Wednesday, August 19, 2009

Bulimia

When you can't control your eating and you're desperate to lose weight, there are a lot of imprudent things that you can do to try and deal with your situation. One is starting to smoke. Smoking increases metabolism and suppresses appetite. A lot of the ever so slightly voluptuous women in Hollywood who become thinner after they become more famous are helped along by picking up this nasty habit. They trade in one problem for another.

It's also possible to start throwing up after you eat (bulimia nervosa). I will admit that there have been times when the thought that the answer to my problems could be as simple as putting my finger down my throat or taking some ipecac after binging or eating too much. This "solution" is very dangerous, of course. It carries a lot of health issues, one of which is heart problems.

In the end, I just couldn't manage to do it, appealing as it was to have my cake and not get fat from it, too. The bottom line is that I'm just not the type of person who can force myself to vomit up the food I've just ingested. Perhaps it has to do with growing up poor and not feeling that it's okay to spend money on food then flush it down the toilet. I could also simply have been frightened of the consequences, but I don't recall that being a part of my thinking process at the time that I rolled the idea around in my head.

Just today, I had a revelation. I was watching an old re-run of the medical drama "House" and he was sitting in the clinic with a patient and said that her bad breath and gnarly-looking fingers indicated she's been regurgitating her food. I had known for quite some time that both of these were signs of bulimic behavior, but hearing it said aloud made something click in my mind about a client of mine.

I sometimes meet with a client in a small space and she often has very bad breath. In fact, the breath issue is so bad at times that it lingers in the air after she has left unless I specifically air out the meeting room. I'm sure that anyone who uses the room immediately afterward can smell it as some odd funk. I didn't think much of this because she's not the only client I encounter who has halitosis. However, she is the only one with deformed fingernails and chewed up fingertips.

I had noticed both the breath and fingers for quite some time, but I never put two and two together. This particular client is quite slender, though certainly not emaciated. I'm pretty sure that she is selectively purging her meals. I mainly think this because she is not engaged in any work or hobby that would explain the condition of her nails and fingers. The worst finger of all is the index finger on her right hand, a prime candidate for sticking down her throat.

I like this client and now I feel sorry for her as well. She's always been friendly to me and we've gotten along well. She doesn't appear to judge me by my weight despite being thin herself. I now wonder if she might have some hidden understanding and compassion for what I face.