Understanding the Interplay for Recovery: The Impact of Food Restriction in Bulimia Nervosa

We invite you to dive into a closer examination of the intricate relationship between food restriction and bulimia nervosa.

On Sarah Lee Recovery, my personal practice website, I recently wrote about the nuanced journey of food restriction and its significant impact on one's relationship with food. Moving beyond the conventional view of the eating disorder recovery community, that all forms of food restriction are inherently harmful. I shed light on how well-intentioned actions for some can unwittingly pave the way for disordered eating and the development of full-fledged eating disorders. While for others, types of restriction positively serve well-being and overall health.

Today, here on Conquering Bulimia, our objective is to take a more in-depth look at the pivotal role that restriction plays within the context of bulimia nervosa. As we peel back the layers, our aim is to challenge preconceived notions and foster a better understanding of the connection between food restriction and the challenges faced by individuals dealing with bulimia nervosa. Continue reading as we unravel the complexities and gain insight into the profound impact of restriction on the journey of conquering bulimia nervosa.

“Every form of disordered eating and eating disorder involves an element of restriction. While we may readily identify it in anorexia, others often fly under the radar. Clients will assert, "I'm not one of the restrictive types," inadvertently overlooking their internal belief systems influenced by diet culture and distorted opinions.” – Sarah Lee Recovery

Review: Defining Bulimia Nervosa

Before we go into the complicated connection between food restriction and bulimia, let's revisit the fundamental definition of bulimia nervosa. This eating disorder is characterized by recurrent episodes of overeating (binge eating) followed by compensatory behaviors aimed at preventing weight gain and ease discomfort. These behaviors often include self-induced vomiting, excessive exercise, fasting, or the misuse of laxatives, diuretics, or other medications. Individuals with bulimia experience an intense fear of gaining weight and struggle with a distorted body image.

However, the traditional definition fails to explicitly mention the significant role that restriction plays in the complex cycle of bulimia. Despite not being explicitly stated, restriction is a critical component that often acts as a catalyst for the binge-purge cycle. This comprehensive article aims to shine a spotlight on the subtle yet powerful ways in which restrictive behaviors and thoughts contribute to the multifaceted challenges faced by individuals wrestling with bulimia.

The Role of Restriction in Binge-Purge Cycles

"When you are overly hungry, you will find it almost impossible to listen to body signals, pay attention to healthy choices, stop eating when you are satisfied, or care about how you feel afterwards." This excerpt from "8 Keys to Recovery from an Eating Disorder" underscores the profound impact of hunger on our ability to make mindful and healthy food choices. The physical drive to eat often overrides other considerations, leading to mindless and unconscious overeating.

To reiterate, restriction, whether intentional or subconscious, acts as the catalyst for the binge-purge cycle. Deprivation or restriction of food creates a powerful drive to eat, often triggered by intense emotions or feelings. This is followed by episodes of mindless, unconscious, avoidant, or habitual binging, perpetuating the harmful cycle.

In the article, Food Restriction Is at the Root of Most Eating Disorders – Not Just Anorexia, Equip Contributing Editor writes, “Equip Dietitian Caitlyn Neuendorf agrees, explaining that all types of eating disorders can be rooted in restriction, and that “restriction” doesn’t necessarily have to mean limiting food in order to avoid weight gain; it can also be physiological or psychological. “In patients with ARFID, many are restricting food variety, volume, or both,” she explains. “In patients with BED, there is often both a physiological and psychological restriction going on concurrently.” She says that even if a person is eating throughout the day, if they’re mentally restricting—meaning they only focus on nutrients, avoid foods they think they “shouldn’t” eat, or make food rules for themselves (like just one French fry or just one bite of cake)—their brain still registers that as restriction. “This can lead to binging behaviors and an unhealthy relationship with food,” she says."

Well-Known Restrictive Behaviors

Certain restrictive behaviors are well-known and acknowledged within the context of eating disorders. These include:

• Counting calories to maintain a specific low number.
• Counting macros to adhere to a specific low number.
• Measuring food meticulously.
• Consuming very small portions.
• Ignoring hunger cues.

