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FEMALE STRESS SYMPTOMS: BULIMIA.

How many women are thinking, despite these gloomy statistics, that they would gladly trade in their compulsive eating for a "mild case" of anorexia? Undoubtedly more women feed themselves than starve themselves when they are under stress. They chomp, chew, and sip, trying to sweeten up, spice up, or fill up their lives.

When gorging and binging become extreme and compulsive, the resulting stress symptom is called bulimia. Its source can vary, since food can have many different correspondences and meanings. Food can be tied to a memory of being mothered. It can provide a touch of home. It can be a reward, or it can be part of an attempt to gain strength and fortification. It can be a substitute for "taking in" sexual pleasure, praise, or love from others. It can be a safe outlet for anger: we can chew it, bite it, or cut it. It can be a safe outlet for dependency needs: we can hide it, stock it, and hoard it. The list may go on and on, but the symptom remains the same-uncontrolled eating.

Gloria hinged secretly. Publicly she complained that her sluggish metabolism was responsible for her weight. Privately, she used her obesity as an excuse for her lack of popularity. She periodically tried to diet, but felt too deprived to continue for long. When she was tense, she could imagine no other release, and told herself that her eating was a combination of a bad habit and good cooking.

Gloria was a food addict, and as with other dependencies, management of her symptom would be a lifelong problem. First she would have to recognize that she was no longer a helpless infant whose only active capacity for soothing herself was to put something in her mouth. She would have to understand that when she had finished her munching, the source of her stress had still not been dealt with! She would have to admit to bulimia. The stress triggers would have to be identified and alternative strategies for coping developed.

Bulimics run many of the same health risks as anorexics. Their diet becomes nutritionally unbalanced as they "just pick" at healthful foods to compensate for devouring desserts or junk food. Their biochemical electrolyte balance becomes threatened if they use forced vomiting, enemas, and/or diuretics to undo their loss of eating control. If they hide their bulimia by maintaining normal weight, the disorder is harder to identify and help is less likely to be offered. If they alternate between anorexia and bulimia, they are in double jeopardy.

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