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Eating disorders Bulimia

Bopha is only 4 feet 11 inches tall. Her body is strong and solid like a rock. But Bopha's parents criticized her build and compared her with her slimmer cousin.

Sometimes their criticism was specific. "Your arms are fat," they'd say. "Your legs are fat."

"Parents want their kids to fit in," says Dr. Roberto Olivardia, clinical instructor of psychology at Harvard Medical School. "They don't realize their comments can make the child self-conscious."

Bopha had always pushed herself to succeed. It was one way she handled her parents' need for perfection. She also stared into the mirror, imaging a different body shape. "I hated my body," she says. "I went on a big diet."

She skipped meals and got so weak she fainted. She ran many miles every day to burn calories.

Bopha felt guilty after she ate. One night after dinner, she made herself throw up.

"I felt euphoric, like I'd lost 10 pounds," she says. "The feeling was so powerful, I did the same thing the next day." Soon, vomiting after eating was routine.

The effects of forced vomiting are physical and emotional. "When bulimics vomit," says Dr. Olivardia, "there is a lightheadedness from the way blood is circulating the body. But psychologically, it feels as if you're getting rid of anger, self-hate, fear, and guilt."

But the feeling is false - and short-lived. "Everything you felt before is still there," says Dr. Olivardia, "plus the shame of bingeing and vomiting. It's a vicious cycle."

Soon Bopha stopped feeling euphoric after vomiting. But that didn't stop her from trying to recapture that feeling.

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