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Bulimia and Crohn's

Hello all,

I haven't posted recently but do a lot of reading on the forum. I have suffered with Crohn's for circa 14 years dx aged 12 and have had a few surgeries etc along with way. Resections, stritcureplasty a couple of times and lived with an ileostomy for a year aged 15. As many of you will know these things take their toll mentally as well as physically.

About 6 years ago I unfortunately developed bulimia. This illness started with being sick the odd time after meals, and has progressed into fully blown, pre planned binging and purging episodes which last days on end sometimes. I have never spoken to my gastroenterologist about this, too scared to do so. I find it very difficult to talk about, but at the moment I am finding my bulimia particularly hard to control. I fully believe for me it is a way of dealing and coping with past and present issues in my life and whilst I have never been formally diagnosed I think i developed it in line with some sort of depression as well.

I am expecting replies along the lines if how damaging it is to my health. I am fully aware of the physical implications and damages bulimia causes and believe me I would love nothing more than to be able to stop and control the illness but it is extremely difficult.

I was wondering if anyone else has ever experienced nothing similar? How did you deal with it? Treat it?

Many thanks for reading
 

nogutsnoglory

Moderator
Welcome to our forum and thanks for having the courage to share your story here. Obviously you are well aware that this is dangerous but I understand that you are stuck and are having a difficult time fighting it. I don't really know much about eating disorders but I think its important your gastro knows so they can help you. Your doctor shouldn't judge you and I sincerely doubt you would be the first with an eating disorder presenting to the dr.

I think its critical you have a team addressing your health issues, a gastro in conjunction with a psychiatrist or eating disorder facility. Wish I knew more but I hope you can get the courage to tell them and get started.
 
Hi, I don't have personal experience with bulimia (though I've known a few people with it), but wanted to offer you another perspective. I was misdiagnosed with an eating disorder before the true cause of my weight loss (various severe digestive problems) was diagnosed. I was a teenage girl, my parents took me to the doctor because I was tired, not eating as much, and losing weight. The doctors concluded I had an eating disorder, despite my claims of physical problems.

What I want to warn you about is the fact that this diagnosis followed me - and still follows me - and once on my medical record, a mental health problem attracted a lot of stigmatisation, from a lot of doctors. Every physical problem I complained of was explained in terms of mental health. The extent of the prejudice among medical professionals - both the mental health doctors I was made to see, and the gastroenterologists and other specialists in physical disease treated me appallingly. (There were of course some exceptions.) The way I was treated was just awful, and would have been even if I had had anorexia. It was assumed that a mental health problem was the fault of the sufferer - that my alleged anorexia was something I could control, with "treatment" basically involving punishing bad behaviour and issuing bribes for good behaviour - what kind of way is that to address a disease?

So my warning to you is to please think very carefully about seeking a diagnosis. I wouldn't ever advise someone to have a mental health diagnosis made official by putting it on a medical record unless the need for treatment was extremely urgent. It is very hard to treat mental health problems anyway, so unless there is immediate danger, I believe getting treatment is not worth the risk. You will be in contact with doctors for your Crohn's, which means additional worry in ensuring doctors believe you should you experience weight loss from physical disease.

I understand you are in a very difficult situation, and this probably wasn't the kind of reply you were looking for, but I can only offer advice based on my own experience. It does seem possible that bulimia could increase the risk of complications from Crohn's, and vice versa. The only thing I can suggest is to take care of you physical health as much as you can - keep regular appointments with your gastroenterologist, have any tests recommended to assess the state of your digestive system, report any physical symptoms to your doctor as soon as possible. Be very careful who you tell about your bulimia and think carefully about what will appear on your medical record.

I'm sorry if you think this advice sounds irresponsible - it feels like I'm supposed to encourage you to talk about the bulimia and get help, but my conscience won't allow me to do that. I realise bulimia can cause serious health problems even without Crohn's, and if getting treatment stood a good chance of curing you of bulimia it might be worth discussing it with doctors. But it's likely that even if you saw psychiatrists or went to some treatment programme you'd still have bulimia and be vulnerable to discrimination as well.

