1, eating disorder is not a beautiful disease, and people suffering from it are very painful. Eating disorder is often accompanied by other mental disorders and physical diseases, which is a minor illness in psychiatry, but it has the highest mortality rate among mental disorders, with the mortality rate as high as 5%- 15%.

2. Both anorexia nervosa and bulimia nervosa can be cured, and the cure rate is over half. Shanghai Mental Health Center, Peking University Sixth Hospital and Dalian Seventh People's Hospital have successively set up specialized wards for eating disorders. If you find that people around you have symptoms of eating disorders, you must seek medical advice as soon as possible. The sooner you treat it, the easier it is to recover.

A whole roast chicken, a hamburger, a chicken roll, a bag of French fries and two 400ml cokes, while watching cartoons, Lin Tingting felt that he had gained a long-lost satisfaction, which was "the happiest and purest moment". Soon, the guilt squeezed away the satisfaction, and a voice in her heart reminded her, "Lin Tingting, you are going to gain weight again!"

She rushed into the bathroom, squatted down beside the urinal, lowered her head and poked her forefinger into her throat. A feeling of nausea came over my mind, and the food I had just eaten poured out of my throat, "like opening a floodgate to release water." Until the vomit became transparent, Lin Tingting knew that she would no longer feel guilty, because all the food she had just eaten had been taken away.

Lin Tingting is a bulimia nervosa patient. In medicine, bulimia nervosa is an eating disorder. Eating disorder belongs to mental disorder. Its related diseases include anorexia nervosa and other specific eating disorders. Western epidemiological research data show that the prevalence of eating disorders is about 0.5% to 1%. This means that one in every 100 to 200 people has an eating disorder.

In China, there are no exact statistics about people with eating disorders, but it is a huge and secretive group. They can't deal with the physical and mental pain caused by food correctly, and they are ashamed to talk to their family and friends. They can only find patients on social networks and hold a group to keep warm. "Gourmet bar" and "vomit bar", QQ groups with similar themes, are the gathering places of these patients.

Chen Jue, director of the Psychosomatic Ward of the Clinical Psychology Department of Shanghai Mental Health Center and head of the Eating Disorders Diagnosis and Treatment Center, said that eating disorders are often accompanied by other mental disorders and physical diseases, and their harmfulness has been ignored by the public. "Eating disorder is a minor illness in psychiatric department, but it is the one with the highest mortality rate among mental disorders, with the mortality rate as high as 5%- 15%."

Mirrors, weighing scale and calories.

"God, how can I be so fat!" /kloc-Lin Tingting, a 0/7-year-old girl from Hubei, accidentally caught a glimpse of herself in the fitting mirror of the shopping mall and was "startled by herself".

The girl in the mirror is 170 cm tall and weighs 200 kg. Lin Tingting is disgusted with his double chin, elephant legs and strong arms.

Since then, the image of this girl has been abstracted as a cartoon girl with short hair and bloated figure, which appears repeatedly in Lin Tingting's diary. In the margin, Lin Tingting wrote "Squat" and "Pie Face", plus several big exclamation points.

Lin Tingting wrote down her determination to lose weight in her diary. Photo courtesy of respondents

Because of her figure, Lin Tingting disliked herself since she was a child. In junior high school, some students nicknamed her fat. Not only was she not angry, but she also smiled at others. When no one was around, she turned her head to wipe her tears. She gradually became inferior. In the sixth grade of primary school, she fell in love with a boy, but she was afraid to confess when she was in the second year of high school.

"Fat people are not happy." In his diary, Lin Tingting warned himself.

17 years old, she decided to change.

She began to lose weight through dieting and excessive exercise. Life is quantified as a series of numbers: only 1700 calories are allowed every day, which is the minimum daily calorie calculated according to her height and weight, which means that she can only eat a bowl of noodles, a bite of rice, a bite of vegetables and an apple for three meals; After self-study in the evening, jump rope 2000 times and do 200 sit-ups; Measure the chest circumference, hip circumference, leg circumference and arm circumference with a tape measure every day. These figures are plotted as line charts every month.

At every meal, Lin Tingting sits at the table, and the rice, apples and steamed bread in front of him are quickly converted into calories in his mind: 2 10 calories, 83 calories and 227 calories. Then, grab a few mouthfuls.

After half a year, she was pleasantly surprised to see the downward trend of the line chart. Weighing scale told her that she had lost 60 pounds. She took out her old trousers, and her legs could be tucked into one leg. "My heart is like fireworks!"

Lin Tingting feels that after losing weight, life seems to have reached a certain peak in an all-round way-the story of her success in losing weight is circulating throughout her sophomore year, and all the girls come to learn from her. Even the boys who nicknamed her in junior high school praised her at the class reunion. "Lin Tingting, you are so beautiful!"

