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The Bulimia-Like Eating Disorder You May Not Have Heard Of

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Editor's Note

If you live with an eating disorder, the following post could be potentially triggering. You can contact the Crisis Text Line by texting “NEDA” to 741741.

I have lived with an eating disorder for as long as I can remember. From a young age, I have obsessed with my weight and had distressing thoughts when I looked at myself in the mirror. My condition has developed from starvation periods and lying about when or what I have eaten to family, friends and teachers, to my now-situation of a cycle of normal eating, to purging, to starvation and back again.

One thing I have noticed is that most people assume that there are two eating disorders: anorexia and bulimia. Since I started purging two years ago, I assumed I had bulimia. However, one thing I noticed medical professionals always asked me was what my binging habits were. The trouble is, I don’t binge. I purge, I starve, but I don’t binge. When I told nurses and doctors, they always gave me a look like I was lying about the whole thing. It wasn’t until I was discussing my problems with a friend that I stumbled across a disorder I had never heard of before: purging disorder.

Purging disorder is defined as an eating disorder that is diagnosed when a person purges to influence shape or weight but does not binge. Essentially, it is bulimia without the binging. Purging can come in many forms. Often, it is assumed to be self-induced vomiting, but it can also be seen in forms of laxative and diuretic misuse, excessive exercising or extreme fasting.

Purging disorder has been studied far less than bulimia nervosa. Many people who live with purging disorder are incorrectly diagnosed as having bulimia nervosa or may not be diagnosed at all. It isn’t listed as an official disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Instead, it is included as a described condition within the category of Other Specified Feeding and Eating disorder (OSFED). Even though it lacks its own official category, purging disorder can be just as serious as any of these other disorders.

When I discovered this condition, I was relieved. I often felt like I was “failing” my eating disorder either by the fact I didn’t restrict my eating enough to fit into the anorexia definition or by not binging enough to be classed as a bulimia case. This sort of thinking only made my condition worse, as well as elevated my depressive states. I have not had a chance to raise this condition with my doctor, but when I do I am hoping that I can either get some focused treatment for this or at least have them recognize this disorder. In myself, I am somewhat happier that I know what I might have now, and I’m no longer obsessing over the fact I’m not a “proper bulimic.”

My hope is that, by writing this, I can share this condition with others. If you feel like you are “failing” your eating disorder, there are others in the same boat as you; there is hope, and you are not alone. When I get in contact with my care team and explain to them my beliefs, I will update either this post or write a new entry to share what professionals say about this disorder and whether there is any treatment specifically for those of us who purge without binging.

Photo by Guillaume Bolduc on Unsplash

Originally published: May 20, 2019
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