The story I am about to tell you is not something that medical science considers a reliable treatment for bulimia, but nonetheless it is something I have witnessed firsthand.
I want to introduce you to Debbie*, lifelong bulimia sufferer and chronic binge eater, who for a period of time in 2012 had to enter a psychiatric facility in order to save her life. This story takes anecdotes from her journals that formed part of her treatment, our subsequent conversations as she embarked on her Paleo journey post-clinic and where possible, research to provide some kind of scientific substance to the discourse.
As you read through this story, please bear in mind that if Paleo is to be a plausible means to heal people suffering from Bulimia, then it does so at the cutting edge of what seems possible with diet and as such, there is little science to back up such claims, for now. Much like the now famous story of Dr. Terry Wahls who healed her Multiple-Sclerosis condition using Paleo, there may be more to diet than we realise, even if we can’t understand or explain it yet.
The Paleo diet, and in general, any diet based on low-carbohydrate, high-fat (LCHF) concepts has been well known to aid or even reverse a wide manner of conditions, illnesses and diseases. There are many explanations for this but they all seem to centre on the following: optimisation of blood glucose levels in the body and hence optimisation of the insulin levels driving fat storage, balancing our acid-base levels towards alkalinity and balancing our omega-6-to-3 ratio towards being anti-inflammatory while correcting our mitochondrial function and endocrine system such that our hormones and enzymes perform optimally. It is any, or perhaps all of these factors which combine to heal the body, and possibly the mind.
While there are reported instances of low-carbohydrate diets healing people with physical (obesity, type 2 diabetes) or even mental ailments (Parkinson’s, Multiple Sclerosis, ADHD, Epilepsy), until now there has been limited reporting of truly psychological conditions such as bulimia being healed. This is understandable because for the most part we have assumed – like we did for the causes behind weight gain – that it is the problem of the patient and as such, psychology couldn’t possibly be controlled or affected by diet.
I am however not going to suggest that a low-carbohydrate Paleo diet is a general cure for Bulimia, that would be irresponsible, but what I am going to suggest is that employing this diet as a treatment is something which should be considered, along with counselling and medication (in some instances).
What is an Eating Disorder?
An eating disorder is a complicated and debilitating psychiatric illness that results in pain, confusion and anxiety both for the sufferer and their family. By the time the decision is made to admit a patient, a family has often been in turmoil for months and the decision to admit the patient is painful. However what seems a punitive response to a psychiatric disorder is often necessary to save a patient’s life.
There are three major types of eating disorder:
- Anorexia Nervosa is an illness which presents weight loss and changes in eating habits.
- Bulimia presents with a chaotic eating pattern of binging and vomiting.
- Binge Eating Disorder is a severe psychological illness with many features of emotional disturbances.
As you will learn, Debbie was both bulimic and suffered a binge eating disorder and as such, the discussions below apply to both conditions.
The Bulimic Mindset
At the time when Debbie sought psychiatric help she was binging and purging up to four times per day and to avoid getting caught, she would sometimes jump on a bus and travel 45 minutes outside the city so that she could dispose of the “evidence”. Other times she would go into McDonalds, order a water and watch everyone else eat; by not eating anything, she felt (an illusionary sense of) empowerment over the disease. It reached the point where the purging no longer had any reason behind it; it just become a part of her and quite similar to a heroin addict, it was required to maintain a plateau of “normal-ness”.
To say that this situation is psychologically and emotionally exhausting is a massive understatement.
Debbie described the feeling following a purge as
“Being warm and safe, like being hugged by your mother”
The desire to purge was brought on by a complex ruleset relating the amount of food eaten throughout the day with guilt about that food, self-destructive and obsessive thoughts generated by a low self-esteem, a desire to “remove” the stress of the situation and a sense of empowerment which occurs following the purge. The counterintuitive concept (for non-bulimics to understand) is that by purging she actually felt calmer, relieved of guilt and was even able to sleep. Perhaps most startling was that purging gave her a sense of self-control over her weight and situation. Of course this self-control is a complete illusion created by the bulimia and is not dissimilar from that experienced by a nicotine or heroin addict. By smoking the cigarette the person actually feels calmer, but of course this is simply the nicotine itch being scratched. The “calmness” is the sensation of the nicotine hit. A non-smoker is at this level all the time and thus has no need for this calming sensation.