She didn't know that Pandora's box had been quietly opened.

One day in senior three, Lin Tingting was hungry. She retaliated by eating a big bowl of sparerib soup and two bowls of rice. Soon, physical satisfaction and psychological guilt began to tear at her. She almost instinctively thought of a way-spit them out so that she wouldn't gain weight.

The next life seemed to enter a revolving door formed by overeating and vomiting. "It feels like a drug addiction." While overeating and vomiting, Lin Tingting warned himself in his diary, "You can't do this, you will die".

When she vomited in the dormitory bathroom, Lin Tingting turned the music in her mobile phone to the maximum so as not to let her roommate hear her vomiting. In the winter when the frequency of overeating and vomiting was the highest, her right index finger joint was scratched by her teeth because of spitting. When a classmate asked, she quickly concealed it. "This is frostbite."

Due to long-term vomiting, Lin Tingting left scars on the index finger and middle finger joints of his right hand. Respondents of the "rabbit" family

After going to college in Wuhan, Lin Tingting found himself with the same kind. When she was a sophomore, she saw a group of people named "rabbits" on the blog page of a big-eating king.

These bulimia nervosa patients call themselves "rabbits". "Rabbit" is a homonym of "vomit", which means weakness and timidity. They are extremely afraid of being fat, and their self-evaluation system is completely based on the changes of figure and weight. They overeat in the middle of the night, alone, anxious and depressed, and then, driven by guilt, try to remove the food they have eaten by diuretics, laxatives and vomiting.

Most of these "rabbits" gathered in Baidu Post Bar and QQ Group are young girls. They share their dark and secret side with strangers-change their heads without losing ten pounds, and share the pleasure of overeating and the method of inducing vomiting on time every day before and after meals.

Every day at noon and around eight o'clock in the evening, it is time for the "rabbits" to concentrate on their activities. According to the routine of ordinary people, people in these two periods just finished eating. So are the "rabbits", except that there is one more process in their lives-vomiting. They have to spit out the food they have just eaten in various ways, by hand or by inserting plastic pipes directly into their stomachs.

In QQ group, "rabbits" call vomiting "raw" and eating "heavy". In their context, it would be better not to have the word "vomit".

Li is the boss of one of the groups. She was born in 1994. The huge work pressure in the financial industry made her suffer from bulimia nervosa. She said that every time someone joins the group, she feels particularly lost-another person in this world has fallen into "this great pain."

The girls in the group didn't and didn't intend to go to the hospital. They think it's "black and ugly". Li's idea represents almost most people. "Overeating and vomiting are incredible and incomprehensible things."

"Overeating and vomiting after meals are essentially emotional mishandling." Han Xu, a psychotherapist who participated in the "China Red Cross Relief Project for Eating Disorders", said that many eating disorders patients have the common characteristics of perfectionism and inferiority. They are excellent, but they are not good at discovering and expressing their emotions.

Most patients believe that the social and cultural values of "thinness is beauty" provide a hotbed for eating disorders. Many of them encountered pressure from family and society on their physical problems when they were growing up.

Although young girls like Lin Tingting have realized the dangers of overeating and vomiting, deep down, they still agree that "thinness is the standard of beauty".

Parents also hold this view. When talking about her daughter's weight-loss behavior, a mother said that there was nothing wrong with the weight-loss behavior itself, but it led to bulimia nervosa. "Isn't losing weight the career that women pursue all their lives?"

The research shows that the high incidence age of bulimia nervosa is 12 to 35 years old, the average onset age is 18 years old, and the ratio of male to female is 1: 13. Female middle school students and college students like Lin Tingting are at high risk of eating disorders.

Is obesity more valuable than life?

No one knows what caused Lin Tingting's pain. Chen Jue said that the medical community is also trying to find it, but there is no conclusion. Like all mental diseases, eating disorders are multifactorial diseases.

"Genetic basis, life events and personality basis, social environment and family environment work together, that is, the' biological-psychological-social' model." Chen Jue added that "social and cultural" factors, such as the social values of "being thin is beautiful", play an important role in eating disorders.

20 17 years 10 month is the coldest winter in Lin Tingting's memory. She confessed her bisexuality to her mother, who could not accept it, and the mother and daughter fell into a cold war.

It's the Spring Festival, and the dining table at home is full of big fish and meat. Lin Tingting enjoyed the food crazily, then rushed into the bathroom and spit it all out. This is the most serious period of her illness, from overeating and vomiting once a month to overeating and vomiting three times a day.

