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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by jack623 on January 31, 2006, at 12:26:41
I have been bulimic for 10 years and I am so hopeless. One of my problems, though, is that I think my urges to binge are all biological in nature. Like my neurotransmitters and hormones are so out of whack that I can't help but binge. Although my childhood was very traumatic, I just can't seem to stop the underlying belief that it's all biological. It really creates a sense of powerlessness over my eating.
Posted by Poet on January 31, 2006, at 21:43:11
In reply to Is it all biological?, posted by jack623 on January 31, 2006, at 12:26:41
Hi Jack,
I think, for me, biological plays a part in it, but psychological plays an equal part. If it were just biological I would think I'd reach a point where I've eaten enough. I'm satisfied. I'm satiated. I'm comforted. I'm full. Whatever physical need I'm fullfilling.
That I don't feel that need met, leads me to think that it's psychological, too.
That's my take on what I think my bulimia is.
Poet
I know that feeling of being powerless well.
Posted by Racer on February 1, 2006, at 14:14:04
In reply to Re: Is it all biological? » jack623, posted by Poet on January 31, 2006, at 21:43:11
I don't think you can separate biology from psychology in this sort of thing. Yes, biology must play some part in it. I can't imagine that anyone could be "trained" to purge otherwise.
There's a guy at UPMC called Walter Kaye who has been studying eating disorders, and has found some interesting anomolies in the serotonin systems of anorexics, for instance, that seem to show that there are abnormal levels of 5HT *before* the anorexic symptoms start up, and that semi-starvation is actually self-medicating. The semi-starvation reduces the amount of tryptophan taken in, which in turn reduces the amount of serotonin produced in the body, reducing the distress caused by that overactive serotonin system. One of these days I'd bet the same sort of thing shows up in bulimia, and binge eating disorder, and that disorder that involves purging without binging, etc.
But then again, I also think that there's another side to it: my guess is that most of these mental illnesses -- from depression to bulimia -- are actually a cluster of disparate disorders with similar symptoms. So, who knows? And I certainly don't know much, but I will share the non-knowledge I have with anyone, it seems.
Is biology all there is to it? Of course not. There's also behavior, and some sort of behavior modification can at least control the behavior, even if it doesn't help the underlying issues. That's why therapy is so necessary for bulimia, and for anorexia. Also, Topomax has been shown to reduce the urge to purge, so it might be worth looking into.
And Poet:
>If it were just biological I would think I'd reach a point where I've eaten enough. I'm satisfied. I'm satiated. I'm comforted. I'm full. Whatever physical need I'm fullfilling.
>I don't know about that. I think that those feelings of hunger and satiety are biological, but we screw them up with our behaviors. I know that I never feel full, either -- either I feel hungry, or I feel sick-from-overeating. Never anything like just neutral, or satisfied. (Actually, I do feel satisfied at times when I'm restricting most. It's only when I'm not restricting so strongly that this is true. Makes any sort of recovery so much harder.) While there is probably some psychological part to it, there's also the biology of the chemical messangers that tell the brain when you're full, when you're hungry. Those get screwy from eating disorders. Basically, I've heard it described as kinda use it or lose it. If you're going to ignore the sense of being satisfied, for instance, and keep eating -- your body will say, "Oh, you're not using it, so we'll save our energy and stop making it." That sort of thing.
I know that a big part of where I was when I still had nutritional counseling was trying to learn to recognize hunger and fullness. Didn't get far, but things were changing a bit.
Dunno if there's anything in my brain that makes sense today, but there it is if you want it.
Posted by overtheedge on February 2, 2006, at 19:42:03
In reply to Maybe it's both?, posted by Racer on February 1, 2006, at 14:14:04
can i ask , have any tried the meds they say work or claim to work for binge eating....
i find when i have restricted long enough, or in my case starved,,, i B/P..which i take topamax for, i thik not the best of a an... but it helps with the thoughts....just a question if you have tried.....
Posted by jack623 on February 2, 2006, at 19:58:21
In reply to Re: Maybe it's both?, posted by overtheedge on February 2, 2006, at 19:42:03
> can i ask , have any tried the meds they say work or claim to work for binge eating....
> i find when i have restricted long enough, or in my case starved,,, i B/P..which i take topamax for, i thik not the best of a an... but it helps with the thoughts....just a question if you have tried.....I tried Topamax for 2 years, and it helped for about 4 months when I combined it with a high dosage of Zoloft. I quit the Zoloft bec/ of the sexual side effects and the Topamax never worked again. I stuck with it for another year after it petered out. I just quit taking it about a monh ago because I was so sick of the apathetic feelings and cognitive impairments. I really do feel better and haven't noticed much in terms of appetite changes or weight gain.
This is the end of the thread.
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