Smokers have each cigarette only to get back to the feeling that non-smokers have.
This applies identically to bulimics and perhaps all classes of eating disorder sufferers.
The mental rules, checklists, balances and rituals which a bulimic person goes through are extreme. From a solution point of view these need to be understood as they are so deeply ingrained into the psyche that crafting a way forward, be it Paleo or otherwise, must shift the rituals from being destructive to those which enforce greater health while bringing about positive habit change.
Here is a sample of the mental rules Debbie applied in the past:
- No eating in public. If you must, then it can only be a salad.
- Avocado is allowed only if it is part of a salad.
- Can’t walk down the road with a Coke in your hand because everyone will think “she should be on a diet”.
- Can’t walk down the road with a Coke Light in your hand because everyone will think “oh shame, she is trying to diet”.
- Only drink that can be consumed in public is water.
- Must sit at the edge of a restaurant when planning to binge so that she remains inconspicuous. Also the waiter must be given an extra large tip.
- When routinely binging in a certain place (such as a shopping centre), the bathroom used must be rotated so as to avoid suspicion.
- Never talk about food or weight in public (this is in contrast to anorexics who may speak about food constantly, most likely because they are starving).
- Never be too loud or take up too much space.
Internal mental rules include the following:
- Each food group has a certain number of points.
- The more dietary fat the food contains, the higher its point score.
- Each night in bed, the points must be calculated for everything eaten that day.
- If the point score is too high then a purge is needed to recover points and shift the balance towards “weight loss”.
- If a purge doesn’t or can’t happen at this time then excess points are carried over to the next day. This means less food must be consumed tomorrow such that a “perfect” day can be obtained.
- Meal times are crucial. If food can’t be eaten at a predefined time then panic occurs and the meal must be forfeited (a form of self-punishment). This creates a secondary feeling of pleasure since missing the meal makes extra points available.
- Food must be cut up and eaten from a bowl with a spoon. This creates a child-like psychological safety net when eating, another form of self-protection as well hiding the amount of food eaten. Anorexics will totally douse food in hot sauce and pepper to hide the flavour and the amount of food consumed. For a period of two years, Debbie ate every single meal out of a bowl and it was only once she entered psychiatric treatment that she was made aware of the psychological reasons for this.
- All food must be eaten before 7pm, failure to do so will result in the a forfeit of the meal.
- “Sneak-eating” must be done at all times. Examples include opening and closing a microwave without it making a sound, opening the fridge while turning its light off so as to avoid being caught eating. Eating will also be done in the shower where any noise can be masked (this is used for purging as well). In general the aim was to make it appear that no food was being eaten.
- Mascara must be removed beforehand as it might run when purging.
Binge and Purge Process
The following is a sample of the process:
- Planning and preparation is required to ensure the right type of trigger food is available and in the right amount. Debbie uses three packets of instant-noodle pasta; most bulimics use some kind of carbohydrate.
- Once eaten, tea must be prepared in advance of the purge.
- When Debbie decides its time she can do so without an implement. A “skill” obtained through many years of practice. Thoughts alone are enough to trigger the purge.
- Once it has happened, a quick brush of the teeth followed by drinking the tea she prepared previously. This gives her a sense of calm and peace as well as removing the guilt associated with anything eaten that day (or part thereof).
This is a somewhat simplified chain of events but it is important to understand that the bulimia mindset is obsessive, masochistic, ritualistic and ultimately based in fear, self-loathing and guilt with external validation and nurturing being derived from food, while simultaneously using it for self-harm.
Debbie has suffered a number of physical after-effects include a loss of teeth due to the acidic nature of consistent purging, chronic acid reflux even though grains are now out of her life and permanent damage to the vocal folds in her throat, affecting her voice. During the height of her bulimia she stopped her period and although no longer purging, she suffers from chronic cramping in her quadricep muscles, calves and feet as well as lower back pain.
Mentally, emotionally and physically this is not easy to overcome but I’ll describe how we approached it.
At the time of writing, Debbie hasn’t purged in 7 months and counting.
The Journey to Paleo
Debbie’s journey into Paleo wasn’t the usual sequence of events: See some interesting blog post/tweet, follow a link, spend a week on Robb Wolf/Marc Sisson’s website, buy one of their books, get really excited about the Paleo potential and get going. She was not looking for a diet; she was not even looking for a solution to her bulimia.