In the evening, she stays alone in her room, thinking about the meaning of life. I can't figure it out. Then keep your eyes open. Stay up all night. A few days later, she was diagnosed as anorexia nervosa and depression by a general hospital in Wuhan.

In fact, Lin Tingting is not an isolated case. Foreign scholars have found that bulimia nervosa patients like her suffer from depression and anxiety, and these patients may also suffer from substance abuse, impulsive/risky behavior and borderline personality disorder.

He Yi is an eating disorder patient with a 7-year history of bulimia nervosa. When gluttony and vomiting lasted for four or five years, she saw blood in the vomit. The instinct of survival made her start to save herself-reading medical books and asking for help from medical institutions. But it's still a little late. Frequent vomiting brought a morbid reaction to her body.

Every night, He Yi is always hit by a disgusting feeling. Too late to go to the toilet, she could only stick her head out of bed and spit sour water on the floor. After several rounds of vomiting, the reflux will stop and the nausea will gradually disappear. This is a rare moment of despair in her life. "I lay alone in the dark, crying silently, worried that I would never get better."

Her teeth were also corroded by stomach acid. Four molars have serious dental caries, and eating food that is too cold or too sour will hurt. Every time she goes to the dentist, the dentist tells her to eat less sugar. She could only say with a wry smile, "Good."

"Some patients repeatedly vomit, which not only causes dental problems and swollen glands, but also may cause serum electrolyte disorder, causing arrhythmia and life-threatening." Chen Jue explained. It is reported that patients with eating disorders died of cardiac arrest, renal failure or other physical complications.

Even in the most desperate moment, Lin Tingting and He Yi never thought of asking their parents for help. "They won't understand."

Eating disorders form a barrier between children and parents. Few parents can break it.

Lin Tingting's mother didn't know that her daughter was overeating and vomiting. Compared with bulimia nervosa, Lin Tingting's mother thinks depression is more worrying. After her condition was stable, He Yi confessed her tortured experience to her parents.

In the memory of psychotherapist Han Xu, even if parents take their children to see an eating disorder specialist, they often fall into a strange circle of mutual accusations. Parents always think that children just do too much. If they hadn't done it, they would have been fine. The child also thinks that her illness is related to the way her parents treated her when she was a child. When parents say that their children are fat, they will feel inferior and try to lose weight.

Chen Jue said that many patients don't know that eating disorder is a problem that needs to be treated in psychiatric department. In the diagnosis and treatment, many parents think that not being able to eat is a gastrointestinal problem, depending on the gastroenterology department; Amenorrhea is an endocrine problem, which depends on Chinese medicine or endocrine. Many times, the illness has been delayed.

Even professional doctors have failed to get out of the cognitive blind spot. Li Miao is an eating disorder patient who has suffered from bulimia nervosa for nine years. She once saw in the textbook that her symptoms met the diagnostic criteria of bulimia nervosa, but she was not sure. One day on 20 15, when she finally got up the courage to walk into a local mental hospital, the doctor told her that it was not a disease and did not need treatment. Due to the lack of timely treatment, the eating disorder in Li Miao has become more and more serious.

Han Xu once encountered an extreme case. The day before, a girl was still consulting on an online medical platform about how to treat eating disorders. The next day, she saw the news of the child's death from her parents. Han Xu said that every time I see such news, I feel very sad.

Similar tragedies have been repeated too many times. In Baidu's "Gourmet Bar", which has gathered more than 23,000 users, many patients know the story of a mother and daughter.

My daughter died of excessive weight loss. In the two years after graduating from college, the postgraduate entrance examination and the national examination failed one after another, so she had to pin her hopes on controlling her figure. Finally, even her most trusted body betrayed her. At the end of her life, she wrote: "gastric ulcer, secondary amenorrhea, esophageal reflux, I don't know how many problems there are." Maybe one day, this tortured body will never work like an aging machine again ... "

In the same post bar, my heartbroken mother wrote a post: "Since the moment you left me and closed your eyes, my heart has been broken. Son, you are not fat but slightly fat, but you don't know who misled you and fell into the wand (palm) to lose weight. In the past three years, this wand (palm) has been in charge of your destiny, draining your blood and controlling your soul until the oil runs out and the lamp runs out. Is obesity more valuable than life? I hate myself for not discovering your secret earlier, and the result is irreversible. My mother wants to cry. "

The sooner you come for treatment, the easier it is to recover.

Eating disorders are not hopeless.

Chen Jue said anorexia nervosa and bulimia nervosa can be cured. Taking anorexia as an example, the data show that 45% of patients can be cured, 30% have a moderate prognosis, 25% have a poor prognosis, and the mortality rate is 5%- 15%. But at least nearly half of the patients can be cured. Similarly, the cure rate of bulimia is over half.