I wish I had something more positive to say. If you do feel some kind of talk therapy would help, perhaps you can see a counsellor not associated with the medical system (I know when I was at university there was a counselling service that was nothing to do with the medical system). I'm sure there is plenty of online support too - forums to talk with other people with eating disorders. And perhaps you have family or friends who it would help you to talk to or could perhaps help you avoid binging and purging.

There may be certain circumstances in which you need to disclose your bulimia to doctors, and if you ever feel your health to be at immediate risk of course seek medical help.
 

Jennifer

Adminstrator
Staff member
Location
SLO
lukefarrell if you're afraid to tell your doctor that you have bulimia then what you could do is ask to see a psychologist and psychiatrist for depression. Treating the depression could possibly help the bulimia some but it's possible that in the future you may need to try support groups or medication (often times antidepressants are used to treat bulimia, so if you saw a psychiatrist for depression then it's also possible that the medication for that would help the bulimia as well).

An old friend of mine has bulimia but she's been able to control it pretty well over the years. It's possible to have relapses so try not to get discouraged. She explained it to me as having control over at least one aspect of her life. It's probably a really simple way to put it but it makes sense especially when you hear about a lot of eating disorders presenting themselves during depression, after traumatic experiences (like divorce in the family, being picked on a lot at school etc) or possibly in your case after being diagnosed with a chronic illness and all the horrible experiences that come with it (like all the surgeries you've been through etc). Yet it's likely from more than one thing and can also be genetic.

So far you've made the first step in admitting that you have an eating disorder and then reached out for help. If possible your next step could be to see someone for your depression and go from there. This may be a long road to recovery so you may not see the results you want right away. Slow and steady wins the race. Keep us posted. We're here for you anytime. :ghug:
 
On the first day of my Abnormal Psych class in college, the professor told us that around 50% of people will meet diagnostic criteria for an Axis I DSM disorder at some point in their life...Showing that the course title "abnormal" psych could really use an update.

The stigma around psychological disorders is really appalling. However, it will only change if we start treating these conditions as common, medically serious, and not anyone's fault....If we stop being secretive about them.

I can understand your hesitation to tell your gastroenterologist... I don't exactly have a warm and fuzzy relationship with mine either... but I would definitely suggest telling your primary care doctor and seeking therapy from a psychologist.

I was really reluctant to talk to people about how I was doing during my first and most debilitating depressive episode, but when I finally sought treatment, just the fact that I had made that decision made me feel better. It put the power back in my hands, instead of feeling overwhelmed by a disorder.
 
The stigma around psychological disorders is really appalling. However, it will only change if we start treating these conditions as common, medically serious, and not anyone's fault....If we stop being secretive about them.
In theory I agree, but one person talking to her doctors isn't going to change the general perception of mental illness - it will make that one person vulnerable to the negative consequences of current stigmatisation.
 
