressed as eating behaviour disorders. Those who suffer from bulimia are expressing a desire for help.
Certain eating behaviour disorders are not bulimia. It is possible to have a compulsion that pushes us to eat sweet products such as sweets or chocolate as consolation after a dispute or through boredom. This is perfectly normal. Childhood and the teenage years are the age of hunger and cravings and food has an important place. Feelings of guilt should not exist. The main thing is to be able to please ourselves without feeling guilty, to eat food that we want to eat, to savour it and not to be in a hurry. And, to eat three balanced meals a day.



How can we help our dancers?
What can we do?
We certainly cannot change the female dancer's image. Angels, nymphs, sylphs that fly across the stage on the tip of their pointes can hardly be performed by overly round, female dancers. It is difficult enough to imagine a 65 kilo cherub going across the stage, let alone one weighing 80 kilos.
It must be acknowledged that female dancers who appear very thin when we examine them, have the ideal figure when on stage. Those having the figure of a normal teenager would appear overly round on stage. The tights which are often white, the costume and the position of the stage in relation to the audience, all, have a fattening effect.
Young female dancers have only one aim in life, they make sacrifices and suffer in order to be able to dance.
Medical care must, therefore, be established in ballet so that these female dancers are protected. Care must be taken to ensure that their meals are balanced as far as is possible. Moreover, their figures will very often improve. Lessons on nutrition must be integrated into their programme so that they become aware of the importance of a balanced diet. It must be made easy for them to see a doctor specialized in nutrition or a psychologist.
One point that I believe to be a key factor is that young female dancers, very often, attribute the beginning of their failings to their figure.

This can leave deep scars including a negative self-image and a false body image. It must be explained to them that the discipline they have chosen, very often demands that they acquire a weight inferior to their normal weight when they, the children and teenagers, have normal figures!