Low self-esteem and low self-worth: What it’s like to live with bulimia

As many as 725,000 people are affected by an eating disorder in the UK per year

Bulimia nervosa is typically defined as food binging, and before 1980 this disease did not even exist in the eyes of medical professionals.

Bulimia is a secret disease; on the outside the individual suffering usually appears confident and in control, however, on the inside they struggle with low self-esteem and self-worth, and find it difficult to put their feelings into words.

Brookes third year, Rachel, suffered from bulimia for four years. In that time, she went from a size 10 to a size four. Rachel said it was worst the first time she purged, and shortly after when weight loss was noticed. Rachel commented: “Liking someone and seeking their approval, which I thought was body image, meant I was focused on having a good body. I found being sick as a way to lose weight was a fix for the full feeling after a large meal.”


Often small statements, such as “oh, you’re going to eat all of that?” can be taken deeply. Rachel found such words hard to hear, commenting: “They didn’t know all that food wasn’t going to stay in me, and it made me think that they thought I was fat”.

Registered dietician, Shannon Casey, told The Tab Brookes that this shows the power of the media to our generation, and how easy it is to think “weight loss associated with positive reinforcement”.

Shannon continued: “Often working with someone is helping them understand their hunger levels and responding accordingly to satisfy themselves”.

Coming out of a relationship with an older, popular guy, Rachel felt the pressure to “uphold my reputation”, which at this point was her tiny figure. Rachel commented: “He was into emo culture that in particular glorified drugs. He expressed that he liked my tiny figure and that made me feel I had to uphold it”.


There isn’t always a clear cut moment where you know you have an issue and need help, often it is an amalgamation of events that opens your and the eyes of those around you to the problem. Through continued drug and alcohol abuse, Rachel had the feeling something was off. Ending up in hospital following an attempt on her own life solidified this thought. She said:”I realised something was wrong, but it didn’t make me stop””I realised something was wrong, but it didn’t make me stop”. Shannon explained that this kind of behaviour can be a cry for help. She commented: “This is often the signal that they know something isn’t right but they truly cannot articulate it”.

At this point Rachel got professional help: “I went to CAMs to appease my mum, but I lied throughout and didn’t care”, seeing a dietician once and a counsellor on and off for a year didn’t help Rachel, and she expressed that “you have to want the help, and to change.”


I finally asked Rachel if she felt she understood what was out of control for her, an answer followed that we can all sympathise with: I was insecure, changing schools meant a change in social status, and I didn’t understand that. I wasn’t doing as well academically and I couldn’t seem to control others around me. Food was what I could control”.

Overall, those suffering need to want the help, it cannot be forced. Shannon explained: “The hardest and biggest thing is to admit a problem and get help, once you’ve done that you are affecting change. Life needs to get in the way and food needs to move back to just being fuel. The patient and the professionals need to have a good working relationship in order for change to happen”.