The diet that never ends

In teenagers and women, bulimia usually begins after intentional weight loss. Typically the person starts out ten to twenty pounds overweight, and for a variety of reasons, decides to go on a strict diet. When the low caloric intake becomes unbearable, the person begins to overeat. To prevent weight gain, purging begins. Purging is a compromise between the desire to remain thin and be full. It is a panic reaction and a desperate solution to more than one problem.

The resulting eating disorder can be described as a diet that never ends.

I often ask teenagers and young women what occurred before “The Diet.” Usually I find it is preceded by a loss or injury to self-esteem. Approximately ten percent of children and adolescents in the USA are bullied and excluded by peers. This shaming and ridicule leads to many physical and emotional symptoms, including bulimia. Being called fat by peers or being ridiculed by a boy is enough to cause a girl to stop eating or engage in bulimic behavior. Merely comparing oneself to peers and feeling fat or inferior can also initiate the eating disorder.

These are comments I’ve heard many times from women and girls:

“He broke up with me. Probably it’s because I’m too fat. He started dating a thinner girl. I’ll never let that happen again.”

“All of my friends wear size 0 jeans, and I wear size 6. I have to go on a diet.”

In these examples, weight has become the focus of what are really interpersonal or self-esteem issues.

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