She was trying only to survive.
The bulimic mindset is one based in tremendous fear: Fear of the future, fear of change, fear of rejection, fear of success, fear of failure, fear of being found out, fear of never being found out and fear of being incapable of taking care of oneself.
Bulimia can be caused by many things and it differs from person to person but for Debbie, it was borne out of a tremendously low self-esteem, created through a lifetime of being a stage performer and suffering all the pressure and at times, the humiliation that goes with it. Having grown up with a performer in the family myself, I know all too well how cruel and brutal to one’s self-worth that world can be. Most of us think we have a hard job and have to deal with a tough boss, however in comparison to the world of performing arts, we simply haven’t got a clue. Being told you are too fat, too tall, too short, too slow, too ugly, too skinny or too dumb every day of your life is something most of us have no concept of. Even if we do hear it from time to time, it’s a case of it being acute rather than chronic, i.e. we hear it in small doses but it is not a consistent part of every single day. From a psychological point of view, this chronic “putting down” does nothing but destroy the inner compass through which we view ourselves and to make matters worse, people in the performing arts typically get paid a tiny fraction of those sitting behind a desk doing “knowledge work” so their ability to take care of themselves from a financial perspective can be challenging, which too plays its part in eroding their self-esteem.
When Debbie and I first started discussing the Paleo diet, let’s just say it was met with resistance. The whole idea that dietary fat could actually be good for you was something she really didn’t care for. In fact, and perhaps this applies to most bulimics, fat was often used as a purge trigger precisely because it was believed to be the best way to “harm” oneself. You see bulimia is also a disease of masochism. It is where self-harm comes through the external mechanism provided by food. In Debbie ‘s case, and as I came to understand, the case of many bulimics and anorexics, coconut oil, a Paleo staple, is often seen as the most evil thing on earth, and thus the best tool to use for personal harm, precisely because it is so high in saturated fat. So if we were going to convince her to go Paleo, we had to start with the internal battle she had against saturated fat.
Going Paleo in this case also couldn’t follow the usual prescription: Cut out all sugar, grains, legumes and dairy while eating grass-fed meat, wild-caught fish, loads of vegetables and healthy fats with a bit of fruit, nuts and seeds. It couldn’t work because as a bulimic, Debbie had powerful attachments to certain food and drinks and breaking this attachment too severely or too early could create havoc with her delicate state of mind.
The Game Plan
We decided to forget the potential weight-loss capabilities of Paleo and focus foremost on its hormonal healing properties.
Practically this meant not cutting out all sugar and rich-carbohydrates from word go but rather strategically giving her body and brain time to get used to different parts of what Paleo brought to the table (specifically loads of vegetables and fresh meats), which over time would allow her mind to reach new conclusions that were implausible before.
It took 6 months of convincing before Debbie decided to give it a go. Ultimately she was convinced out of a combination of desperation, it being something she hadn’t tried before, my persistent attempt to convince her of the merits of Paleo and a realisation that it couldn’t get any worse.
I asked her to take a leap of faith with me based on the changes she had seen the Paleo diet create in my life and with the knowledge that everything she tried before had failed (particularly eating any kind of calorie restricted low-fat diet) she reasoned that trying the same thing while expecting a different result was madness and so gave in. Mentally first and then emotionally, she decided to try Paleo.
Perhaps the most crucial thing we created in those early stages was a powerful non-judgmental, always-available support system.
This support system existed for two reasons: positively reinforce her self-esteem and give her a kick in the ass when needed, without judgement.
Challenges to Going Paleo
Of course for a bulimia sufferer to go Paleo there are a number of challenges and assumptions about food which need to be broken down. I’ll list them first and then discuss how we overcame them when we go through the Paleo-Bulimia Protocol (some of these points apply generally as well):
- The need to count calories and control portion size in order to maintain “control” over weight.
- A general fear of fat, butter and meat based on the belief that saturated fat is evil. This belief is possibly more severe in bulimia sufferers than the general public.
- The challenge of eating meat or high fat foods (like avocado) in public – For someone with severe body dysmorphia (as most bulimics have), eating high fat foods in public is extremely challenging as they believe they are being heavily judged by everyone around them. This perceived judgement makes mirrors and reflections even more terrifying than they already are.
- A general fear of eggs and cholesterol created by the ubiquitous fat-cholesterol hypothesis.
