Eating Disorders: Battling Bulimia (cont.)

Moderator: Yeardley, what kind of coping mechanisms are you learning?

Smith: When I first got into treatment, one of the things they tell you to do is make a list of alternative activities that you will do before you indulge the urge to binge and purge. I had seven things on my list, which included:

  • Calling a friend
  • Going for a walk
  • Reading a book
  • Writing down my feelings

And there were others, but I almost never used my list. My point being that a lot of tools can be laid out in front of you, and I find that some of them work most of the time, but none of them work all of the time. Mostly, I am just trying to sit with whatever discomfort, anxiety, and feelings of worthlessness that may arise, and not act on them. It's really, really hard.

Member question: Dr. Brownell, are there resources out there for spouses, friends, etc., of people suffering with eating disorders? A support group for supporters of loved ones who are suffering?

Brownell: My recommendation would be to go to www.nationaleatingdisorders.org. There are many books written about every aspect of eating disorders, only some of which can be trusted. But the web site I just mentioned is quite helpful. It can also be helpful to visit the message board that I head up on eating disorders on WebMD.

Moderator: Why you think it's important to speak publicly about having an eating disorder? And do you think it's helping you to deal with it?

Smith: I think admitting to myself that I needed help has been the most important step. As I said earlier, it was not actually my intention to go public with my eating disorder, although I was aware that as a public person there would probably be some interest, but that was not a primary function of my recovery.

Moderator: Tell us about your play.

Smith: My play is called The Good Life and it's a darkly comic journey through the ins and outs of my career in show business, and in it I discuss --in great detail actually -- my bulimia, because it has been such a large part of my life. But I wrote the play because I decided I wasn't allowed to keep complaining that I wasn't getting more work if I wasn't going to do something about it myself. And I'm going to do it in New York City off Broadway in the spring of 2004. It's a one-woman show.

Member question: Lisa Simpson is such an amazing and well-rounded character. You bring a great weight to her two-dimensional world. Is it a stretch to think that your struggle with depression and your eating disorder have given your performances an edge? Would Lisa be different if you had been happy and well adjusted?

Smith: I can say that I, Yeardley, would be a different person if my circumstances had been different, but there is actually a large team of writers on The Simpsons that are actually responsible for that marvelous little character. I am only a portion of that collaboration.

Moderator: Do you have any advice for us parents of little girls? Is there anything we can do to help them avoid becoming bulimic?

Brownell: It is important for parents to place eating and exercise in the proper context. Focusing on diet and activity in the service of body weight or appearance can lead to major problems.

Encouraging your children to eat well and to get regular activity can be presented as a means of a child's accomplishing what is important to them at the time. For some, this may mean to be better at sports, for others to be better at music, for others just to have more fun with their friends. This way, eating gets transformed from a fight with food, where you have to eat less of things, to thinking of food as a friend, where you eat more of healthy things to nurture your body and your overall well-being.

Smith: I think for me, one of the things that has been most helpful and effective in my treatment has been a safe place to express whatever it is I'm feeling, whether it be sadness or excitement, that whatever it is I have to offer and wherever I am emotionally is OK and then I don't feel like I have secrets to keep. I do think one of the most nefarious aspects of my bulimia has been secrecy. It's one of those things that feeds off of itself and perpetuated my disordered eating.

Member question: The frequent rejection that is a part of show business (unless you are Jack Nicholson) -- has that aggravated your bulimia?

Smith: I would say any time you're a high achiever, rejection isn't really a part of the equation you make for yourself. So my bulimia served as the ultimate coping mechanism when nothing else worked.

Moderator: How are you feeling today? Smith: Today I feel great. Today I do not feel the urge to binge and purge, meaning I'm not having a white knuckle day, of which I have had many during my recovery. So I happily embrace those gifts for today and don't even think what it will be like tomorrow.

Member question: Now that everyone knows you have an eating disorder don't you find you are watched and judged more, like if you go to the bathroom after dinner?

Smith: I was actually never the person who would get up from the dinner table and go binge and purge. If I was going to binge and purge I would set it up myself. So people may be watching me now, but that was not my MO. I would set aside time, go buy my binge food, binge and purge for sometimes up to four hours, and then be done. But I would not excuse myself from the dinner table and go take care of it in the bathroom.

Moderator: We are almost out of time. Do you have any final comments for us today?

Brownell: I'm delighted that Yeardley could join us for this conversation. Hearing from someone who has lived the problem and expresses herself so clearly and so powerfully can motivate people to take action with their own problems. I'm pleased to have been part of this conversation.

Smith: Gosh, I am so blown away by your kind words, Dr. Brownell; thank you. It's a very new experience to have one's struggle validated like that. You always think that you're the only one, and it gives me great comfort and hope to know that there are people like you out there studying this disease and other eating disorders, because it tells me that other people who need it will get the help they very much need. Thank you for inviting me this morning.