The Anorexic and Bulimic “Voice”

     It is my belief that in bulimia/BED, the urges to binge are the one and only cause of binge eating. Most of the time, these urges have a “voice” – one that sounds like your own – which strongly encourages the destructive eating behavior. In bulimia/BED, the woman usually views the voice as her enemy; she knows (at least on some level) that the voice is not expressing what she truly wants. In Brain over Binge, I briefly talk about how this situation is sometimes different in anorexia, because many anorexics believe the voice that encourages the destructive eating behavior (restriction/starvation) is expressing what they truly want – to lose weight. I recently came across a summary of a study which aimed to systematically examine this voice in anorexia, and I wanted to share it here along with some insights for binge eaters.


     This study aimed to investigate experiences of and reflections on living with an anorexic voice. Participants were invited to write about their anorexic voice in the form of a poem, reflection, letter, or descriptive narrative. The written contributions were then analyzed by researchers. The study found that anorexics bestowed both positive and negative attributes to their anorexic voice; it was found that anorexics viewed the voice more positively in the beginning stages of the disorder and more negatively over time as the disorder developed. The participants felt an affiliation toward the voice, which researchers said could explain their ambivalence to change. The researchers recommended that therapists persist in their endeavors to penetrate the tie between anorexic patients and their anorexic voices.


    I think that once the anorexic patient begins to view her anorexic voice negatively in any way, that is the opportunity for the patient to penetrate the tie. Just as in bulimia, the anorexic doesn’t lose volitional control of her actions; she retains the ability to override the anorexic voice. Whereas to stop binge eating, one must not act on the urges to binge; to stop anorexia, one must act (eat) in spite of the urges to starve. She must put food in her mouth despite what that voice is telling her; but to do this, she has to believe (at least on some level) that the voice is wrong.  If she thinks that voice is right – if she has an affinity for it – she will continue following it.


    Even though individuals with bulimia/BED usually don’t have much trouble viewing their destructive voice as negative, I thought this study could still be useful for binge eaters, especially those who are just learning to separate themselves from their urges to binge. Like the participants in this study, you could write a poem, a reflection, a letter, and/or a descriptive narrative that reflects on your experience with the voice that urges you to binge. Getting to know the voice is helpful in order to recognize the many ways it presents itself. You could write about what you hear (in your head) that encourages you to binge; you could list all the “reasons” the voice gives you to binge; you could describe all the sensations you experience when you hear that voice. It is my hope that in doing this, you will realize that all of this “neurological junk” is not truly you, and you do not have to follow that voice.

17 thoughts on “The Anorexic and Bulimic “Voice”

  1. Hi Kathryn,
    what I read in your book, and what you practiced was mindfulness, which was actually so pure and natural to you, that almost is more powerful because it wasnt a learned model of practice or spiritual tool, although that is exactly what it was you applied !! So you override all the conscious learning of spiritual practice,which can get caught up in the disease mind set, which is what happened top me, so I could not differentiate one voice from any other. I know im a bit muddled that’s because Im still binging…but know the answers..

    thanks this is so helpful,actually very powerful

    Love Mel
    Ireland

    1. Hi Mel,
      I’m glad this was helpful to you. What you said is similar to what my family member (who I reference in the ‘Spiritual Connection in Recovery and Neuroscience post)told me; he said that truth discovered by ‘experience’ and contemplation is the most solid form of gained knowledge.

      So, even though I had no idea I was usual a spiritual tool – or maybe because I didn’t know, the tool was very powerful.

      I hope you are able to find clarity in your thoughts and discover your own true voice, which has the power to stop the binge eating.

      Thanks for writing.

  2. Yes, sorry I forgot to include that information. Here is the citation:

    Psychol Psychother. 2010 Sep;83(Pt 3):243-54. Epub 2010 Jan 28.

    The title of the study is:
    “Living with the Anorexic Voice: A Thematic Analysis”

  3. ….”you are never going to be able to stop yourself ever, if if you do, that day is not today sarah, so walk downstairs, good girl, you know exactly what you want to do, ok yes sarah! yes, get excited now! you can eat WHATEVER you want! how exciting! this is your only way of making yourself happy right now, honestly everything will be fine as long as you are eating… anything! everything! what freedom!”

    WHOA. it literally just felt like i was re-enacting a binge typing that out, you’re right kathryn, that was quite useful, and next time i hear voices like that they will be more identifiable as coming from my animal brain! 3 days after reading your book, and feeling strong and empowered! thankyou, you have helped so many people by sharing your story… and hopefully me too! x

    1. Thanks for writing. I’m glad that little exercise helped you. Once you can detach from those types of thoughts, they will start to sound like “blah, blah, blah…” :-) It will start to make no difference to you what you hear and feel while having an urge to binge, because you know that no thought can make you act. Then, eventually, your lower brain will stop producing those thoughts at all.

