1. Eating disorders are not a beautiful disease, and those who suffer from them are in great pain. Eating disorders are often accompanied by other mental disorders and physical illnesses, and are minor in psychiatry, but are one of the most lethal of the mental disorders, with a mortality rate of 5-15%.
2. Anorexia nervosa and bulimia nervosa are both curable, with cure rates of more than half. The Shanghai Mental Health Center, the Sixth Hospital of Peking University, and the Seventh People's Hospital of Dalian have successively set up specialized wards dedicated to eating disorders. If you find that someone close to you has symptoms of eating disorders, you must seek medical attention as soon as possible. The earlier the treatment, the easier the recovery.
A whole roast chicken, a hamburger, a chicken roll, a packet of French fries, two cups of 400 ml of Coke, watching cartoons while swallowing these, Lin Tingting felt that she got a long-lost sense of fulfillment, which is "the happiest and most pure moment". Soon, guilt crowded out satisfaction, and a voice in her heart reminded her, "Lin Tingting, you're going to get fat again!"
She rushed into the restroom, squatted next to the commode, lowered her head, and poked her index finger into her throat. A wave of nausea hit her, and the food she had just eaten poured out of her throat, "like opening a floodgate." Until the vomit became transparent, Lin Tingting knew that she would no longer feel guilty, because the food she had just eaten had been removed.
Lin Tingting is a bulimia nervosa patient. In medicine, bulimia nervosa is a type of eating disorder. Eating disorders are psychiatric disorders. Its related disorders also include anorexia nervosa and other specific eating disorders. Data from Western epidemiologic studies indicate that the prevalence of eating disorders is about 0.5% to 1%. This means that one in every one hundred to two hundred people has an eating disorder.
In China, there are no exact statistics for people with eating disorders, but it is a large and secretive group. They are unable to properly deal with the physical and mental pain caused by food, and are ashamed to confide in their family and friends, so they can only look for their friends on social networks to keep them warm. The "bulimia bar", "vomiting bar", similar theme of the QQ group, are the gathering place of these patients.
Jue Chen, director of the Psychosomatic Ward of the Clinical Psychology Section of the Shanghai Mental Health Center and head of the Eating Disorder Diagnosis and Treatment Center, said that eating disorders are often accompanied by other psychiatric disorders and physical illnesses, and that its dangers have long been ignored by the public. "Eating disorders are small in psychiatry, but they are one of the most lethal of mental disorders, with a mortality rate as high as 5-15 percent."
Mirrors, scales and calories
"Oh my God, why am I so fat!" When she was 17, Hubei girl Lin Tingting unintentionally caught a glimpse of herself in a fitting mirror at a shopping mall and was "shocked by herself."
The girl in the mirror was 170 centimeters tall and weighed 200 pounds. Double chin, elephant legs and strong arms, all make Lin Tingting feel disgusted.
Since then, the girl's image has been abstracted into a short-haired, bloated cartoon girl that appears repeatedly in Lin Tingting's diary. In the margins of the pages, Lin Tingting wrote "tiger back and waist" and "big pie face", plus a few big exclamation marks.
Lin Tingting is determined to lose weight in her diary.
Because of her size, Lin Tingting has not liked herself since she was a child. In junior high school, some students gave her nicknames and called her fat, she not only did not get angry, but also smiled at others, when no one, and then turned her head to wipe tears. She slowly became inferior. Elementary school in the sixth grade that year, she liked a boy, to the second year of high school also did not dare to confess.
"Fat people have no happiness to speak of." In her diary, Lin Tingting admonished herself.
At 17, she decided to change.
She began to lose weight by dieting and over-exercising. Life was quantified into a series of numbers: she was only allowed to consume 1,700 calories a day, which was the minimum amount of calories she needed for her daily needs based on her height and weight, meaning that she could only eat a bowl of noodles, a bite of rice, a bite of vegetables, and an apple for her three meals; she jumped rope for 2,000 and did 200 sit-ups after her evening study sessions; and she used a tape measure every day to measure her chest circumference, hip circumference, thigh circumference and arm circumference
These figures are plotted as a line graph every month.
