Bulimia


 * IBIS:**

Definition:
An eating disorder characterized by perverted ideas towards food and eating, obsession with thinness and a morbid fear of weight gain. Also characterized by the repetitive, compulsive habit of eating a normal or excessive amount of food only to self-induce vomiting and/or use laxatives in an effort to purge what has been ingested. The patients generally know that their behavior is abnormal, yet have a great fear that they cannot control the binging: when they are finally done eating, they feel markedly depressed and guilty. Low self-esteem may follow: with a negative view of themselves and their bodies: setting into play the next cycle of binging/purging.

Etiology:
Eating disorders such as bulimia and anorexia nervosa (to which bulimia is closely related) are on the increase in western society: it is estimated that 18-25% of college women have one or both of these problems. The typical patient is white and female (males account for only 5% of patients), and come from a middle or upper class family. Bulimia is rare in lower socioeconomic persons and in Blacks and Orientals.

Binge eating generally occurs daily, with one study showing that in 40 bulimic patients the mean times of binging per week was 12 (with a range from 1 to 46). The eating period usually lasted 1.2 hours, though could go on for as long as 8 hours. Caloric consumption could be extremely high: up to 50,000: though the average amount of calories ingested was 3,500. The five most favorite food items eaten were ice cream, bread, candy, donuts, and soft drinks. Patients are often ashamed and embarrassed about their eating and purging habits and live a life of secrecy, to the extent that friends and family are unaware of the patient's problems.

The cause is unknown. Factors that may be responsible for the condition include a hypothalamic problem, psychiatric disorders such as depression, peer pressure, nutritional deficiencies, and cultural and/or familial attitudes about the body. Binge-purge patients have a higher incidence of dysfunctional families than in the general population, notably families with affective disorders, alcoholism, and recreational drug use.

May be related to hypoglycemia where sympathetic compensation is interfering with gall bladder function. (Easley)

Somatic Therapies:
• qigong • tai qi chuan

Nutrition:
therapeutic foods: • increase foods that calm the Shen (Spirit), tonify the Heart, harmonize the Stomach and Spleen • Descending foods: persimmons, cloves, potatoes, prune, plum tea, oyster shell tea (Ni, p. 102)

Botanicals
consider: sedatives • Avena sativa • Chamomilla spp. • Humulus lupulus • Nepeta cataria • Passiflora incarnata • Scutellaria lateriflora

Chinese Formulae
• Hoelen Five Herb F. (Wu Ling San): Water Stagnation: anxiety (Hsu, 1980, p. 516; Yeung, p. 244; Dharmananda, 1986, p. 173; Bensky and Barolet, p. 174, Flaws, 1985, p. 138) • Cinnamon and Ginseng C. (Gui Zhi Ren Shen Tang): Spleen Yang Xu (Deficiency): (Hsu, 1980, p. 306, Flaws, 1985, p. 138; Bensky and Barolet, p. 221) • Pinellia and Magnolia C. (Ban Xia Hou Po Tang): Liver Qi Stagnation: plum-pit Qi, neurosis, vomiting, depression (Hsu, 1980, p. 395; Yeung, p. 42; Dharmananda, 1986, p. 226; Bensky and Barolet, p. 291) • Ginseng Nutritive C. (Ren Shen Yang Ying Tang): Xue Xu (Blood Deficiency) with Qi Xu (Deficiency) and Shen Disturbance: forgetfulness, reduced appetite, fatigue, weight loss (Hsu, 1980, p. 239; Yeung, p. 182; Dharmananda, 1986, p. 407; Bensky and Barolet, p. 260) • Fu-shen 16 (patent): Shen Disturbance (Dharmananda, 1990, p.68 )

Acupuncture
after assessing the person and palpating, consider these patterns: Shen Disturbance; Spleen Qi Xu (Deficiency); Stagnant Liver Qi; Liver Invading Spleen; Cold and Yang Xu (Deficient) Spleen; Cold and Yang Xu (Deficient) Kidney; Stomach Fire; Shi (Excess) of the Du Mai (Governing Vessel)

