Eating Disorder Recovery
Joanna Poppink, MFT
Eating Disorder Recovery Psychotherapist
serving Arizona, California, Florida, Oregon and Utah.
All appointments are virtual.

- Welcome -

If you suffer from an eating disorder now or have in the past, please email Joanna for a free telephone consultation.

bulimia  struggle
Bulimia Story

Again I am asked:  "How can I help my bulimic friend without her going into treatment?"

Example: (not real names) Miranda and Trudy are both in their late twenties. Each has a husband and chidren.  They've been close friends for 16 years.

Trudy recently revealed her twelve year struggle with bulimia to Miranda. Trudy refuses treament. She only confides to Miranda about the bulimia.

Miranda believes she is helpingTrudy  by being her sole confidante and pitching in to help Trudy with family, household and business responsibilities. Miranda also keeps a careful watch on Trudy's behavior and emotional states.

After two months Miranda is happy that Trudy has six weeks of not throwing up and pleads for help in knowing how she can help Trudy continue to get better without her going into treatment.

Who is asking for help?

Please note that in this example, Miranda asks for help, not Trudy.

When I hear this plea for help my heart aches for the suffering Miranda, Trudy and their family members experience. What is it that makes Miranda and Trudy desperate to avoid eating disorder recovery treatment for the illness that is bulimia?

Open letter to friends of people who are bulimic

Dear Miranda,

You are not alone

You and Trudy are not alone in thinking that bulimia is a behavior that can be stopped through will power and love. This is a bulimia story that is lived out all too many times in the hearts and minds of thousands of people.

Bulimia is a serious illness that only grows worse without treatment.  The acting out behavior involving food is only part of a long list of symptoms. Plus, as you understand from your knowledge of other illnesses, reducing or removing symptoms is not the same as healing.

Danger and sorrow of false hope

When you say Trudy has made it for six weeks now! with an exclamation point, I feel an emotional aching because of the all too familiar false hope in your inferred sense of victory.

Bulimia blocks awareness

Trudy is doing her best to remove a defense, to stop a coping mechanism that helps her deal with unbearable feelings.  Without the healing work that occurs in treatment, she has no defense against inner issues that plague her. She probably doesn't even know what those issues are.  Bulimia blocks not only her pain but also will block awareness of the source of her pain.

You are providing support she needs to develop herself

Your valiant efforts in helping her cope with her daily life tasks ease some of her stress. Your attentive and well meaning actions allow her to live without some of her bulimic defenses because you are providing the support she previously received from the binge/purge cycle. You are a replacement for the protective bulimia. She doesn't need to throw up because she has you to tend to her anxieties and help her maintain her psychological oblivion. Will you do this indefinitely?.

Consequences of self sacrifice to you

You willl get tired.  You will be under pressure to put your energy into your own needs or the needs of your family or your business.  You will remember how much of your energy is required to tend to your own life.

As Trudy grows dependent on your energy as a replacement for the numbing caretaking of bulimia her needs and expectations will increase.  Your energy and motivation will decline. You will want and finally, I hope, start putting more of your energy into your life and less into hers.


Gracefully or ungracefully, you will both will struggle from the effects of your withdrawal.

And by withdrawal, I mean easing up. For example, you might do her laundry once a week rather than every day, or watch her children for two hours once a week rather than several hours four or five days a week. You might talk to her once a day rather than five times or even talk to her only once or twice a week.

Facing consequences

When Trudy's stresses - even normal everyday stresses - are present for her to deal with without your constant presence and without her eating disorder coping mechanism, she will go back to the binge/purge pattern to protect her psyche.

When the binge/purge cycle returns she will feel guilt, shame, humiliation, sorrow - and even despair.  She might also feel angry with you for letting her down or feel bewildered and grief stricken at her perceived abandonment.. Those feelings can be unbearable and will only increase her need to binge and purge.

She will feel like a failure.  But she hasn't failed.  She just tried to let go of a lifeline without developing muscle and ability to learn how to swim.  Anybody who is drowning will reach for a lifeline.

The real lifeline is psychotherapy

And your being the lifeline doesn't teach her how to swim or help her understand why and how she came to be so over her head in the first place.

I invite you to examine the benefits you receive from attempting to be Trudy's rescuer through self sacrifice. Many people recover from bulimia throught ther active participation in a recovery treatment program including psychotherapy. Creating a codependent relationship with her only undermines the quality of your own life while giving you a false sense of accomplishment.  For Trudy to heal she needs to embrace the challenging tasks of solid recovery with a mental heal clinician who understands eating disorders.

This could be a time of powerful introspection and resetting of priorities for both of you.


P.S. The end of secrecy is the beginning of recovery.

Joanna Poppink, MFT, psychotherapist in private practice. For a free telephone consultations email This email address is being protected from spambots. You need JavaScript enabled to view it..

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