Every meal time, Lin Tingting sat at the table, set in front of the rice, apple and bun, quickly converted into calories in the brain: 210 calories, 83 calories and 227 calories. Then, casually pick up a few mouthfuls.
Six months later, she was surprised to see the line graph trend all the way down. The scale told her she had lost 60 pounds. She took out her old pants, two legs can actually be tucked into a pantyhose, "heart with fireworks!"
Lin Tingting felt that after getting thinner, life seemed to go into some kind of peak across the board - the whole sophomore class circulated stories of her weight loss success, and girls came to her for advice. Even the boys who nicknamed her in junior high school were not shy about praising her at the reunion, "Lin Tingting, you're so beautiful!"
She didn't realize that Pandora's Box had been quietly opened.
One day in her senior year, Lin Tingting was struck by hunger. She retaliated by finishing a large pot of rib soup and two bowls of rice. Soon, physical satisfaction and psychological guilt began to tear her apart. Nearly instinctively, she thought of a way to get rid of them - spit them out, spit them out and you won't gain weight.
The rest of her life seemed to enter a revolving door formed by overeating and hyperventilating, "the feeling was like an addiction attack". Lin Tingting, while overeating and hyperventilating, admonished herself in her diary, "You can't do this, you'll die."
In the bathroom of the dormitory to vomit, Lin Tingting put the music in the phone to the loudest, so as to avoid roommates to hear the sound of her vomiting. The winter of the highest frequency of overeating vomiting, her right index finger joints because of picking vomiting by the teeth rubbed out wounds. A student asked, she rushed to cover up, "This is frostbite."
Because of the long-term vomiting, Lin Tingting's right index finger and middle finger joints left scars.
After going to college in Wuhan, Lin Tingting realized that she had a kindred spirit. In her sophomore year, she saw a group of people called "rabbits" on the blog page of the King of Appetizers.
These patients with bulimia nervosa called themselves "rabbits". The "rabbit" is the harmonic of "vomit", which implies weakness and timidity. They are extremely afraid of being fat, and their self-evaluation system is based entirely on body size and weight changes. They overeat late at night, when they are alone, anxious and depressed, and then, driven by guilt, they try to use diuretics, laxatives and vomiting to get rid of the food they have eaten.
These "rabbits" gathered in Baidu posting bars and QQ groups are mostly young girls, who share their dark and secretive side with strangers - giving themselves the avatar of "not losing ten pounds, not changing their avatar". The first thing you need to do is to get a good look at the way you're going to be able to get a good look at the way you're going to be able to do it.
Every day at 12:00 pm and around 8:00 pm, the "rabbits" concentrate on the time of activity. The rabbits are active at 12:00pm and 8:00pm every day, when people have just finished eating. The "rabbits" are also, but their life has an additional process - vomiting, they have to just eat the food through a variety of ways to spit out, by hand or directly into the stomach of the plastic tube.
In the QQ group, the "rabbits" call vomiting "raw" and eating "sinking". In their context, the word "vomit" does not appear, will be slightly better.
Li Yuwei is one of the group's group leader, she was born in 1994, the financial industry's enormous work pressure makes her suffer from bulimia nervosa. She said that every time someone adds a group, she feels particularly lost - there is another person in the world in "this great pain".
The girls in the group have not, and do not intend to, go to hospital. They felt "dark and ugly". Li Yuwei's thoughts pretty much represent the majority, "Binge eating and hyperventilating is an incredible and incomprehensible thing to do".
"The behaviors of overeating and hyperventilating after eating are essentially inappropriate processing of emotions." Han Xu, a psychotherapist who has participated in the Red Cross China Eating Disorder Relief Program, said that many people with eating disorders share the same **** of perfectionism and low self-esteem, and they are good at not being able to detect and express their emotions.
