How does someone live with bulimia for 22 years?

I wouldn’t think that it would be possible; however, one of my closest friends has been living with this insidious disease for 22 years. Does anyone have any ideas or anecdotes on how this is possible? She doesn’t look or act unhealthy, either and holds down a decent job, pays her bills, etc. How long can she go on this way? Not looking for medical advice, just wondering if anyone has any insight into this and perhaps info on helping her. Hope this is in the right place… Thank you!

I really think it depends on the severity of the bulimia. There are people who binge and purge several times a day. There are also people who binge and purge only sporadically. If your friend falls into the latter category, it’s certainly conceivable that the behaviour could go on indefinitely with few ill effects.

Obviously, this is just a guess; I don’t believe that she purges after eating “normal” meals. However, sometimes she will eat huge amounts of food, just to purge right after. Another however: she usually only eats supper and about half of her calories come from alcohol. This turns into a vicious circle (cycle?) She drinks a lot, loses her worry about bingeing (binging just looked wrong) then is so full that she makes herself purge. I feel that if she could get one addiction under control, the other would be helped, as well; as it is, they’re feeding (so to speak!) on each other. So, like I said, she keeps regular meals down, which I think is what keeps her going. It’s not like she purges EVERYTHING she eats; and what she DOES eat and keep down is actually quite healthy. I’m sure her teeth are a mess…but that’s neither here nor there. Bottom line is that, although she knows this is bad, she’s lived with it for this long without any severe consequences that she’s not ready to stop yet.

Is she interested in getting help? That’s a dangerous combo of habits.

IANAD, but I had a friend who was bulimic for about 16 years.

She passed away recently. The autopsy confirmed what we knew already, she had done a lot of damage to herself over the years. She died from cardiac arrest, brought on by the years she had abused her system, she was 32. Her kidneys were starting to show signs of damage as well.

Some people just get lucky- which isn’t the right word, really.

For most people, it has a way of getting worse and less-bad. Like there are some periods where they can go a few days without it or just one smallish binge/purge session in the evening and then times where all they do in life is work, eat, and puke. Over those 22 years she’s probably had periods of recovery, maybe even lasting months, and periods where she wasn’t functioning.

I know a few people who have sort of reached a kind of static place where they just live with it. Like it’s just a fact of life- they live normally most of the time but binge/purge when they get stressed out or have a bad day. Their binges may be smaller and their purges less complete than in the really horrible stages. It’s still serious, obviously- does a lot of damage to bodies. And I’ve also known a few people who have gone from fine to fucked in about four seconds after being bulimic for years. But that’s how it can go on for 22 years without killing her.

Also, a LOT of bulimics have impulse control problems in other areas- sleeping around, drinking, drugs, etc. It’s a very violent life.

For some reason, I always associated anorexia/bulimia with wanting to always be in control—I think of binge drinkers as those who like to lose control, so it suprises me that these two issues are apparently often seen together.

Sounds like a tough road ahead for your friend—Hope she gets some help, and soon…

Wow, sounds exactly like me two and a half years ago.

I have no advice and can’t offer any insight into how she’s lasted that long other then it sounds like her drinking and resultant not caring about calories allows her to get enough calories to function.

I was bulimic and an alcoholic. It started with anorexia and transitioned. As said, it is about aspects control (for most, including me) so the drinking was a way to forget the control issues I had and relax. It also helped me sleep/pass out. That was my excuse.

Bulimia isn’t as much about control but about punishment/guilt. You have no control if you binge, so you try to counteract that by purging as a way to get rid of the calories and also to punish yourself for binging. It’s a good feeling to get it all out a lot of the time. I started drinking because I couldn’t handle all the mental shit that goes on when you’re in that mind frame. It was a bad, bad cycle.

Minnie Luna: So sorry for your loss. What an unnecessary tragedy. Maybe this could be the eye-opener my friend needs.

EmAnJ: If you don’t mind my asking. What was your treatment? Do you consider yourself fully recovered or will you always be in recovery?

The reason food addiction is so insidious is that you HAVE to eat to stay alive! How many alcoholics would succeed if they HAD to have three drinks a day, plus maybe a couple of small ones. BUT NO MORE THAN THAT. I can’t imagine it! Do you think the addictions are comparable or am I comparing two completely different things?

Anorexia and bulimia are actually pretty far apart in terms of personality types typically affected.

Strictly restrictive anorexics tend to be more like the person you describe - high achievers, in control, typically don’t cause a lot of troubles - when these people recover they tend to do better, psychologically.

Binging/Purging bulimics tend to be on the opposite end of the spectrum - very poor impulse control, comorbid with other self destructive behaviours such as drinking, drug abuse, promiscuous sex, etc. These people tend to much harder to treat. In addition they also have a much higher rate of depression, BPD, anxiety disorders, etc.

And then there is a whole range of behaviours in between with a combination of behaviours including restricting most times, and then binging/purging on occasion. Semi-restrictive, etc.

Outcomes also tend to mirror the symptoms with patients on the more restrictive end of the scale doing better than those on the more binging/purging end of the scale (all eating disorders are difficult to treat).

Finally, to the OP, a 22 year bulimic is probably a lot like a functioning alcoholic - they may purge only occasionally (i.e. once or twice a day) to take the edge off without binging, or only binge/purge on the weekends (like many college students binge drinking on weekends).

However, like everything, it will likely catch up with your friend soon. The best you can do is try to be supportive and steer her towards programs designed to help.

I had been in ongoing treatment for my eating disorder at the same time that the problems with alcohol developed. For me, treating the alcoholism was paramount to starting to work on everything, but I think that the main reason for that was because I learned how to start dealing with my feelings instead of binging/purging or drinking. It all came down to self confidence, control issues and depression/anxiety.

I went into a two week outpatient rehab for the alcohol and started to learn how to live alcohol free there, then started to deal with the feelings. I continued with my regular therapist three times a week for a month or so, then backed off to once a week, then once every two, and now we’re on an as needed basis. I also spent a lot of time working on myself at home through various workbooks for all of my issues. In addition, I took a month off of work to do the outpatient program and also to just deal with everything.

I am good in the alcohol aspect and I’d say 95% on the bulimia aspect. I still think about it a lot and in the last year I’ve purged after a large meal a half dozen times. Not too bad though! And it’s been months since the last one.

I could certainly see myself falling back into either of the addictions if I’m not careful though.


Wow! Highest respect and admiration for you. Congrats on all of your hard work. You are a great example!