An Introduction to Bulimia Nervosa and the Restrict-Binge Cycle
Bulimia Nervosa is a serious eating disorder characterised by episodes of binge eating - eating a large volume of food within a short window of time, accompanied by the feeling of being out of control - followed by behaviours like purging, fasting, laxative use, or excessive exercise to counteract feared weight gain. This behaviour can feel impossible to overcome, but understanding the underlying triggers can be a key step toward recovery.
The Restrict-Binge-Restrict Cycle
At the core of Bulimia Nervosa is the restrict-binge cycle, where periods of restricting food lead to episodes of binge eating. Many people with bulimia adopt strict rules around what they eat, which results in significant under-eating. However, restricting food for too long triggers a powerful physiological response: something I often refer to as primal hunger.
Primal hunger is your body’s way of signalling that it needs nourishment - and it can be relentless. When you deprive your body of food, your brain shifts into survival mode: your thoughts become preoccupied with food and binge eating becomes a natural biological response. Far from being a failure of willpower or a lack of discipline, binge eating is a survival response from your body, fighting to restore balance.
The Onset of the Binge Cycle
Whilst deliberate dieting for anticipated weight loss or health purposes is the most common trigger for the onset of binge eating, there are other circumstances where restriction occurs. For example:
Relative Energy Deficiency: Athletes and individuals engaged in high levels of physical activity may unknowingly restrict food intake, leading to energy imbalances. This is often seen in sports where thinness or leanness is emphasised.
Illness: Sometimes illness leads to a natural restriction of food intake, either because of a reduced appetite or difficulty keeping food down. After a period of illness, the body might compensate with increased hunger, potentially triggering binge episodes.
Food Scarcity: In situations where food is scarce, whether due to financial difficulties or limited access to certain types of food, restriction can occur. When food becomes available again, the body may binge in response to the previous deprivation.
Religious Fasting: Fasting for religious reasons, like during Ramadan, can temporarily create a restrict-binge pattern if the body is deprived of energy for extended periods.
These situations share a common theme: food restriction. Whether voluntary or involuntary, restriction pushes the body into a state of deprivation. This is what ultimately sets the stage for binge eating.
Binge Eating: Hunger and Deprivation
Whilst physiological hunger is the number one trigger for binge eating, psychological deprivation is a close second. People with bulimia often deny themselves foods they enjoy, labelling them as “bad” or “forbidden,” which only makes these foods more tempting. Over time, the restriction can lead to an intense preoccupation with these foods, eventually triggering a binge.
On top of that, emotional eating is another factor in bulimia. Many individuals use food as a way to cope with difficult emotions like stress, sadness, or anxiety. In these moments, binge eating can offer temporary relief or distraction from overwhelming feelings, even though the aftermath often includes guilt and shame. Often people seek out treatment hoping to address emotional triggers for binge eating; however, for any intervention to be effective, physiological hunger and psychological deprivation must always be addressed first.
The Path to Recovery: Breaking the Cycle
The good news is that the restrict-binge cycle can be broken, and recovery from bulimia is possible. One of the most effective ways to begin healing is by addressing both the physical and psychological triggers of binge eating. This includes learning how to eat regularly and adequately to prevent the cycle of deprivation and primal hunger from taking over.
If this cycle sounds familiar, you may be interested in my upcoming skills group programme, Break the Binge Cycle, starting in February 2025. In this 12-week online group, participants will learn how to normalise their eating patterns, understand the emotional and psychological drivers of binge eating, and work to build healthier relationships with food and their bodies. This is a chance to break free from the exhausting eating disorder cycle and start the journey toward long-lasting change.
If you're ready to learn more, please get in touch or see the Group Therapy page on my website.