Understand The Binge-Purge Cycle in Bulimia

Understanding the cycle is the important first step to stop it

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The binge-purge cycle is a cycle of behaviors, thoughts and emotions experienced by many people who suffer from the eating disorder bulimia nervosa.

The cycle looks like this: diet-binge-purge-repeat

It typically repeats itself over and over, and if you are suffering from bulimia nervosa, you may feel like it's impossible to stop. But understanding this pattern of behavior is one of the best ways to figure out how to stop it and start on the road to recovery.

Triggering Events for Binge-Purge Cycle

It is important to recognize that the model above, derived from cognitive-behavioral therapy, shows how a binge cycle is maintained. It does not indicate how the eating disorder first developed.

Every binge cycle has an event or series of events that trigger the cycle. These triggers need not have caused the eating disorder itself — in many cases, the triggering events or emotions are different every time. But these triggers do start a new cycle of bingeing and purging.

Many binges stem from physiological or emotional deprivation. Individuals who diet or restrict their eating, even in subtle ways, predispose themselves to binge eating.

Many people identify specific emotions as triggers, such as: sadness, loneliness, guilt, or feelings of helplessness or hopelessness. These emotions, which so frequently are difficult to handle, may be experienced throughout the course of a day or days.

They may be caused by a specific event or series of events, such as an argument with a loved one, criticism at work, or self-criticism.

Regardless of the specific emotion or event, identifying your own triggers is one way to recognize "red flags" that mean you need to do something different.

Binge-Eating Episode

Binge eating is defined as eating more in a single setting than most people would.

Although this definition is very subjective, binges are much larger than a regular meal, and can contain several thousand calories.

Many people describe binges in terms of feeling "out of control" or not really even knowing how much they are eating. Some people describe the experience as being "zoned out" as they're eating — they then look down to find empty boxes/containers.

Binge eating is one of the main behaviors in the binge-purge cycle. It may begin innocently with eating a small portion of a food that is typically considered “off limits.” After eating this portion many people feel guilty and decide to “eat the rest” as they’ve already “blown their diet” and would rather finish the rest of the forbidden food so it won’t be around to tempt them tomorrow. Alternatively, a binge can begin with eating comfort foods to soothe the negative emotions related to an upsetting event, and then continue into a full binge. It can also be your body's way of getting nourishment when you haven't been eating enough food.

Physical and Emotional Results of Cycle

After a binge, most people feel uncomfortably, or even painfully, full. This feeling goes beyond the fullness you experience after, say, a major holiday meal with family and friends.

It's simply the result of eating so much.

Along with these physical pains comes emotional pain, possibly including feelings of embarrassment, shame, guilt, disgust and/or self-criticism. These emotions typically lead to the purge part of the cycle.

Purging Episode Often Follows Quickly

For many sufferers, the time span between binging and purging is very short. Purging becomes a way to relieve oneself of the negative feelings (physical and emotional) of the binge.

Most people think of purging as self-induced vomiting, but it can also include laxative and/or diuretic use. Sometimes people use other behaviors, such as exercise, to compensate for the additional calories consumed in a binge.

Some people will have one binge and purge episode and then go into a period of calm. Others may binge and purge multiple times before stopping.

Calm Period Before Cycle Restarts

After a binge and purge episode, there may be a period of calm.

At this point, a person may resolve to never binge or purge again. He or she may even decide to begin restricting his or her food intake. Unfortunately, research shows this will simply lead to binge eating again.

There are also people who acknowledge that they will likely binge and purge again. They feel hopeless to stop the cycle.

A Message from Verywell

If you are experiencing bingeing and purging, the first thing is to know that recovery is possible. You may be able to apply some strategies on your own. Keep food records to understand your own patterns. Learn some strategies for breaking the cycle here and here. You can read more about self-help approaches here. Finally, seek help form a qualified professional. 

    Sources:

    American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed., Text Revision). Washington, DC.

    Fairburn, C. G. (2008). Cognitive behavior therapy and eating disorders. Guilford Press.

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