With bulimia nervosa, patients starve and perhaps vomit as well. This causes the body to demand food. It is normal to eat a lot in this situation, as is shown by both animals and healthy people. However, these patients continue to eat even when satisfied, and the overweight compulsive eater gobbles down food even if she has not been starving. Why do they do this?

How do you learn to identify your real feelings?

A simple method for getting an answer to this question is to have contact with compulsive eaters just before they begin binge eating and ask how they feel. However, binge eaters often withdraw when they feel that an attack is on the way and do not seek help. It is afterwards that they realize that they should have obtained help from a friend or therapist, in order to discuss their feelings, instead of eating compulsively. It is easier if patients are at a treatments center. People working there can then take care of the patient's feelings.

How do patients feel when they miss an attack of compulsive eating? Like an alcoholic who is not allowed to drink it all up, or a drug addict who can't obtain drugs. They feel that they must; or otherwise they must endure the unendurable. For example, if they don't get any tranquillizing food but are with a therapist, many feelings may come out: anger, disappointment, shame, guilt, hopelessness, despair, hunger and discomfort. If the therapist listens and allows patients to go through all their feelings and supports them as they proceed, they gradually learn to listen to their unpleasant feelings instead of eating compulsively. It then becomes possible to begin the work of solving their problems.

How do patients learn to recognize their real feelings? Even those who don't have a therapist can learn to manage their problems. When the urge to eat comes compulsively they can lie on a bed and, with eyes closed, concentrate on their feelings instead of eating. The alternative to compulsive eating is daring to endure their emotional life. Those with eating disorders are not clearly aware of their hunger and satisfaction feeling. They misinterpret other unpleasant feelings as a need to eat more. As the feeling of satisfaction does not automatically terminate the meal, as it does with normal eaters, they can continue to eat until their anxiety has ended. After the meal, anxiety increases again when they realize that they have acted wrongly and cheated themselves.