Medicine

Eating their cake and heaving it too

Janice Neil November 3 1980
Medicine

Eating their cake and heaving it too

Janice Neil November 3 1980

Eating their cake and heaving it too

Medicine

Night after night, Addie Ternes, a quiet-spoken 23-year-old manager with a Winnipeg consulting firm, would wake up in the middle of the night and gorge on ice cream, cookies, buns and anything else she had hidden for her ritual. Within 15 minutes, heart palpitating, head spinning and bloated stomach aching, she would scurry to the washroom, stick her fingers down her throat and vomit repeatedly. “After I’d finished, I didn’t have any problem going back to sleep. I was relaxed and at peace with myself, finally.”

Ternes is not unusual. She is one of a growing number of women and men who suffer from a psychological disorder called bulimarexia. Doctors estimate that one in 200 teen-age girls are bulimarexic—and that for every patient diagnosed there are nine more suffering. The disorder is in the same family as the better-known anorexia nervosa in which girls, terrified of becoming fat, starve themselves to 80-pound skeletons and sometimes to death. But bulimarexia sufferers cope with emotional problems by stuffing their emotions down their throats with food and then perhaps gorging diuretics and laxatives—-as many as 200 squares of ExLax a week.

Just two years ago, doctors rarely encountered the gorging-purging syndrome. But last year Winnipeg psychiatrists Dr. Wade Junek and Dr. Pierre Leichner were so alarmed by the increase in their bulimarexia case load that they sought a $2,500 Manitoba Medical Services Foundation grant to find out why and what to do about it.

The results of their study, which has focused on 25 patients, should be complete by the end of the year. But in the meantime, therapists in major cities across the country, faced with similar increases, are apprehensive about the future. On the one hand, publicity about the disorder will prompt closet bingerpurgers to seek help. On the other hand, doctors fear that the ranks of untreated bulimarexics may swell because some people will jump at what sounds like the perfect, if unpleasant, diet.

Not just figure-conscious women find this the perfect diet. Winnipeg exjockey Ken Murray says about 30 per cent of his colleagues eat high-protein food for 20 minutes and then “flip it back up” to avoid those fatal pounds. Registrar of the Royal Winnipeg Ballet Faith Rynders admits that dancers in the company suffer from bulimarexia, “although we don’t like to talk about it around here.” But while jockeys,

dancers and models think binging and vomiting is the best way to lose weight and keep their jobs, more serious victims like Ternes have psychological problems. Dr. Leslie Solyon, a psychiatrist at Vancouver’s Shaunessy Hospital, had one patient—a secretary— who ate and threw up 15 pounds of steak every night. His other patients include a family doctor, a former member of Canada’s national swimming team and a former Miss British Columbia. “Bulimarexics have a fear of never being able to stop eating,” says Junek. “They are obsessed with food.” Ternes knows

what her psychiatrist means. “I think it’s sick behavior. I get so wrapped up in thoughts of food it puts a stalemate on the rest of my life.”

But the real problem doesn’t have very much to do with food. “The victims have little self-worth, usually because they come from families with tight parental control,” comments Dr. Kripa Thakur, a Saskatoon psychiatrist who says he has successfully treated 33 patients by hypnosis. This lack of selfworth tends to make bulimarexics obsessive, systematic, stubborn overachievers, adds Solyon. “They love food

but they want to be thin—to eat their cake and have it too.” Halifax psychiatrist Dr. Idian Stokes even estimates that one in three anorexics are really misdiagnosed bulimarexics.

While other people throw temper tantrums or drink alcohol to vent their frustrations, Ternes and her fellow victims turn to food. “When I get upset or mad at my boy-friend, I lose control. Next thing I know I’m eating.” Sometimes, though, specific feelings do not trigger the binge, as is the case in her midnight raids to the refrigerator. There are occasions when she remembers neither binge nor purge. “I call them my food-aholic blackouts.” Solyon says one of his patients often wakes up in the morning to see empty Kentucky Fried Chicken boxes and stripped bones littered throughout her house—she can’t remember going to the outlet, much less lickin’ her fingers.

Although bulimarexia is an emotional problem, the disorder ravages its victims physically and economically. The syndrome may cause ulcers, stomach and bowel disorders, dental cavities, gum diseases, throat irritations, loss of equilibrium and even death. Like alcohol and drugs, food does not come cheap. Ternes estimates it cost her an additional $200 a month for food she only momentarily enjoyed. A 42year-old Saskatoon homemaker tallied her 20-year habit to $35,000. After a decade, another woman required an operation to repair a torn stomach lining. But 10 more years passed before she finally admitted her problem and sought help.

As is common in psychology, treatment is varied. Saskatoon’s Thakur claims an almost 100-per-cent success rate with hypnosis while Dr. Leon Sloman of Toronto’s Clarke Institute of Psychiatry counsels the victim and the entire family. But perhaps the most intriguing therapy is the “negative reward” system employed by Solyon in Vancouver. “If a patient goes on a binge, I make him pay. For one woman that means sending a $600 cheque to OXFAM. Another is forbidden to drive for two days.”

The real sign of recovery occurs when a patient comes to terms with his mind and body. Ternes has been with Junek’s group therapy program for five months and has reduced her binging to once a week. “If I feel like I’m going to binge, I stand in front of the mirror and say out loud, ‘You want to be in control.’ ” She has put five pounds on her 5Vè-foot frame, bringing her to a healthy 112 pounds. And she no longer feels grossly overweight. “My boy-friend started pinching my bum,” she admits self-consciously but proudly, “because he says there’s finally something to pinch.”

Janice Neil