XXXVI

Distorted body image? Nah.

Bulimics (sometimes) look in the mirror and are surprised how thin they look.

(Especially when they haven’t looked in a mirror for weeks. But that’s an anorexic tendency — to distort the body image to seem bigger than reality.)

In anorexia that might be used as an excuse to fast.

In bulimia that might equally be used as an excuse to eat.

XXXV

Veganism.

You like silk and wool. You get cold without them when you’re in an anorectic phase.

You are not really a vegan. What if you want sashimi?

You’ll become vegan anyway.

External, mass-sanctioned restriction (and the other benefits).

XXXIV

You fast because you don’t want to have to deal with food. It’s okay — it’s over. You have a plan, and you can do it for a week or so, and then you can eat something liquid and non-scary till you feel you’re ready to deal with food again. But food catches up with you: it insinuates itself into your life when you’re weak and panting from twenty minutes’ walk, and it comes hand-in-hand with common sense, which says: well, of course you need to eat. You’re human, and you need energy. So you eat a little, because you really do feel awful, and you’re very aware that you’re being unhealthy. But by a few days later you’re eating normally again, because you broke your fast and you wanted to be healthy and you thought maybe you could. But you feel fat and you don’t think you can fast again and how else are you supposed to lose all the weight you put on from the last cycle of bingeing?

When you’re overeating all you want to do is give up food and fast — what you do with it disgusts you, and it makes you ill anyway — and when you stop eating all you want to do is eat again, in small quantities, at regular intervals. Like a drip machine. Wouldn’t that be a better treatment for an eating disorder than antipsychotics and SSRIs?

Perhaps you should take people’s advice on fasting. Learn how to do it properly. You have done long fasts. You’re not a beginner. But perhaps you should follow advice and learn to do it as if you were.

XXXIII

Time for a primer on the Shangri-La Diet. Seth Roberts says that taste encourages hunger. You eat chocolate: you want more food. You eat plain rice: you finish your bowl and go off to work. The body has a ’set point’: you lower it by eating less stuff with taste but which still has calories, and you feel less hungry so you eat less and magic, magic — you lose weight.

This doesn’t work with bulimia. Bulimics don’t eat when we’re hungry — we wish! — we eat when there’s food and when we have to go out and buy food, and when someone next door has food and when no-one’s looking as we scoff down another half-litre tub of yoghurt, with raisins and dried fruit and pumpkin seeds and brazil nuts. Because nothing’s more fattening than brazil nuts. And then we eat tofu. But we put honey on it because it might as well be special, and then we eat crystallised fruit and baked beans and that seemed like a fairly normal meal, so what about some yoghurt to finish it off?

Before we waddle to a loo and poo out enough for the pain to go away.

And purge.

If it were about hunger, the Shangri-La diet would be a fairly good idea.

It might make very low calorie restrictions easier. But they’re possible anyway. Temptation is more potent in the mind than in levels of circulating leptin.

If Marion gets some more basic things under control, she might do some testing and tell you about the use of Shangri-La in serious restricting.

XXXII

Anorexia is very similar to bulimia. You can see the truth in the idea that anorexics are the ones who might have had bulimia but they are stronger than it; they care more, they work more. After all anorexics crave food too. They just less often get as far as ingesting it.

But the disorders are so different. Bulimia centres around the desire for food; anorexia centres around the exultation from not eating it. What are the other differences? The disorders are so very different from each other. They just show up with surface similarities and doctors and the general public think — oh, it’s all about weight, and food. But there are so many ways to deal with food. Food is omnipresent.

Bulimics as well as anorexics wish it could dissolve away so they didn’t have to deal with it.

And then bulimics think they are anorexics who don’t try hard enough, and then bulimics recognise themselves at the centre of this massive trope of bulimia, and they are it, and it fits and is the whole life as it’s lived at that moment, and it’s them. How could it ever be anything else?

It’s possible to be anorexic and bulimic at the same time. It’s the balancing of the thought patterns. ‘At the same time’ doesn’t need to mean at the same instant. One can be anorexic in the morning and bulimic by night. What dedication!