Unnoticed Restrictive Behaviors

However, several restrictive behaviors often go unnoticed and unacknowledged, contributing to the complex dynamics of bulimia. These include:

• Skipping meals, such as breakfast.
• Avoiding certain food groups, like carbohydrates.
• Allowing large amounts of time between eating sessions, leading to extended periods of fasting.
• Solely focusing on eating "clean" or "safe" foods, creating a narrow dietary pattern.
• Rejecting nutrient-dense foods under the guise of healthy eating.

Restrictive Thinking and Diet Culture Mentality

The impact of restrictive thinking and diet culture mentality cannot be overstated. Individuals struggling with bulimia often engage in thought patterns that reinforce disordered eating. Some examples include:

• Labeling food as "good" and "bad," creating a moral hierarchy around food choices.
• Adopting all-or-nothing thoughts, such as believing that one cookie leads to consuming the entire box.
• Succumbing to "should" and "should-not" statements, reinforcing rigid dietary rules.
• Diet Culture Concealed as "Normal"

What is Diet Culture?

Because it is talked about so much in my world, I often forget people may have never even heard the term “diet culture.” Per Medical New Today, this is the official definition, “Diet culture is a set of myths and expectations around food and weight, which typically equate thinness to health and categorize foods into “good” or “bad” types. Diet culture creates a moral hierarchy of body sizes and shapes, which typically idealizes thinness and creates fear and negativity about fat.”

Many restrictive behaviors have become so ingrained in our culture that they are perceived as normal and acceptable. Individuals may unknowingly adopt these behaviors, considering them a part of a healthy lifestyle.

A Real Story: Unveiling the Reality of Restriction with Bulimia

To illustrate the impact of restrictive behaviors, let's examine a real story from one of my private clients. I once worked with a client whose profession was in the healthcare field, plus had a significant social media following for her fitness blog. On the surface, she appeared to have a comprehensive understanding of the human body and nutrition, but she secretly battled bulimia.

Despite her wealth of knowledge, her relationship with food had become legalistic and restrictive. Even her exercise routine served as a form of purging, compensating for a perceived loss of control. During our sessions, she vehemently defended her habits, convinced that her strict rules were the only thing keeping her semi-okay. However, her eating disorder was distorting the truth.

Over the first few weeks of us working together, it became evident that her restrictive mindset, coupled with a disconnection from her body, fueled the cycle of bulimia. Despite eating three meals a day, she adhered to a rigid dietary pattern, emphasizing lean protein, lots of veggies, minimal fats and grains. In addition, the unpredictability of her eating schedule created long gaps between meals (sometimes up to 6-8 hours) and contributed to a significant calorie deficit during certain periods of time. In our conversations, she also frequently used restrictive language, employing terms like "only," "should," "never," and "rarely" when describing her meals.

Despite her belief that she did not intentionally restrict food and was eating plenty, her body experienced prolonged periods without fuel, triggering the urge to binge, particularly in the evenings and at night. Her mind was trapped in a restrictive judgement state where initial intentions of “eating healthy” became rigid rules of her eating disorder. This becoming a deprivation mindset to rebel against when her body was in need.

During one of our sessions, she raised a compelling point, expressing, "But Sarah, so many people aim to maintain healthy diets, engage in regular exercise, and can't always stick to eating every 3-4 hours, and they don't end up with an eating disorder." In response, I posed a question that hit home: "How do you really know what their relationship with food and their body is? Except for me and the therapist you visited for a while, would anyone guess you're wrestling with bulimia?" As those words hung in the air, tears began streaming down her face. In that poignant moment, she had a profound realization—one of the roots fueling her struggle was her tendency to compare herself with others.

Just as there isn't a singular cause for the development of an eating disorder, there isn't a one-size-fits-all solution for healing and achieving lasting recovery. The path to recovery involves a unique synergy tailored to the individual. Drawing from the experiences of this courageous woman who allowed me to generously share her story anonymously, here are the top strategies that played a pivotal role in her bulimia recovery.