Hello...
I also suffered from eating disorders for a long time. I was a compulsive under-eater and over-exerciser in my mid teens, and at points my resolve would crack and I would have episodes of binging and making myself sick. This continued throughout my 20s, but more bingeing at that point, and it was always worse the more depressed I was. Sometimes I would have a month with only a single binge and purge episode, other times it would go on for days on end as you've described.
I never managed to find a therapist that was helpful to me, I tried a few times whenever I was at my worst. That is not to discourage you from therapy, definitely try to find someone and hopefully you will be luckier (or more responsive!) than me.
I read tons of self help books about bulimia and binge eating, this helped me A LOT.
I figured out a couple of things that eventually let me get over the bulimia completely. One was that bingeing and vomiting is really a vicious cycle. I think when I would eat all that food, my body would be preparing to digest that food. I imagine a huge amount of insulin was secreted to deal with all the sugar I was eating, and my stomach was stretched out. So when I would vomit afterwards, all this insulin had no sugar to process leaving me with unbearably low blood sugar levels, and craving sugary foods immediately to "set things right" again. Plus a stretched out but painfully empty stomach. Plus feeling depressed and guilty and smelly and disgusting and disgusted with myself. Difficult in that situation not to start eating all over again. And then throw up again. Etc.
So the first step for me was not to purge after overeating. To just try to be with the feelings of self-disgust, to process that, to digest the food, cry, think about what I would do the next day to make things better, and go to bed.
The other thing that helped me was to figure out a way of eating that made bingeing the least likely. For me, that meant including more protein in my meals, this helped me control my blood sugar levels and my hunger. It also meant making sure that every meal I ate was something I truly enjoyed, that I didn't feel deprived or hungry. Feeling deprived or hungry would surely lead to a binge later on, it was just a question of time. And finally, since sweets were my thing, I made a point to include something sweet daily, again to prevent myself from feeling deprived. I generally would try to save my treats for later in the day (after dinner), as eating something sweet early would often make me want to keep eating junk all day long. Eating (within reason) what I really felt like eating: sometimes eating chicken when I really wanted a bowl of cereal would just make me feel frustrated and a binge more likely eventually. I never did well with having sweets around the house, the constant temptation was too much for me, so I would buy something in an individual portion each day, or order a dessert if I went out for a meal etc.

Other things that I would suggest are trying to wait to eat until you are hungry, trying to stay present (not zone-out) while you eat, stopping when you are full even if something is left on the plate (you can always eat more later). And give yourself a break when you need one... I found I had to learn to trust myself to feed myself and look after myself, and it took a long time to build that trust. I haven't binged for a decade, though i do still get unduly upset with weight gain, and i do still exercise a lot. I don't know if anything I wrote is any help to you at all. I wish I remembered the titles of the self-help books that influenced me the most, but I don't unfortunately. I wish you the best of luck, feel free to pm me.
 

Jennifer

Adminstrator
Staff member
Location
SLO
In theory I agree, but one person talking to her doctors isn't going to change the general perception of mental illness - it will make that one person vulnerable to the negative consequences of current stigmatisation.
I don't have an eating disorder but I was placed in a mental institution for attempted suicide. It's never been brought up or caused any issues with my treatment. I think the way one is treated may depend more on your location. I'm sorry that you had such a horrible experience with doctors but it is possible to get proper care and not have it affect the rest of your life. :)
 
Hi, it's great to see such supportive responses to your original post.

I understand your reluctance to disclose bulimia, but as someone working in healthcare myself, I feel it is paramount for your team to be aware of it.

Bulimia is a disorder of impulse control and often becomes an unhealthy way of coping with intense unpleasant emotions. In therapy you can learn to channel those emotions into healthier, less impulsive self soothing activities. Not only does this help you to be emotionally more resilient, but your general health and IBD are likely to better regulated and improve as well.

I'm sorry to hear that you're struggling with both right now, but I am also happy to report that I've seen patients with eating disorders improve considerably with cognitive behavioural therapy (usually one session/week lasting 16 weeks).
 
All

Thank you kindly for your above responses. Juding by the responses the opinion brakes about the best way to deal with this. I have arranged to see a psychiatrist tomorrow to discuss my bulimia, although this has been done separately from my crohns treatments and doctors etc.

I suppose it is going to be trial and error going forwars about how best to deal with the issues and health. Thanks again
 
All

Thank you kindly for your above responses. Juding by the responses the opinion brakes about the best way to deal with this. I have arranged to see a psychiatrist tomorrow to discuss my bulimia, although this has been done separately from my crohns treatments and doctors etc.

I suppose it is going to be trial and error going forwars about how best to deal with the issues and health. Thanks again
Well done. Good Luck,.
 
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