» illustrative combinations: • Ht-7 and Sp-6 to treat bulimia associated with Shen Disturbance, Spleen Qi Xu (Deficiency), and/or Stagnant Liver Qi (Eisen) • UB-18 (-); UB-20 (+), Lv-3 and Sp-6 to treat bulimia associated with Liver Invading Spleen (Eisen) • consider treatment for "Internal Dragons" or "External Dragons"; External Dragons: GV-20, UB-11, UB-23, UB-61; Internal Dragons: Master point 1/4" below CV-15, St-25, St-32, St-41; In both treatments, sedate first. If the person and the pulses change, fine. If no change with sedation, then tonify. (Worsley) • UB-20 (+ and ind. D), UB-23 (+ and ind. D), PC-6, Sp-4 and Kd-2 to treat bulimia associated with Cold and Yang Xu (Deficient) Spleen and/or Kidney (Eisen) • SI-3 and UB-62 open the Du Mai (Governing Vessel) for which Shen disorders are a symptom of Shi (Excess)

Homeopathy
• Aurum metallicum: appetite and thirst increased; digestion difficult often finishing with a lot of belching and vomiting • Iodium: alternating bulimia/anorexia • Kali phosphoricum: feeling of the epigastric emptiness, depression often followed by vomiting • Folliculinum: history of birth control pills and/or estrogen replacement therapy, esp. bad reaction, i.e., estrogen poisoning; tendency to put others' needs before her own, and then become resentful later; woman has lost touch with her own inner rhythms and her reference has become external rather than internal; often best used in a single dose, or repeated every two weeks, possibly at new and full moons • Lac Humanum: history of difficult mother-daughter relationship; issues of nourishment and addiction • Lycopodium: voracious hunger; much bloating; eating ever so little creates fullness; dyspepsia • Natrum carbonicum: voracious hunger especially after 5 p.m.; epigastric emptiness > eating; digestive weakness: bloating, flatulence, nausea, vomiting and sensation of weight in stomach • Phosphorus: hungry right after finishing eating ; feeling the "inner emptiness"; ashamed, gets up at night • Platina: sexual energy, excessive behavior • Pulsatilla: fixed ideas about weight; mental state tied to appetite, self gratification tied to eating, eat to ameliorate loneliness and depression

Subtle Support
• Mi (Gardner, p. 72, 78) • Fa# (Gardner, p. 82, 87)

mental/emotional: • rhythmic folk songs • County Derry • songs of Steven Foster • Spanish tangos • Brahms' Hungarian dances • Sousa's marches • Strauss' waltzes • Gilbert and Sullivan • Indian Love Call • My Wild Irish Rose • Wishing • Estrellita (Heline, p.18)

Mind/Body
• Extreme fear, self hatred, and rejection. (Hay, 1984, p. 152) • To explain the paradoxical illnesses of anorexia or bulimia, one has to drop the distinction between mind and body. In anorexics, the distorted idea, 'I must be thinner,' takes over the bodymind like a malevolent and elusive phantom. Even after long hospitalization and exhaustive psychiatric treatment, the patient rarely eats like a normal person. In the binging and vomiting of bulimia, the distortion goes beyond, 'I have to be thin,' to 'I can never be thin enough.' Thus, in a similar ways, obsession with an unrealistic body image takes over as 'a ghost of memory', a memory picked up and stored in the body. These patients do not feel they have a disease, they are the disease, and to heal, they must reach the level where the 'ghost lives.' (Chopra, p. 79-81) • "Extreme states are not purely random and meaningless pathological behaviors. Each has a highly ordered, almost mathematical, predictability. One goal of process paradigm has been to demonstrate that the cause-and -effect, illness-and-cure philosophy governing much of psychiatric research and treatment is not the only useful way of either observing or treating the effects of these syndromes. A process oriented paradigm which studies the various channels of human expression and which deals concretely with both individual and collective issues, normal and extreme states, is sorely needed." (Mindell, 1988, p. 162) • Anorexics and bulimics have an exaggeration of an ascetic ideal, and resist their own femininity and sexuality in an aim to free themselves of bodily needs, to be pure and spiritual renunciates. "Asceticism generally throws a shadow, and the name of that shadow is 'greed'. Thus, anorexics never succeed in finding a happy medium in the conflict between greed and asceticism, between hunger and renunciation, between self-centeredness and self-sacrifice. These patients have to discover and accept their own greed, their craving for love and sex, their egocentricity and their femininity, with all the instinctiveness and corporeality that this entails." (Dethlefsen, p. 142-5)