- A specific fear of eating chicken skin, bacon and more than a few avocados per week.
- Fear of converting to full-fat dairy (yes I know dairy isn’t Paleo but I’ll explain later why we kept it in Debbie’s diet).
- The need to eat coconut oil. While a Paleo staple, it is also a very common binge food for bulimics.
- A belief that we need to eat “low glycemic index” foods such as whole wheat bread or bran cereals to get our requisite fibre.
- Failures with previous diets, all the typical low-fat variety based on calorie restriction.
The Paleo-Bulimia Protocol
Here is how we approached it:
To overcome her fear of diets, based on years of failure, we had to reframe Paleo as an attitude towards health, not weight-loss. Moreover Debbie had to understand that Paleo isn’t actually a diet, it’s a way of life that doesn’t involve calorie restriction. If any part of the destination became related to losing weight then her mind would immediately return to autopilot mode, attaching weight-loss to guilt, leading to a binge and purge.
The idea of cheating had to be reframed as it too led to a guilt cycle which might trigger a purge. Practically this meant that eating some fruit, a few too many nuts or even a chocolate or hamburger were positioned as treats, not cheats. This subtle difference meant her psychology considered these foods within the boundary of what was allowed and as such, didn’t treat these moments as weakness which required punishment.
Portion control was tricky in the beginning because this is such a huge part of a bulimic’s life. She described it as “Like saying to an alcoholic, you have to drink three times a day but only one drink”. It’s confusing because no portion control doesn’t mean eat without limits. Moreover, portion sizes are attached to self-worth so in the beginning when I gave her smaller portions of food, she believed it was because I thought she was “less-than”. I had to explain to her that I am male and require more food than her, nothing more. Based on her previous experience, she also believed that lack of portion sizes would allow her to cheat the system, something bulimics are good at.
In order to overcome her strong desire to control portions, I banked on the hope that blood sugar and insulin stabilisation, combined with all-day satiety would lesson the mental attachment to control every ounce of what was eaten. My reason for having this belief was not based on the science of Paleo, but rather on what I experienced in my own Paleo journey: when our hormonal and enzymatic systems are stable, so our mitochondria become stable and ultimately, our brain, and mind. Like Dr. Terry Wahls curing her Multiple Sclerosis diagnosis through Paleo, it seems to work.
Core attachment items were kept including a cup of milo (a chocolaty warm drink) every night before bed as well as quite a few cups of sugary tea each day (6-7). The tea and milo gave her a sense of calm and were seen as a place of peace. Removing them would have been a bad idea. Alcohol consumption and smoking was not stopped. Again this would have been too much change and it seemed like a step too far. In time she will stop smoking and drink less but for now, it’s ok.
All fruit was removed from her diet. This seemed like the best compromise in terms of removing sugar, initially at least.
Dairy was kept in the diet (and still is to this day) although it was immediately changed from fat-free to full-fat. The reason we kept it was because her attachment to it was too strong. It was tough to convince her on the merits of full-fat dairy but it was done by reminding her that low-fat dairy contains more sugar than full-fat and based on the carbohydrate-insulin hypothesis, it is the sugar (carbs) which makes you fat and sick, not the dietary fat.
Over the course of a month, we incorporated hard-boiled eggs with cooked spinach (in coconut oil) into breakfast every morning. As mentioned the coconut oil was tricky because it was a previous trigger. This required a lot of time convincing her of the “saturated fat isn’t bad” argument while reiterating the carbohydrate-insulin hypothesis (carbohydrates raise glucose level, glucose causes insulin secretion, insulin make body store more fat and use less for fuel hence: we don’t get fat because we overeat, we overeat because we get fat). This was crucial because in order for her to accept the Paleo diet, her negative perception of fat and meat/eggs/bacon/chicken skin had to be broken down as well as her understanding of what makes one overweight.
We spent some time on the awfulness of vegetable oils and their effect on the omega-6-to-3 ratio, specifically how they have led to a western diet ratio of 40:1, meaning chronic inflammation and a sure-fire way to cancer. We discussed the ideal 4:1 (in modern times) ratio and why the Paleo diet is the best way to achieve it (grass-fed meat, wild-caught fish, no vegetables oils). The health benefits of monounsaturated fats (nuts, avocado, olive oil) required discussion as she had to be convinced to eat these almost liberally.
