Read time: 14 minutes

Quick safety note
If you feel physically/mentally unwell right now or have severe stomach pain, vomiting blood, chest pain, fainting, or signs of very low potassium from self-induced vomiting like muscle weakness or a racing or irregular heartbeat, seek urgent help. In the UK call 999 for immediate danger or use NHS 111 for urgent medical advice. Beat Eating Disorders also offers helplines and webchat.

Before we focus on change, let’s name what is happening

If you’re reading this blog post having just berated yourself for having no willpower, then I get it. I cried myself to sleep more times than I can count because no matter how much I wanted to stop the binge-purge cycle, I found myself fantasising binges, speed eating in secret, and trying desperately to compensate through self-induced vomiting, exercise and restriction. I wanted help, but I felt weak, broken and beyond help.

If you’re feeling the same, then I understand. What you might not understand right now is how your brain is working during the binge-purge cycle and what that means for bulimia recovery.

You’re stuck in a habit loop

Put very simply, there’s a cue/trigger, followed by the routine behaviour of binge eating, and reward of purging (we can get more detailed since a binge can also be a reward and there are thoughts involved as well as behaviours – I studied this in my PhD – but you just need to know the basics for now).

Relief now, consequences later

I felt the rewards from self-induced vomiting and before I made the decision to pursue recovery, I was only binge eating so that I could purge. However, you might HATE making yourself throw-up; some of my clients tell me there is nothing good about it. I totally respect their experience and feelings towards self-induced vomiting, however, I’d beg to differ in the sense that your brain is viewing it as a reward that is reinforcing the habit (otherwise it wouldn’t have developed into a habit). For example, on a purely biological level, the neurotransmitters thought to be released after vomiting have a calming and sometimes euphoric effect. Plus, often people say there’s physical relief for your stomach and reduced worries of weight gain. Yes, this immediate reward is also paired with dangerous physical consequences – but those costs can seem less important as they might show up later.

When is the cost too high?

I knew self-induced vomiting was dangerous – a quick Google tells you a sizeable list of negative health effects, including death. Still, I needed three things to land before I pursued recovery.

First, a compassionate dentist telling me fairly bluntly the damage that bile was doing to my teeth, followed by a tooth extraction.

Second, forcing myself to sit down and make a spreadsheet of just how much I was spending on food. The nearest supermarket was Waitrose, so it wasn’t a small amount.

Thirdly, I spent a whole trip to Lanzarote planning when my boyfriend would be out of the hotel room and I could purge in peace.

I got angry – bulimia was costing me too much. It was ruining my teeth, my finances and what was supposed to be a lovely holiday. The pain of continuing finally outweighed the pain of change.

Is it time to take action on self-induced vomiting?

Perhaps you’re at that point where you know you absolutely can’t continue this way, you’ve tried to fight the urge to purge but nothing has helped so far and it almost always wins out. Or perhaps you’re just starting to consider that you need to make a change and haven’t taken any action yet.

Here are some things you can try when you want to stop self-induced vomiting after a binge, based on research and experience (personally and my 1-1 clients).

What can actually help in the next 60 minutes?

You do not have to find a perfect answer right now. A great place to start in breaking the binge-purge habit loop would be to reduce reinforcement from vomiting and show your brain a new story.

Delay acting on the urge, even by 1 minute

 If you’re reading this article for a couple of minutes, that is an excellent place to start and I’m so proud of you. Even a one minute delay could be enough to start changing the pattern because you’re not getting the immediate reward your brain expects. Plus, it gives you evidence that the urge does not control you.

If you’re so inclined, you might like to literally set a timer and challenge yourself not to purge until at least after it goes off. I have seen some articles about delay tactics that suggest starting with 10 minutes, but that would have been a complete non-starter for me at the height of bulimia and feels unachievable for many of my clients when I first see them. I say, start where you can. Sometimes it’s better to start small, see how you feel when the timer goes off, and add on extra time if you feel like it in the moment.

Within the ‘delay’ you can try the strategies suggested below to reduce the urge. Or just sit watching the timer count down!

The point isn’t necessarily that you don’t purge after the timer, it’s to increase the time between the end of a binge and a purge.

Urge surfing

Within the delay between a binge and purge, you might notice that the urge rises, peaks, and (with a longer delay) falls. Learning to notice and sit with that is called ‘urge surfing’.

I found this tricky to master because sometimes at the peak, when my thoughts were literally screaming at me to open the cupboard (side note: I was in a flat where my bedroom and living room were literally in the kitchen), it felt like they would never die down. Being mindful of the thoughts and feelings sometimes seemed to intensify them, as I would latch onto them, instead of trying to distance myself and observe what was happening. However, after having a few experiences of waiting it out and the urge subsiding, it strengthened my belief that I could ride it out. Sometimes I’d binge later (because I wasn’t addressing the triggers/cues, how I felt about myself or other important things), but I still think urge surfing was worthwhile to reduce the power of purging as a reward.

Use grounding techniques that you can tolerate right now

Go gentle. For example,

• Simple box breathing; four counts in, hold for four, out for four, hold for four
• Emotional Freedom Technique (EFT)
• Butterfly tapping
• 5-4-3-2-1 grounding scan using your senses.