• Heart ~ Xin houses the Shen (Spirit), rules the Xue (Blood) and its vessels and directs the circulation, opens into the tongue, and relates to the integration of the organs and the personality. » Healthy expressions are warmth, vitality, excitement, inner peace, love, and joy. » Heart Shi (Excess) signs include false or facile laughter; sobbing; agitated spirit; insomnia (Seem, p. 28); frightful dreams; anxiety; tongue feels numb and heavy; heavy chest; hot sweat; and orange-colored urine. » Heart Xu (Deficiency) signs include sadness; absence of laughter; depression; fear; anxiety; shortness of breath (Seem, p. 28); cold feeling in the chest and limbs; palpitations; cold sweat; inability to speak; memory failure; nocturnal emissions; and restless sleep. » The Heart is the Emperor of the bodily realm so that when the Heart is disturbed all the other organs will be disrupted.
 * Chinese psychophysiology:**

• Stomach ~ Wei is the Sea of Nourishment and origin of all fluids; transforms and digests food so that the Spleen can separate the distilled food essences; with the Spleen, is the root of post-natal Qi; and as Earth, relates to the ability to assimilate, stabilize, and feel balanced and centered. » Healthy expressions are fairness, openness, and nurturance. » Stomach Shi (Excess) signs include nightmares; acne; skin eruptions; excess stomach acid (Seem, p. 28); heat in the abdominal area; overactive digestive system causing hunger and thirst; dark yellow urine; gluttony; halitosis; swollen gums; red dry lips; pains and cramps in legs.

• Spleen ~ Pi governs digestion and manifests in the muscle tissues; transforms food into Qi and Xue (Blood); governs the Xue (Blood); and relates to the ability to assimilate, stabilize, and feel balanced and centered. » Healthy expressions are fairness, openness, deep thinking, and reminiscence; » Spleen Xu (Deficiency) signs include slightness (deficient "form"); abundant elimination; morning fatigue; cold, wet feet (Seem, p. 28); abdomen taut and distended like a drum; craving for sweets; flatulence; nausea; mild edema; memory failure; heavy feeling in legs; easy bruising; pale lips; loose stools; muscular weakness; and, indirectly, obesity. » The excessive use of the mind in thinking, studying, concentrating, and memorizing over a long period of time tends to weaken the Spleen. This also includes excessive pensiveness and constant brooding. (Maciocia, p. 241) Likewise, inadequate physical exercise, overexposure to external Dampness, and excess consumption of sweet and/or Cold foods will also deplete the Spleen.

• Liver ~ Gan is the home of the Hun (Ethereal Soul); it relates to decisiveness, control, and the principle of emergence; maintains smooth flow of Qi and Xue (Blood); and reflects emotional harmony and movement. » Healthy expressions are kindness, spontaneity, and ease of movement. » Liver Qi Stagnation reflects and accentuates emotional constraint as the Liver's function of facilitating smooth flow in the body is constricted. Stagnation is associated with frustration, irritability, tension, and feeling stuck. With time this pattern tends to produce a gloomy emotional state of constant resentment, repressed anger or depression, along with tightness in the chest, frequent sighing, abdominal tension or distension, and/or a feeling of a lump in the throat with difficulty in swallowing. (Maciocia, p. 216) » Liver Shi (Excess) signs include discontent; anger; pain in lumbar region and genitals (Seem, p. 28); muscular tension; excessive sex drive; insomnia; moodiness; excitability; genital diseases; red, tearing eyes; compulsive energy; and bitter taste in the mouth. Chronically suppressed anger can implode and give rise to Fire in the Liver and Gall Bladder with symptoms of irritability, bitter taste, headaches, etc.

• Kidney ~ Shen stores Jing (Essence) and governs birth, growth, reproduction, development, and aging; houses the Zhi (Will); expresses ambition and focus; and displays the effects of aging, chronic degenerative processes, and extreme stress. » Healthy expressions are gentleness, groundedness, and endurance. » Kidney Xu (Deficiency) signs include indecisiveness; confused speech; dreams of trees submerged under water; cold feet and legs; abundant sweating (Seem, p. 28); hearing loss; fearfulness; apathy; chronic fatigue; discouragement; scatteredness; lack of will; negativity; impatience; difficult inhalation; low sex drive; lumbago; sciatica; and musculoskeletal irritation and inflammation, especially when worse from touch. » Intense or prolonged fear depletes the Kidney. Often chronic anxiety may induce Xu (Deficiency) and then Fire within the Kidney. (Maciocia, p. 250) Overwork, parenting, simple aging, and a sedentary or excessively indulgent lifestyle all contribute significantly to Kidney Xu (Deficiency).