<p>I’m a dedicated viewer of A&E’s Intervention, and there’s one episode I absolutely cannot get my head around. The addict in question is a ~20 year old bulimic and is very fit, toned, etc. Her binges are far from boarderline (6,000+ calories in three hours, eating 6 weeks worth of food for 70 girls in three months), yet she remained incredibly fit and thin (in fact, she worked as a stripper to have hundreds of dollars to spend on food). My understanding of bulimics were that they tended to be a normal weight or even slightly pudgy on account of the fact that some of food calories would still be digested regardless of the purging, but this girl seemed to disprove that. Anyone have any insight on how this is physiologically possible? It’s been gnawing it me since I saw the episode.</p>
<p>Well, very few nutrients are absorbed in the stomach – most nutrient absorption occurs in the small intestine. So if she is purging very soon after she eats, it would be possible for very little of the food to actually get into her system.</p>
<p>Mollie is correct in that most of the nutrients will not be absorbed if she is purging very quickly after the binges. Recent studies have shown that female bulimics retain about 1200 calories, regardless of how much is consumed. </p>
<p>It also is not particularly uncommon for an individual to experience both bulimia and anorexia. Its possible that the woman in question is eating much lower than her caloric demands most of the time. The massive binges also support this hypothesis; as binges are often a natural response to food deprivation. </p>
<p>If the woman is binging once a week (this is included in part of the criteria for diagnosis of bulimia nervosa) and rarely eating at other times, it is quite possible that she is operating on a severe caloric deficit and likely will lose weight rapidly. Of course, this weight loss will come from a variety of sources (bone, muscle, fat, etc.) and will likely have negative effects on both her physical and emotional health.</p>
<p>Well, Jessie was most certainly not co-morbid anoxeric/bulmic, at least from what we saw–she seemed to live for food. Her family kicked her out of the house because they couldn’t afford to feed her; she ate industrial-size bottles of ketchup in a matter of days, etc. It was truly bizarre, and it was also quite interesting that no one (including her) ever mentioned her weight, just how much she was addicted to food (she said something along the lines of “I’m never not hungry”). Also, when anoxerics talk about “binging,” they usually aren’t talking about what we would consider binging but about eating 500-1,000 calories, which would be binging if one was restricting/fasting.</p>
<p>To my knowledge, she wasn’t doing any drugs or exercising all that much, and yes, she was fit and rather toned.</p>
<p>And yes, do not get any ideas from this. Jessie was miserable. She dropped out of college because she skipped class to binge and purge. She destroyed all the relationships she had with her family. She stripped to finance her habit. She never had any money because she spent it all on food. She probably did God-knows-what in terms of physical damage to her body. She hated herself. She didn’t even seem to enjoy the food she lived for at all.</p>
<p>(BTW, she did accept treatment and has been binge/purgew free for a while now [a year maybe two], re-enrolled in college, and seems to be doing quite well for herself. I wish her all the luck in the world).</p>