fade away and radiate (bitchorexic) wrote in ed_ucate,
fade away and radiate

Would restricting qualify as a "compensatory behavior" even though it's not specifically listed?

Some of you may find this too long, too self-indulgent, and too personal, but I think it's interesting.

I've been considering my diagnosis a lot lately. Note that I've never been diagnosed by a doctor, but I like to think that I possess the mental muscle to diagnose myself. ;)

Originally I always thought of myself as both ednos and NES. I don't know if that's a technically possible combination. I don't see why not, but I'm not a doctor so I don't know for sure. Anyway, I thought that because I had all the mental criteria for ednos down, I restricted, and I didn't meet the physical criteria for anorexia. I also fit every single criterion for NES. So there you have it.

Anyway, the thing with NES is that you're not binge eating, but rather you're eating continually throughout the evening. I used to be like that; I would just eat basically nonstop from dinner to bedtime, but I generally didn't eat to the point of being really uncomfortably full. I would nibble or have a bowl of this and some of that or whatever. However, here recently, my behavior pattern has changed from just eating a lot at night to actual, condensed time period binges. So I thought perhaps a more proper diagnosis for me would be BED/COE. However, looking at the criteria, the important thing about BED/COE is that it doesn't involve "inappropriate compensatory behaviors," which are defined in the bulimia criteria as "self-induced vomiting, use of laxatives, diuretics or other medications, fasting or excessive exercise." It also doesn't list "Self evaluation is unduly influenced by body shape and weight."

Well, I do evaluate my self-worth pretty much solely on the basis of my body. I also compensate for my binges. So, I couldn't have BED/COE. When it comes to purging, I use laxatives, although I have made myself vomit a few times. I also compensate by not allowing myself to eat or by allowing myself to eat very little the next day, which of course then leads to a binge that night and the cycle continues. The problem is, though, that restricting is not specifically listed as a compensatory behavior. However, I don't see why it wouldn't be, because I restrict in order to make up for my binges so that I don't gain weight, therefore making it a compensatory reaction.

Which brings me to what is basically the point of this post. I feel like I'm "more than just ednos," if you know what I mean. I don't mean that in the sense that I don't think ednos is a real disease, because I do. I mean it in the sense that I feel my behaviors go beyond the "bounds" of ednos.

I am beginning to think that perhaps the most appropriate diagnosis for me is actually bulimia, and the reason I say that is because of the aforementioned shift of the "focus" of my disorder from ednos/NES behaviors to hardcore binges and purging or "compensatory" behaviors.

I know everybody knows the criteria, but allow me the satisfaction of posting them anew:

Bulimia nervosa

Recurrent episodes of binge eating.

An episode of binge eating is characterised by both of the following:
Eating in a discrete period of time (e.g. any 2 hour period), an amount of food that is definitely larger than most people would eat during a similar period of time in similar circumstances;

A sense of lack of control over eating during the episode (e.g. a feeling that one cannot stop eating or control what or how much one is eating)

Recurrent inappropriate compensatory behaviour in order to prevent weight gain such as: self-induced vomiting, use of laxatives, diuretics or other medications, fasting or excessive exercise.

A minimum average of two binge eating and inappropriate compensatory behaviours per week for at least three months.

Self evaluation is unduly influenced by body shape and weight.

I basically fit all of those criteria. I binge, and I have been for definitely more than three months, and I usually binge at least two or three times per week. So, like I said earlier, the problem lies with the compensatory behavior. Yes, I use laxatives, and I have been since some point this summer, but I don't remember exactly when I started, so I don't know if I fit the "three month" criterion. However, I know that I have been restricting in order to compensate for binges since God knows when. It feels like forever. So that would definitely fit the "three-month" part. (Another compensatory behavior I have is the tendency to pop tons of pills afterwards, like ridiculous amounts of chromium tablets and the like, even though I know it's a waste of time. Although they aren't medications per se, I kind of feel like they could be considered as such.)

So I guess what I'm saying is that the only thing holding me back from a bulimia diagnosis is whether or not restricting is considered an inappropriate compensatory behavior. I'm wary of calling myself bulimic since restricting is not specifically listed, but I really don't see why it's not being expressly stated would not make it compensatory. I feel "compensatory" is kind of subjective; different people do different things to compensate, so there is probably no way the criteria could list every single thing that every person has ever done.

I don't know!

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