Fat is murder, so I vomit up my food

After dinner I purge in the basement bathroom. How do I fix this?

By Cary Tennis

Published August 16, 2011 12:20AM (EDT)

Dear Reader,

In Sunday's column I gave voice to an anguished, furious patriotism of disillusionment, the anger of a native son at a country whose shining hope seems to be slipping away.

I don't have a program of national renewal. It's just how I feel.

Two images come to mind. One is James Dean in "Rebel Without a Cause" screaming at his impenetrably dense parents, "You're tearing me apart!" The other is Quentin Compson's famous words at the end of "Absolom, Absolom!" when asked why he hates the South: "I don't! I don't hate it! I don't hate it!"

Some days, I feel that way about America, this bold and tragic experiment, source of my life and inspiration, country of my blood: It's tearing me apart. But I don't hate it! I don't hate it!

Dear Cary,

I'm sorry to hear of your recent health terrors, and I hope you are feeling better. I'm glad you're back at work.

I am a 42-year-old woman with a new problem that I am not sure what to do about. When I was in my 20s and 30s, I was a drop-dead gorgeous girl -- the sort of woman who made men walk into walls when they walked past. I married a handsome, fabulous, funny, wonderful, successful man, and we have three entirely delightful children. I have everything in life I ever wanted. But since turning 40, my body has started to rebel against me. I am gaining weight in places that were formerly smooth and taut, I am suddenly soft in places I was always firm, and this is killing me.

In despair, I tried forcing myself to vomit, and watched my scale hold steady when I did. This has now become a habit. My body does not want dinner. It insists on transforming any dinner I have into fat, and I could honestly live very well without eating after 2 in the afternoon. But we have a family. And therefore a family dinner. I am an outstanding cook, and we often have guests for dinner -- my husband's colleagues and friends and family. And dinner is killing me. I don't want it. Dinner makes me fat. Being fat is a horror to me. I do not want to eat, but since I almost always must, I have learned to deal with it by vomiting, in the dark privacy of the lower-level bathroom, after the guests have gone and sometimes even before.

I love my husband, I love my children, I love my life. But I cannot abide becoming fat. It is a fate worse than death. So I purge. I vomit. My heart races and my stomach churns and I regurgitate everything that makes me loathe my reflection in the mirror. And I can see that this is not a strategy that is going to work out well for me in the long term.

So what do I do? Do I sit down with my beloved husband and tell him I do not want to eat dinner anymore? Do I accept the fatness of age? Do I let go of my need to maintain the body of a Victoria's Secret model (and believe me, I really do look that good)? Do I keep vomiting? Do I exercise more? Do I just do a radical acceptance of who I am, and go with what works for me?

What are my choices? Spell them out for me, and tell which ones make the most sense. I won't necessarily follow your advice, but I will listen to it.

42 and Fighting Fat

Dear 42 and Fighting Fat,

I would say you have only two choices -- to go on as you are or ask for help.

Take a look at the Mayo Clinic site on eating disorders. It should give you a good overview. And pay special attention to this: "Bulimia usually doesn't get better on its own."

Whom you ask for help is up to you. Talk to your primary care provider or go directly to a mental health practitioner. Or, if those options don't work for you, the Mayo site suggests, "try to work up the courage to confide in someone about what you're going through, whether it's a friend or loved one, a health care professional, a teacher, a faith leader, or someone else you trust. They can help you take the first steps to successful bulimia treatment."

Break the secrecy. The important thing is that you begin.

You are not alone. Many people like you have gone through the same thing. Wise, compassionate and skilled experts offer many treatments and much support. If you work well with such things, you might want to start with the clinic's online health forum.

As to what I personally can bring to the situation, I would like to say from personal experience that asking for help can be surprisingly hard. Don't underestimate its difficulty. If you find yourself putting it off, avoiding it, or if you make a phone call or two and fail to complete an appointment, keep at it.

You may have to overcome certain obstacles of thinking and belief. For instance, we Americans pride ourselves on being self-reliant. If we have been successful in most everything, if we are blessed with talent and ability and independence, we may be flummoxed when we meet a problem we cannot solve on our own.

So let me remind you that this is not a personal shortcoming, nor is it something you can overcome through willpower and hard work. It's a new kind of problem.

It's an illness. That's why it has a Latin name.

All the wonderful things you have now --  your beauty, your lovely family, your fabulous husband -- they are powerless over this thing.

Take it from me, a guy who waited too long to consult the doctor about a potentially life-threatening condition. I know how tempting it is to believe that this is nothing, it's a temporary glitch, you will beat this on your own, you will figure it out, you will fix it.

But you are not unique. This is not something you fix yourself. You need to get help.

So right now, before you have a chance to think about it, just go to the phone, call your physician and make an appointment. Do this now. Don't think about it. Just begin.

Citizens of the Dream

What? You want more advice?


Cary Tennis

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