XXXI

The trouble (of course) is, you can’t control it. It’s all very well eating healthily, but if it leads to your bingeing, repeatedly, day after day for a month, at breakfast: but you eat as much as people do in two meals; at lunch: but you eat as much again; at dinner: and again — what do you do but give up food altogether.

Except you can’t. You restrict it, and make it bland, but eventually you crave muesli. And muesli is benign, you think, and you can swap it for rice cakes that evening. But the muesli tastes so good, and the next day you are out shopping and you want cake. Even though you might have eaten the entire packet of muesli the night before. That is bulimia, and you give in.

~~~

It’s a sign of an eating disorder when you use anorexia to cure bulimia.

XXX

You pig!

Have you got your period back? You hate to think how much you must weigh. It’s about bearable when your stomach’s completely empty, when you’ve been fasting for four days, but you balloon and bloat and swell the instant food passes your lips and oesophagus and stays there — in the stomach of food.

You must fast again. You don’t want to bleed; it’s a sign you’re eating as much as the rest of the piggish population.

XXIX

You are an utterly unattractive person. You catch glimpses of yourself in mirrors and are appalled by the greasy hair and ill-fitting clothes. It isn’t just about weight, it’s the total neglect of the rest of your appearance. And do you deserve clothes? Can you afford to buy them at the rate you fluctuate in sizes?

People don’t take you seriously when you don’t dress well. People don’t take you seriously when you look unkempt. Their gazes pass over you from the previous person to the next, or their faces show brief, unspoken condemnation. It is the same attitude shown to people who are overweight — how dare they not be beautiful? And how should they demand respect if they can’t achieve that?

You hate the way you look.

You think, I’ll just look ridiculous if I make an effort while still so fat. Better not to bother till I’m thin.

People might mistake it for deliberate unconcern.

XXVIII

C. Costin says that around 1200 calories are absorbed after vomiting, no matter the size of the binge. (Rather than the standard ‘50% if you’re thorough’.) She probably takes it from this study.

Which is a bad piece of information to perpetuate as it promotes bigger binges.

XXVII

To occupy your mouth; to provide taste — don’t chew sugar-free gum or munch celery. Eat something you don’t like the taste of. A taste that lingers.

XXVI

And you are still disgusting! Oh, forget summer. You weren’t going to prance about in a swimsuit anyway. That’s not the point. The point is that another season’s past and you’ve wasted another slice of your life being fat.

You want to wear this sort of thing (if you borrowed someone else’s arms)

—but is there really that much point in buying new clothes when you’re scared your old, huge ones will fit you again anyway soon? They make you feel worse. Because it’s true we have no self-confidence and are likely to swim in misery till we’ve past any possibility of being gorgeous and extricating ourselves from our lives. Feminism! You’re still not sure where it went wrong.

So spend the money on mangoes. Mangoes! They are a sugar binge.

And you love mangoes.

XXV

The secret of buying health food is not to. All the calories in a range of low-cal foods make a calorie mountain. When every weight-loss company tries to sell you chocolate chip fudge ice creams even you can work out that their business model is to ensure their diet products don’t work. Are you going to learn to dislike overeating by bingeing on low-sugar chocolate cream? Monotony. All you need is a carton of soy milk and a multivitamin.

XXIV

Yet bingeing isn’t really something you’ve been doing that much recently. Except yesterday, and the day before. And before. Bingeing really can make you dislike food, so that fasting isn’t a burden—but it can also make you binge repeatedly, as your stomach stretches to push out your belly and your fat cells expand. ‘Food!’ your stomach says. ‘Why would I ever give this up?’ And you don’t know.

The problem with healthy eating is all the fat that crowds onto your body. At least when you binge you have to fast. And that feels nice, until you binge again. How are you supposed to cope with eating healthily if you can’t binge afterwards?

XXIII

Bulimia—when a trace of a menstrual period is horrifying, not a relief. Your bingeing has been catching up with you.

XXII

When a highlight of your planned shopping day is focused around eating, being allowed to eat because you can’t stick to your miso soup routine on a bus, the mesmerising blissful walk around the supermarket, where you plan every tiny bite based on detailed knowledge of the shelves and you know you’ll end up binging anyway—that’s a disordered relationship with food. You want to be infinitely fascinated by the minutiae of something less gross.