She started drinking 2L of water per day as well as a juice made from green superfoods every morning (wheat grass, hemp powder, moringa leaf, spirulina and honey – available as a powder, just add water and honey). The green juice was used to enhance alkalinity, another hallmark of the Paleo diet (created by vast vegetable consumption) and its disease prevention. We live in South Africa so used this one; I’m sure you have something similar where ever you are in the world.
Refined carbohydrates were aggressively cut except for a pasta once or twice a week. Like the milo and sugary tea, this was a place of solace and needed to stay in her diet while she broke down other barriers. This was however the only form of rich-carbohydrate that remained in her diet. No roots or tubers were eaten either.
For the fibre argument I made her understand that grains and legumes, while containing fibre, are a poor source of nutrition due to the antinutrient properties provided by phytic acid, amongst others which bind to the vitamins and minerals, preventing their absorption in the body. This leaves you undernourished per consumption (something vegetarians should be aware of).
Vegetables provide the same or greater amount of fibre for the body, without any of the antinutrient or insulin spiking effects and so are far superior.
As far as glycemic index (GI) goes, I explained that what’s more important is actually the glycemic load which takes the GI value and multiplies it by the amount of carbohydrate contained in that food. The GI of a food defines how quickly it will be turned to glucose in the blood. A low GI value means it will be converted slowly while a high GI value means rapid conversion. Whether its converted slowly or quickly, ultimately, it will still end up as glucose which raises insulin levels, driving fat storage. Thus what’s more important is how much carbohydrate will be turned into glucose and hence understanding the glycemic load for a specific food is more valuable. Vegetables have a low GI value AND contain a small amount of carbohydrate, thus their GI load is low, meaning a smaller amount of glucose in the system. Conversely whole-wheat bread/bran cereal, which is often sold under the premise of being low GI, contains a large amount of carbohydrate, thus has a high GI load meaning more glucose, insulin and fat storage.
Debbie’s meals weren’t balanced throughout the day as her work and life allowed little time for preparation, so we started creating Paleo meals in bulk. We prepared one-pot type dishes which were used for dinner and a number of lunches throughout the week. Things like beef stew with a bunch of veggies, herbs and spices were made and divided up so that she wouldn’t have to think about what to make. We also made large salads on the weekend which could be divided up for each day. This made things simple, enforced routine and empowered her control of the disease through cooking, meal planning and shopping for ingredients.
To summarise her daily meal plan: Breakfast was eggs, spinach and some avo, lunch was leftover stew or chicken/tuna salads and dinner was more stew or chicken/beef/pork with a bunch of steamed veggies (usually broccoli and cauliflower) with avocado oil and/or butter thrown over. It was repetitive but by doing this we replaced the negative psychological rituals with more positive ones. As things began to improve, she gained confidence in the process which in turn positively reinforced the ritual. It’s a constructive self-fulfilling prophecy which allowed her to grow confidence in her ability to look after herself, something the bulimia had robbed her of for many years.
For snacks she had almonds, goji berries, pumpkin and flax seeds mixed together which she would nibble on throughout the day.
In addition to the diet, she started journaling and painting as a means of expressing emotions and separating from her thoughts.
I also gave her some self-development books, specifically The Power of Now by Eckhart Tolle which speaks of living in the present moment and practicing acceptance/non-resistance to what life throws at us, a life-changing concept for those who are open to it. She also did a course on improving one’s self-esteem (not affiliated). Ignore all the salesy speak, its a great course, I’ve done it too and it was life changing.
The Role of Counselling and Medication
I do not want to paint a picture which implies diet alone can aid or cure this condition. A support system is crucial to overcome over this disease and ideally this extends beyond just family and close friends to include both a psychologist and a psychiatrist.
In Debbie’s case she changed psychologist to someone who better resonated with her, while simultaneously changing her medication to something more appropriate via psychiatric counselling.
Counselling is absolutely critical! In all likelihood, the bulimic person has a lifetime of extremely complex rules, self-esteem issues and negative self and world belief systems which need to be broken down and rewired. To do this takes the skill of a psychologist, don’t pretend otherwise.
Psychological treatment is designed to:
- Start the process of reversing weight loss (if anorexic).
- Work towards normalisation of an eating pattern.
- Initiate a process in stabilisation of weight.
- Develop a healthier relationship with food and self.
- Develop a healthy and adaptive coping mechanism.