Most sufferers believe that eating disorders are fueled by socio-cultural values of "thinness is beautiful". Many of them have grown up with family and societal pressures about body image.
Young girls like Lin Tingting, despite recognizing the dangers of overeating and vomiting, still believe that thinness is the standard of beauty.
Parents also share this view. A mother said about her daughter's dieting behavior, dieting behavior itself is not wrong, only excessive to cause neurotic bulimia. "Isn't weight loss a career that women pursue for the rest of their lives?"
Studies show that the high incidence of bulimia nervosa is between 12 and 35 years old, with an average age of onset of 18 years old and a male-to-female ratio of 1:13. Female high school and college students like Tina Lin are at high risk for eating disorders.
Is fat or thin more valuable than life?
No one knows what the source of Lin Tingting-style suffering is. The medical community is also trying to find out, but it's inconclusive, says Jue Chen. Like all mental illnesses, eating disorders are multifactorial disorders.
"The genetic basis, the life events and personality basis, the social environment, and the family environment **** all play a role together, the 'biopsychosocial ' model." Jue Chen added that "sociocultural" factors, such as the social value of "thinness as beauty," play an important role in eating disorders.
January 2017 was one of the coldest winters in Lin Tingting's memory. She confessed her bisexuality to her mother, who couldn't accept it, and mother and daughter fell into a cold war.
It was the Chinese New Year, and the family table was filled with big fish and meat. Lin Tingting frantically enjoys the food and then rushes into the bathroom to vomit it all out. This is the worst time for her condition, which has changed from overeating and hyperventilating once a month to overeating and hyperventilating three times a day.
At night, she stayed alone in her room, thinking about the meaning of life. How can't think about it. Then keep your eyes open. Wake up all night. A few days later, she was diagnosed with anorexia nervosa and depression by a general hospital in Wuhan.
In fact, Lin Tingting is not an isolated case. Foreign scholars have found that patients with bulimia nervosa like her suffer from depression and anxiety disorders at the same time in more than 50 percent of these patients may also *** disease substance abuse, impulsive / risk-taking behavior and borderline personality disorder traits.
He Yi was an eating disorder patient with a 7-year history of bulimia nervosa. When the bulimic hyperemesis continued for the fourth or fifth year, she saw blood in her vomit. Survival instincts made her start to help herself - reading medical specialized books and seeking help from medical institutions. But it was a little too late. Frequent emesis had given her body a morbid reaction.
Every late night, He Yi was always hit by a feeling of nausea. It was too late to go to the restroom, so she could only poke her head out of the bed and vomit the reflux of acid on the floor. Only after a few rounds of vomiting would the reflux stop and the nausea slowly fade away. It was one of the few moments of despair in her life, "I was lying alone in the dark, silently weeping, worrying if I would never get better."
Her teeth were also corroded by stomach acid. Four molars were so badly decayed that it hurt to eat food that was too cold or too acidic. Every time she went to the dentist, the dentist urged her to eat less sugar. She could only smile bitterly and say, "Good."
"Some patients vomit repeatedly, which, in addition to causing dental problems and enlarged glands, can cause serum electrolyte disorders, triggering cardiac arrhythmia, which can be life-threatening." Jue Chen explained. Patients with eating disorders have been reported to die from cardiac arrest, kidney failure, or other somatic complications.
Even in their most desperate moments, neither Lin Tingting nor He Yi thought to ask their parents for help. "They wouldn't understand."
Eating disorders form a boundary between children and their parents. Few parents can break it.
Lin Tingting's mother is still unaware of her daughter's binge eating and hyperventilating behavior. Compared to bulimia nervosa, Lin Tingting's mom thinks depression is more of a concern. He Yi took the initiative to confess the tormenting experience to her parents only after her condition stabilized.
