Eating Disorders: Battling Bulimia (cont.)

Brownell: It is absolutely essential that you see a physician immediately and that you be completely honest about your eating patterns and any behaviors like vomiting that you may have been engaging in. Believe me, you won't be the first one to tell your doctor these things, nor will you be the strangest thing your doctor has seen. What is essential is that you be honest with the physician so you get the medical care you need and deserve.

Member question: Yeardley, do you see yourself as a person free from an eating disorder in a few years? Are you excited or nervous about that prospect? After all 24 years is a long time. Not being bulimic might be hard to picture.

Smith: That's a good question. There does seem to be a period of mourning as I deal with giving up the behaviors of binging and purging, which I did not expect. I hope to be free of the urge and the behavior of my bulimia in a couple of years, but I don't think I will ever be able to take my eyes off the ball, in the same way that alcoholics need to be mindful of their addiction to alcohol.

Brownell: Believe it or not, bulimia can seem like a person's best friend. After all, it becomes a means of coping with difficulties in life. If you take away anyone's primary means of coping, the grieving that Yeardley described is entirely understandable. The bulimia tends to have less prominence in a person's life as people develop alternative means of coping with what life brings us.

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.


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