      I truly hope this is the start of a binge-free life for you.

  4. I’ve ordered your book, and I can’t wait to read it…I’ve struggled with the urges and voices in my head since I was 9, and no therapy has ever been able to help me. I’ve been anorexic and bulemic and now super morbidly obese…I’ve gotten to the point where I ‘want’ to stop eating, but my body just takes over and keeps going…it’s a nightmare.

    1. Hi,
      I truly apologize for the delay in my response. I sometimes lose track of comments that are on older posts, and I need to get better at that.

      I assume by now you have received the book. I truly hope it helps you in some way, because I know how awful it is to be caught up in that nightmare. Please feel free to contact me with any questions/comments (kathryn@brainoverbinge.com), or just post here!

      I wish you all the best.

      Delete

  5. Hi Kathryn,
    I want to get hold of your book (Living with the Anorexic Voice: A Thematic Analysis) , but can’t find it anywhere, and it’s not on Amazon.
    My step-daughter has gotten this awful “disease”, and from what my conversations with her show, the “voice” seems to be the biggest factor preventing her from recovery. If we can neutralize this screaming tyrant inside her I’m sure the remaining resistants will collapse.
    Where can i get the book or download Kathryn??
    Many thanks!

    Best regards,

    Johnb

    1. Hi John,
      I’m sorry your step-daughter is struggling. My book is titled “Brain over Binge” and it’s available through this website or Amazon (Kindle also available for download on Amazon). “Living with the Anorexic Voice: A Thematic Analysis” is a research study which I was referring to in this blog post. Sorry for any mix up.

      If binge eating is your step daughter’s biggest problem, then my book would be a good fit; but if the “voice” she is struggling with is more anorexic in nature (encouraging her to starve herself), then you might want to check out a program called “Mom Please Help.” I don’t have any personal experience with the program, so I can’t vouch for it’s effectiveness; but I like how it specifically targets the anorexic’s “tyrant voice,” as you describe it, and how it references neuroplasticity – which held the key to my own recovery. Here is the link:

      http://www.mom-please-help.com/index.html#_protect_

  6. i was just wondering so do the voices do opposite things? so for anorexics the voice tells them theyre fat and should starve, whereas for bulimics it tells them to eat and then later they regret it. just to clarify

    1. Yes, I believe that is true, although often bulimics have the “anorexic voice” as well. That voice tells them they should starve/lose weight, so they diet restrictively until their survival instincts kick in and they binge (which is why about 50 percent of anorexics eventually become bulimic). Then, they regret it and purge and the cycle begins.

      The reasons some anorexics don’t eventually binge (although some do in cases of anorexia binge-purge type)aren’t fully understood, but research is showing that it’s perhaps due to differences in the brain’s pleasure centers. This article explains some of that research:
      http://ucsdnews.ucsd.edu/newsrel/health/05-09EatingPleasure.asp

    1. I wouldn’t say that you need maivtotion. It is important to establish regular eating habits which includes your 3 meals a day. Eating regularly increases metabolism. Not eating regularly decreases metabolism. Under eating not only also decreases metabolism but also means that the body becomes depleted in vitamins and minerals. It is about re-establishing an eating regime and feeling a lot better within yourself.

  7. Hey my friends I tell you some tips. As you may know, I am now a recovery coach here at Bulimia Help. My recovery inspires me every day to continue sharing the message that a lifelong recovery is possible and within your reach. In order to accomplish this, you have to let go of those thoughts and false beliefs that are holding you back.
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  8. Thank you Katheryn, I had the anorexic voice first and I started starving to lose weight even though I was very athletic and not at all fat. (I didn’t look like Twiggy and I truly thought being thinner would make me loveable and a better gymnast) The longest I could ever starve myself was about 30 days and the resulting binges were very frightening and led to bulimia. I never understood it was an anorexic voice because I became FAT following that voice. I have continued to have the anorexic voice urging me to diet/starve to get the excess weight off. I now know my excess weight was caused by binging after stringent dieting or starving. I have been in a starve/binge cycle for nearly 42 years. I have had a lot of success with your book and I have a lot of hope. I think what has stood in my way of completely giving up binging is my anorexic voice.

    1. Hi dolla,
      Thanks for sharing some of your experience here. I do think that a continuing desire to diet/starve to lose weight (the anorexic voice) can make recovery more difficult. It’s harder to separate yourself from binge urges that are driven by primal hunger (due to severe calorie restriction). I hope you are able to have success overcoming the desire to diet, and begin nourishing your body. This should help make resisting the binge urges much more manageable. Thanks again for writing, and I’m truly sorry my response time is slow right now. I hope you are doing well.

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