As psychotherapist Han Xu remembers it, even when parents bring their children to see an eating disorder specialist, they often fall into a circle of blaming each other. Parents always think that the child is just too much, if not, would have been better; the child and feel that she had this disease, and the way the parents treated her as a child, the parents words out of place that the child is fat, the child will have an inferiority complex, try to lose weight.
Chen Yu said, many patients do not realize that eating disorders are a psychiatric problem to deal with. In the diagnosis and treatment, many parents feel that can not eat is a gastrointestinal problem, to see the gastroenterology; amenorrhea is an endocrine problem, to see the Chinese medicine or endocrinology. Many times, the condition is delayed.
Even professional doctors have not been able to get out of the cognitive blind spot. Li Miao is an eating disorder patient with a nine-year history of bulimia nervosa. She had read in textbooks that her symptoms met the diagnostic criteria for bulimia nervosa, but wasn't sure. one day in 2015, when she finally worked up the courage to walk into a local psychiatric hospital, the doctor told her that it wasn't a disease and didn't need treatment. Due to the lack of timely treatment, Li Miao's eating disorder became more and more serious.
Han Xu has encountered an extreme case. The day before, a girl was on a network medical platform to consult the eating disorder to be treated, the next day to see the parents of the message that the child has passed away. Han Xu said, every time I see such news is very sad.
Similar tragedies have been repeated too many times. In Baidu's "Bulimia Bar", which has more than 23,000 users, many patients know the story of a mother and daughter.
The daughter died of excessive weight loss, and in the two years after she graduated from college, she failed her graduate school and national exams one after another, so she had to pin her hopes for life on controlling her body, and in the end, even her most trusted body betrayed her. In the last hours of her life, she wrote: "Gastric ulcer, secondary amenorrhea, esophageal reverse reflux, I don't know how many other problems, maybe one day, this body that I tortured will be like an aging machine that never runs again ......"
In the In the same posting, the grieving mother wrote a post, "Since the moment you left me and closed my eyes, my heart is broken. Children, you are not fat just slightly plump, but you do not know which high people listen to the misguided fall into the weight loss wand (palm), the three years this wand (palm) in charge of your fate, drained your blood and control of your soul until the end of the oil. Is fat and thin more valuable than life? I hate myself for not being able to find out your secret earlier, the result can not be reversed, mom wants to cry without tears."
The sooner you come for treatment, the easier it is to recover
Eating disorders are not without hope of cure.
Jue Chen said that both anorexia nervosa and bulimia nervosa are curable. In the case of anorexia nervosa, for example, data show that 45% of patients can be cured, 30% have a moderate prognosis, 25% have a poor prognosis, and the mortality rate is 5-15%. But at least nearly half of all patients are curable. Similarly, the cure rate for bulimia is more than half.
Support from medical resources in related fields has been increasing over the years. The Shanghai Mental Health Center, the Sixth Hospital of Peking University, and the Seventh People's Hospital in Dalian have set up specialized wards dedicated to eating disorders one after another.
" Social support is very important for recovery." After experiencing eating disorders, He Yi quit her job in Beijing and went to the United States in 2016 to study for a master's degree in clinical social work, where she expects to become a professional psychologist.
Revisiting the past seven-plus years, she realized how ridiculous her mindset was at the time.
"I would attribute the fact that the boys I liked didn't like me because I was too fat, ignoring the fact that men and women looking at each other at the same time is a small probability event in itself; I would attribute the fact that I didn't get promoted soon after joining the workforce to the fact that I had a bad appearance without thinking about other reasons." He Yi analyzed, "Overeating, vomiting and these behaviors then unconsciously became tools to help me escape from the pain in my life, because it was too difficult to face many problems in life, and 'getting thinner' became a concrete and actionable task."
Lin Tingting, like He Yi in the past, is still in the mindset that "being thin will solve all the pain".
