We recently had the opportunity to interview a teenage girl (we will name her Katie) who had the condition of bulimia nervosa. We will not mention her real name, or any identifying details of her life, since they are of little relevance in the first place. What we will do is share her story of how her condition developed and how she achieved such a rapid and dangerous degree of weight loss while she researched how to be bulimic. Of particular interest is how she found the information to do what she did, and how she adapted and expanded on it.
Katie’s story starts pretty much the same as so many other bulimia patients. She became concerned with her weight and a few fad diets soon snowballed into an unhealthy obsession with rapid weight loss. Dieting was not common among her friends, and in order to participate in the normal social outings that her networks of friends took part in, it was often required that she eat out at restaurants and the movie theater with them. She was determined to fit it and not appear any different than the others, so it was not long before she got the idea of vomiting the food she eat. She would frequently excuse herself to visit any nearby washroom and expel what she had just consumed. There was just one problem with her plan when she first formulated it; she discovered that she was unable to vomit by simply sticking her finger down her throat like so many other people can.
The pharyngeal reflex, also called the gag reflex is the contraction of the soft tissue at the back of the throat. It can be induced by touching this tissue causing eventual vomiting. Everyone has a different sensitivity to the gag reflex, and there is a small percentage of the population that does not have one. Sometimes this can be an indication of another underlying medical condition. In Katie’s case, she was otherwise completely healthy. But she faced the dilemma of how she would proceed. Her brother was studying medicine at the nearby university which allowed immediate relatives of student enrolled there to access some of the campus facilitates. She used this advantage to access the medical library where she began to research a solution to her predicament. It was deep within the medical texts that she discovered syrup of ipecac. Ipecac is an emetic (meaning it induces vomiting) that is extracted from plant alkaloids. It is used in hospitals, sometimes in conjunction with activated charcoal, to induce vomiting in patients who have overdosed on drugs or ingested poison and other noxious substances. Ipecac is intended to only be used in emergencies (1) because it has been linked to chronic heart disease and is known for causing sudden heart failure. The most famous case of a fatality caused by ipecac use is the death of singer and bulimic patient Karen Capenter. There have since been numerous calls for the drug to be removed from the market.
Katie began to self medicate with ipecac, and would take some with her wherever she went. Now, she no longer needed to struggle with trying to vomit. She would simply go to the nearest washroom, drink some of the syrup from the vial she carried with her, and effortless throw up everything she had just eaten. After a few weeks of doing this she was hospitalized after suffering a heart attack. It was there that doctors and her parents learned what she had been doing. Luckily, Katie survived, but the damage to her heart is irreparable and her lifestyle has forever been altered due to her weak heart.
She Began Using Another Bulimia Drug
Despite almost dying and having to severely restrict her physical activity due to the heart condition the ipecac caused, Katie was still preoccupied with her obsession of how to become bulimic to lose weight. No longer able to obtain ipecac after her parents put local pharmacies on alert about her drug use, Katie began to use salt and mustard powder dissolved in water to cause vomiting. This is actually a method of inducing vomiting that dates back to ancient times, but is still effective. Like ipecac however, it too has its own dangers. The salt causes an extreme spike in one’s sodium level which over the long term can also be fatal.
We wanted to replace Katie’s bulimia strategy with a dieting solution that would both keep her safe, and at the same time achieve results that she will be happy with and not be tempted to resort to vomiting again. We also knew that her obsession of doing so would take long term psychiatric treatment to remedy. That treatment is ongoing at present and she seems to be doing well. In the meantime, she has started a diet based on the information we covered in one of our previous articles.