Restriction

• She embraced a regular eating schedule, nourishing her body every 3-4 waking hours.
• Granting herself full permission, she enjoyed foods she once labeled as 'bad' whenever she desired.
• Reconnecting with her body, she honored hunger and fullness cues.

 Exercise

• Exploring a new relationship with fitness, she sought activities that genuinely made her feel her best.
• Saying goodbye to the gym, she found solace in the serenity of trail running.
• Taking a step back from the public eye, she decided to dismantle her blog.

 Discomfort

• Learning to sit with challenging emotions, both emotional and physical, she embraced discomfort.
• During uneasy moments, she experimented with new habits.
• Riding out the urges to binge and purge, she discovered that with time, they gradually faded.

 Comparison

• Embracing the wisdom that 'comparison is the thief of joy,' she let go of the tendency to measure herself against others.
• Challenging her assumptions, she questioned, 'How do I really know?' when making conclusions about others.
• Shifting her focus, she began to highlight her strengths and blessings, consciously steering away from hyper-focusing on weaknesses and imperfections.

In summary, as we finish our exploration into the interplay between food restriction and bulimia nervosa, we invite you to reflect on the profound impact these interconnected elements wield on the journey of conquering this complex eating disorder. The insights shared on Sarah Lee Recovery and Conquering Bulimia aim to challenge conventional perspectives, encouraging a nuanced understanding of how restriction, whether subtle or overt, plays a pivotal role in the challenges faced by individuals battling bulimia nervosa.

In the realm of eating disorders, the pervasive influence of restriction cannot be overstated. It weaves itself into the fabric of disordered eating and becomes a silent force, fueling the binge-purge cycle. It's essential to recognize that the impact of restriction extends beyond the traditional boundaries of anorexia, affecting individuals with bulimia in ways often unnoticed. My Sarah Lee Recovery blog aptly highlights how internal belief systems, history, subtly influenced by diet culture and distorted opinions, can unknowingly contribute to restrictive behaviors.

Our journey through the definition of bulimia nervosa and its traditional understanding exposes a significant gap—restriction is an integral yet unspoken component. The cycle of overeating followed by compensatory behaviors finds its roots in the deep-seated drive created by deprivation or restriction of food. The interconnectedness of restriction with emotions and the subsequent mindless or unconscious binging becomes a challenging path to navigate.

As we unravel the layers, we shine a spotlight on both well-known and unacknowledged restrictive behaviors. From counting calories to skipping meals and adopting an all-or-nothing mentality, these behaviors contribute to, again, the interplay of restriction and the subsequent challenges faced by those combating bulimia nervosa. It becomes evident that the impact of restrictive thinking and diet culture mentality is not just a personal struggle but a societal norm, concealed as "normal" behavior.

To drive these points home, we shared a poignant real story—one of struggle, comparison, and the powerful realization that societal norms often conceal the silent battles within. My client's journey exemplifies the need for a tailored approach to recovery. The top strategies outlined, encompassing areas of restriction, exercise, discomfort, and comparison, offer a holistic perspective on overcoming bulimia nervosa.

In essence, just as the journey into the complexities of bulimia nervosa and its relationship with food restriction is multifaceted, so is the path to healing. This exploration is an invitation to go deeper, question assumptions, and foster a compassionate understanding for the lives of those facing bulimia nervosa. May this knowledge empower individuals, practitioners, and communities alike to navigate this challenging terrain with empathy and resilience.

With Love & Light,

Sarah Lee

Sarah Lee is a Certified Eating Disorder Recovery Coach with four professional certifications, including one from the esteemed Carolyn Costin Institute. Since 2016, she has run a private practice currently located in Dallas, TX, assisting clients globally along with mentoring newer recovery coaches.

Posted on January 03rd, 2024. 

^{Struggling with Bulimia? Claim your complimentary offer now! Dive into a 25-minute video presentation outlining our most effective strategies for addressing purging behaviors. Click Here.}

Resources: Sarah Lee Recovery Blog, Equip Health, Medical New Today, 8 Keys to Recovery From an Eating Disorder