Bulimia Case Study by Debbie Cotton

Sam is a 21-year-old woman that developed type I diabetes at the ag3e of eight. Throughout her teenage years, she struggled with the rigid dietary restrictions and frequent insulin injections required to manage her condition and consequently, developed bulimia in a bid to be 'normal'.

The first aim was for Sam to control and maintain her blood sugar levels, as I knew this would be exacerbating the need to binge. I used Magnesium 200g and Chromium 1000mcg taken once daily, both with a view to control her insulin resistance. With this I combined an Ayurvedic herb, Gymnema Sylvestre, which is also used for increasing insulin receptor sensitivity. We worked with simple dietary changes and taught her how to control her blood sugar fluctuations with food choices. We discussed the use of both simple and complex carbohydrates when needed. She began to check her blood sugar regularly and kept a binge diary for me, which also detailed the triggers that made her binge, as well as body sensations related to her blood sugar levels.

After a few weeks, she improved her blood sugar control measurably. The number of binges that she was undertaking in a week dropped to three times a week from one to two daily. We spoke more about the use of protein (Tryptophane) rich foods and I gave her a B Complex formula, primarily for the B6, plus Zinc Citrate 50mg daily to aid conversion from Tryptophane to Serotonin. Within a few more sessions, including talking about some of the psychological causes of her binging, she was able to begin to notice the feelings in her body that warned her of hunger and a need for sugar. She began to practice listening to her body sensations, using a mindfulness programme so that she could catch herself before she got to a place where the binge was inevitable. We discussed techniques of managing anxiety, other than using binging, and she began to practice giving herself time during the day to look after herself. We also identified her binge triggers and how best to avoid them. In our last few sessions together, Sam was very proud that she had managed to stop binging and made positive steps in her life towards getting her health back. One of these decisions was to move home to her original country, so that she could be near her family. Sam left feeling more in control of her life and was excited about the possibilities of self-care, but also loaded with the knowledge that she didn't have to battle bulimia on her own anymore.

We worked together for 10 sessions, comprising of nutritional therapy, naturopathy, western herbal medicine and counselling.