Struggling with Guilt After Eating: When to Seek Help for Binge Purging

Inducing vomiting immediately after eating can lead to feelings of guilt if one is unable to do so?

Hello, doctor.
I don't know when it started, but in the past, I would only induce vomiting after overeating.
Now, even if I eat just a little, like a single piece of candy, I feel the need to vomit immediately.
If I don't, I experience a strong sense of guilt.
I've been trying to stop this behavior, but I can't seem to control it.
I feel like I have no energy, but my menstrual cycle is still normal.
However, I rely on medication to induce vomiting, and after that, I feel the urge to eat again.
I eat and then vomit again.
Throughout the day, I don't allow any food to stay in my stomach.
Should I really consider seeing a doctor?

Ling, 10~19 year old female. Ask Date: 2017/08/23

Dr. Cai Qijin reply Psychiatry

Are you very concerned about your weight or external appearance? It seems that eating, purging, and feelings of guilt have formed a vicious cycle.
It is recommended to seek an evaluation and assistance from a psychiatrist as soon as possible.

Reply Date: 2017/08/23

More Info

It sounds like you are experiencing a very challenging situation with your eating habits, particularly with binge-purge cycles. This behavior can be indicative of an eating disorder, specifically bulimia nervosa, which is characterized by episodes of binge eating followed by compensatory behaviors such as self-induced vomiting. It's important to recognize that these patterns can have serious physical and psychological consequences.

Firstly, it's commendable that you are aware of your behaviors and are seeking help. The feelings of guilt and the compulsion to purge after eating even small amounts of food are significant red flags. These feelings can be overwhelming and may lead to a cycle that is difficult to break without professional support.
From a medical perspective, engaging in such behaviors can lead to a variety of health issues. Physically, frequent vomiting can cause electrolyte imbalances, dehydration, and damage to the esophagus and teeth due to stomach acid. Additionally, it can lead to gastrointestinal issues, such as delayed gastric emptying or chronic sore throat. Psychologically, the guilt and anxiety surrounding food can lead to depression, anxiety disorders, and a distorted body image.

You mentioned that your menstrual cycle is normal, which is a positive sign, but it does not negate the need for help. Eating disorders can affect individuals differently, and some may maintain regular menstrual cycles even while engaging in harmful eating behaviors.
It is crucial to seek help from a healthcare professional who specializes in eating disorders. They can provide a comprehensive evaluation and help you understand the underlying issues contributing to your eating behaviors. Therapy, particularly cognitive-behavioral therapy (CBT), has been shown to be effective in treating bulimia nervosa and can help you develop healthier coping mechanisms and a more positive relationship with food.

In addition to therapy, a registered dietitian can help you establish a balanced eating plan that addresses your nutritional needs and helps you work towards a healthier relationship with food. Support groups can also be beneficial, as they provide a space to share experiences and learn from others who are facing similar challenges.

If you are feeling overwhelmed, it is essential to reach out for help sooner rather than later. The longer these behaviors persist, the more ingrained they can become, making recovery more challenging. Remember, seeking help is a sign of strength, and you do not have to navigate this journey alone.
In summary, please consider reaching out to a healthcare provider who can guide you through this process. You deserve support and the opportunity to heal and develop a healthier relationship with food and your body.

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