One day, she felt too sad. Sent a tweet to her mom, "Mom, you have lived such a long life, have you ever felt a dark day?"
"Yes, there are, the days when you are sick." Mom back.
That night, Lin Tingting stared at her cell phone screen and bawled.
"If I accept myself one day, I probably won't overeat and hyperventilate." She had known the crux of her problem for a long time, and she wanted to try to start accepting her imperfect self.
The next day she woke up and dutifully took the Prozac and Tourette's her doctor had prescribed.
"The sooner you come to treatment, the easier it is to recover." Jue Chen said the hardest step for many people with eating disorders is to resolve to get treatment.
(To protect patient privacy, Lin Tingting, Li Yuwei, He Yi, and Li Miao are pseudonyms in the article.)
Writer/Zhang Wei Ma Xiaolong
Editor/Hu Jie
Come to talk and play with Onion~?
You want to ask how it feels, the following is the description of a bulimia patient who came to me for counseling:
1, Feeling that you are not a normal person , even the most basic so-called eating will not be. Either you starve yourself to death, or you have to hold out once you eat, hold out to 20 points, and then spit out 15 points.
2, feel lonely: countless times a person walking on the campus of the road, a person walking on the road after work, looking at the normal people passing by, they have people holding hands, some people say effective, feel they are far away from their own far away, the world is only left with themselves and food. Behaviorally, others are normal people, only their own such loneliness; psychologically, only their own death to keep this untold secret loneliness.
3, feeling divided and ironic: every time and boyfriend from the gym Qingmei finished, after the separation, I want to be a billion thieves, fleeing hurriedly rushed to the dessert store, the last second is still in the intimate lips of the boyfriend, this moment: greedy shame, mechanical stuffed into the food, inhumane chewing, unable to restrain the desire to repeat again and again.
4, feel the loss of human dignity: and boyfriend travel, bought to bring teachers and students of the specialties, overeating on the head of a one-time a person eight boxes of durian cake swept away, while he went out, the bag did not dare to throw in the hotel, the original seal back to the exquisite box to go, as if a thief as if the theft; bought food, while on the road, while eating; a person to point out a table of food without regard to the eyes of the next person! Can't wait to stuff food like a starving man; in the dormitory to steal the roommate's snacks to eat ~ feel yourself
5, feel surrounded by low self-esteem and self-doubt all day long, there is no more happiness: If someone praises me for looking good, I will feel that this person is a king of liars, serious lack of self-confidence, low self-esteem and depression, feel that I am a pile of garbage, all the people like me are fake, they are attracted to my fake shells, and they all They are all hypocrites. And then look at those good looking girls on the road, thin and white and with a great boyfriend who really loves her, it feels like the world is unfair.
Bulimia is seriously corrupting the inner world of countless people,
I am a bulimia healing Wenqi, 17 years of bulimia, recovered and focus on bulimia healing counselor.
If an eating disorder is present, that person's body should be in trouble.
In fact, it is a combination of anorexia or bulimia, the psychological level of the strict requirements of the body, weight loss addiction. Or only rely on food psychological comfort people, gluttony addiction, binge eating after and to offset inappropriate ways, such as induced vomiting, abuse of diuretics or laxatives, dieting or excessive exercise.
This is particularly prone to endocrine disruption, eating behavior is abnormal, the psychological level is also problematic, generally not many people are willing to directly admit that they have a disease, will not be arbitrarily taken out to say it. In some cases, the disease must listen to the doctor's diagnosis, not once or twice this performance is said to be is.
For patients with eating disorders who meet the criteria for hospitalization, the mortality rate is about 12%; in patients diagnosed with severe malnutrition, the mortality rate is 15-20%; for anorexia nervosa alone, the mortality rate also reaches 0.56%, which is more than 12 times higher than the mortality rate for young women in the general population. About half of patients with anorexia nervosa are cured, about 30% have partial clinical remission, and 20% show no symptomatic improvement.