In recent years, the support of medical resources in related fields has been increasing. Shanghai Mental Health Center, Peking University Sixth Hospital and Dalian Seventh People's Hospital have successively set up specialized wards for eating disorders.

"Social support is very important for rehabilitation." After experiencing an eating disorder, Ameliia quit her job in Beijing and went to the United States to study for a master's degree in clinical social work on 20 16. She looks forward to becoming a professional psychologist.

After re-examining the past seven years, she realized how ridiculous her mentality was at that time.

"I will attribute the fact that the boys I like don't like me to being too fat, and ignore that it is a small probability event for men and women to look at each other at the same time; I will attribute my failure to get promoted soon after joining the job to my bad looks and will not think about other reasons. " He Yi said, "Overeating and vomiting have unconsciously become tools to help me escape the pain of life, because it is too difficult to face many problems in life, and' slimming' has become a concrete and operable task."

Lin Tingting is like He Yi in the past. She is still spinning in the thinking that "getting thinner can solve all the pain".

One day, she felt very sad. Send a WeChat to my mother, "Mom, do you feel black after living for so long?"

"Yes, the day you were sick." Mom, come back.

That night, Lin Tingting stared at the mobile phone screen and cried.

"If I accept myself one day, I may not overeat and vomit." She knew the crux of her problem for a long time, and she wanted to try to accept her imperfect self.

When she got up the next day, she obediently ate the prozac and topiramate prescribed by the doctor.

"The sooner you come to treatment, the easier it is to recover." Chen Jue said that for many people with eating disorders, the hardest step is to make up your mind to receive treatment.

(To protect patients' privacy,, Li,, He Yi, are pseudonyms. )

Text/Zhang Xiaolong

Editor/Hu Jie

Come and play with onion jun ~?

You have to ask about feelings. The following is a description of a bulimia patient who came to me for consultation:

1, I feel that I am not a normal person and can't even eat the most basic things. Either starve yourself or eat and die until 20 points, and then spit it out 15 points.

2, feeling lonely: countless times a person walked on the road of campus, a person walked on the way to work, looking at the normal people passing by, some holding hands, some saying it was effective, feeling far away from themselves, leaving only themselves and food in the world. Behavior, others are normal people, only their own loneliness; Psychologically, only oneself are obsessed with this unspeakable secret loneliness.

It's ironic that every time I leave the gym with my boyfriend, I feel like a millionaire thief and rush to the dessert shop like a defeated thief. For a second, I was still clinging to my boyfriend's lips. This moment: greedy shame, mechanical stuffing, inhuman chewing, repeated over and over again.

4. I feel that I have lost my dignity: I traveled with my boyfriend, bought special products for my teachers and classmates, and ate eight boxes of durian cakes by myself. When he went out, he dared not leave his bag in the hotel, so I put it back in the exquisite box intact and stole it like a thief. Bought food and ate it on the way; A person orders a table of rice, regardless of the eyes of the people next to him, and can't wait to stuff it like a hungry ghost; Stealing a roommate's snack in the dormitory to eat ~ feel for yourself

5. I feel that I am surrounded by inferiority and self-blame all day, and I have no happiness: if someone praises me for being good-looking, I will think that this person is a liar, seriously insecure, inferior and depressed, and feel that I am a pile of garbage. People who like me are fake. They are attracted by my fake shell, and they are all hypocritical. Looking at those beautiful girls on the road, thin and white, and a good boyfriend who really loves her, I feel that the world is just unfair.

Gluttony is seriously eroding the inner world of countless people.

I am a consultant who specializes in treating bulimia after my recovery.

If you have an eating disorder, that person's health should be very troublesome.

In fact, it is a general term for anorexia or bulimia. The psychological level is strict with the body and addicted to losing weight. Or people who are comfortable only by eating are addicted to gluttony, and after overeating, they have to offset it in inappropriate ways, such as vomiting, abuse of diuretics or laxatives, dieting or excessive exercise.

This is particularly prone to endocrine disorders, abnormal eating behavior and psychological problems. Generally, few people are willing to admit that they are sick directly and will not take it out at will. Sometimes, a disease must be diagnosed by a doctor, not once or twice.

The mortality rate of patients with eating disorders who meet the hospitalization criteria is about12%; Among patients diagnosed with severe malnutrition, the mortality rate is15%-20%; As far as anorexia nervosa is concerned, the mortality rate is 0.56%, which is more than 12 times that of young women in the general population. About half of anorexia nervosa patients can be cured, about 30% patients have partial remission of clinical symptoms, and 20% patients have no improvement.