Psychiatry and medication may or may not be required, this depends on the specific situation and the psychologist or eating disorder clinic will be the one to advise if/when this is necessary.
The most important type of support a person with an eating disorder requires is a non-critical, non-judgemental friend/family member/counsellor who will provide a constant source of optimism with an “ok it didn’t’ go so well today, let’s try again tomorrow” attitude. At the same time, this person needs to have the conviction and courage to stand their ground when challenged because challenge will come and believe me when I tell you, a person with an eating disorder can be very convincing in their logic and ability to manipulate. If you are that support person, then you also need to realise you are in it for the long-haul. Even after the bulimia has ended, the need for care, love, conversation and reiteration of crucial realisations is always required.
Like alcoholism, bulimia is a lifelong disease which requires on-going support and patience from those watching from the outside.
Where Things Stand
Although Debbie intellectually understands the carbohydrate-insulin hypothesis and why fat and meat is good for you, she still battles with eating them. This may continue for years to come but with each month of increasingly great-health and confidence in the process, her attachment to the idea of bad-dangerous-unhealthy fat subsides. Her desire to purge has decreased enormously and it has been 7 full months since the last one.
She can now express a love of food without expecting rejection and for the first time in her life, can comment on what she likes and dislikes. She is able to eat meals in public without needing to apply many of her previous rules. She now listens to her body for signs of fullness or hunger and using this mechanism, she is beginning to understand why portion control isn’t required when going Paleo. In doing this, she is breaking down her complex rules, checks and balances and slowly, her points system is fading away.
Purging used to give her a sense of empowerment, now for the first time in her life, the ability to not to purge is creating that same sense of empowerment.
By the simple nature of what can be eaten when Paleo, her trigger foods (pasta) are no longer included in her diet. Most importantly, as her body has adapted to fat metabolism, the desire to eat pasta has decreased massively, making a binge and purge situation more unlikely to occur. Her stabilised energy levels means she no longer feels the need to purge in order to sleep and because Paleo isn’t actually a diet, she doesn’t feel deprived of anything.
Psychologically, she finally feels she can act as thin people do, or perhaps better phrased, she has given herself permission to live like thin people do.
Due to the satiety of protein and fat, she feels fuller for longer, which makes her mind less likely to reach for a carbohydrate-rich, purge-triggering meal. Sometimes she is unable to resist the urge to control portion sizes but as a large chunk of each meal contains leafy and non-starchy vegetables, she finds this easier on her mind when the points system monster rears its ugly head.
Recently, and for the first time in a decade, she was able to go to the beach, take off her shirt and tan, just like everyone else. We did this twice.
Her focus is on optimising energy levels and health and for the time being, this is her only goal.
Through psychology, her pathological self-critic which she calls “the mafia” is being broken-down and her self-esteem increased. Through medication, her impulse control has improved, creating less need to self-attack using food.
There is still a long way to go but our next steps are as follows:
- Up the ante with the Paleo diet by adopting it fully, i.e. removal of all sugar, grains and legumes (still not dairy as the attachment is too strong). By better controlling the amount of carbohydrates she is eating, we aim to get her body into a state of Ketosis (20 – 50g carbohydrate per day) for a period of time to encourage weight-loss. This will support her slowly-increasing confidence levels tremendously.
- Start a regular home-based CrossFit style training regime as well as swimming and interval-based walking and running.
- Continued weekly therapy sessions with her psychologist to further break-down and resolve self-esteem issues.
- Continued bi-monthly sessions with her psychiatrist to evaluate the efficacy of her medication.
I would like to thank Debbie for having the courage to share her story. Our hope is that it may help someone out there battling bulimia. Her bravery and tenacity to overcome this disease has been inspirational to me and I hope to those reading this as well.
I would like to ask that you kindly share this post. You never know who in your circle may be battling bulimia or another eating disorder. This article may give them inspiration, a desire to act or a change in mindset which could save their life.
I leave you with this quote from Debbie’s journal during her time in the clinic.
“Wars don’t last forever, people change and I will continue to be brave. The greatest challenge in life is being yourself in a world trying to make you someone else.”
Do you have any advice for eating disorder sufferers or have you battled and overcome it yourself? Please leave a comment below, we’d love to know your thoughts.
*While the person in question has asked that I share her story, she also requested that her identity remain secret, thus I have called her Debbie.
Image by lauralewis23