I had a client who loved to go outside barefoot, to feel the grass between her toes and cuddle her dog until the urge passed. She told me one week how much she had enjoyed going outside in the pouring rain as it really changed her emotional state and took her mind off how full her stomach was and how guilty she felt.

Check out this instagram post for 35 emotion regulation strategies

Change the reward with intentional activities

Generic advice like “read a book” or “go for a walk” rarely reduced my urge to binge or purge.

I tried to read and realised that I hadn’t taken in half the words because I was thinking about how awful I felt, which prompted me to purge.

Or I’d go for a walk and spend the whole time planning what else I would eat when I got back.

Funny enough, reading helped me immensely when I came to the idea myself. I realised that the bingeing and purging had become a way to regulate my emotions and avoid going to work in university because I was putting so much pressure on myself to be the perfect PhD student (I think purging did start out very much about trying to ‘get rid’ of a binge, and the rewards morphed along the way). I spoke to my PhD supervisors (to tell them I was dropping out) and they convinced me to cut myself some slack. So instead of going home at lunch time to the inevitable binge-purge marathon I decided that I wouldn’t go back to uni and I’d read a pop-psychology book instead. I gave myself the reward of avoidance through a different means. It wasn’t a magic fix, but it worked way better than other things that I’d tried until that point.

I’ve had more than one client tell me that choosing to walk on the beach has been helpful – they have found ways to make it enjoyable and rewarding by picking up treasures like sea glass and pebbles, and regulating by attuning themselves to the present moment (smelling the salty air, feeling the wind in their hair).The key is not simply reading or walking, but understanding the role purging can play for you and trialling new behaviours to achieve that, ideally without harm.

If the reward of vomiting is feeling soothed, then think warm shower, weighted blanket, scented candles and calming music. If your reward is connection, then why not send a prewritten text to an accountability buddy. If you think a key reward of making yourself vomit is self-punishment, then perhaps it is best to focus on one of the other suggestions here, or you may be able to take a harm-reduction approach in behaviour swapping.

Note: I put ‘change the reward with intentional activities’ the ‘quick-wins’ subheading because once you have found the activity then you can do it quickly after a binge, but it can take you a while to better understand the habit loop and explore options.

Distract, distract, distract

I think distraction can get a bad rep, when we are told to ‘feel our feelings’ or be mindful. I did mention about mindfully ‘urge surfing’ above, and at the same time, I recognise that wanting to tune out the urge is real and distraction has its place. I’m totally ok to tell you that within the space of a few months I watched all 121 episodes of the OG Gossip Girl while simultaneously playing Candy Crush, just to keep myself glued to the sofa after a binge and ride out the urge to purge. It felt dysfunctional and I was angry at myself for procrastinating instead of finishing my PhD, but now I see it as active coping and doing what I could to break the cycle.

Get comfortable

If you’ve eaten past the point of fullness then it can be really uncomfortable. Experiment with what can support you during that time – loose fitting clothes, a warm blanket (weather dependent) and peppermint tea were my go-to. Using essential oils that feel calming or comforting is another option. I share 3 blends with my new clients in their welcome pack so they have something easily to hand.

What can help stop self-induced vomiting in the next 24 to 72 hours?

Regular eating

The temptation to start a new diet or to skip the next meal to compensate for a binge that you did not purge is often strong. However, I can’t think of a  time that I’ve seen drastic diets like juicing, fasting or cutting whole food groups help someone stop purging long-term.

Skipping meals and imposing new rules is likely to set you up for another binge. Many people find three meals (with protein, carbohydrates and fats) and two to three snacks beneficial to stabilise hunger and reduce the binge-purge momentum. If a binge happens right before breakfast, lunch or dinner and eating a full meal feels physically impossible, then be honest with yourself. Is this restriction to cancel calories, or is it self-care in choosing a little less this one time, then returning to your normal pattern at the next planned eating time? If the binge happened at night, breakfast the next morning is often protective.

Track patterns with curiosity, not for punishment

Some people would identify themselves as structured binge eaters, for example only bingeing in the evening or after specific events. Others have no idea what triggered it. For the next few days, keep a journal with significant events from the day, a rough overview of what you ate, and how you felt. It’s not a calorie log it’s meant to be a way to remember what happened and find patterns. If you’re getting sucked into self-judgement, then sometimes it helps to visualise yourself literally stepping back and trying to take a third person perspective on what happened that day.

If you’re struggling to identify triggers, then check out this post on Instagram.

Create an ‘implementation intention’

Usually we say to ourselves something like “This is the last time I will purge EVER. I’ll never let myself do it again”… and then you likely soon find yourself acting on the urge to purge.

Creating a specific intention or plan can help you to follow through. Brainstorm all the ideas that could help you ride an urge or replace the reward. Then choose one (or maybe two). When you keep it too broad or don’t give yourself a precise instruction then decision fatigue hits at the exact moment you need clarity. So instead, say to yourself “If I have binged and get the urge to purge then I will [insert specific behaviour or self-talk here]”.

So, as I explained above, my coping was to say “If I’ve binged and want to purge, then I will avoid the bathroom and instead watch Gossip Girl and play Candy Crush until it passes”.

If you made yourself throw up 

Debrief and redefine success

It can feel like everything you’ve tried was for nothing. You might want to throw in the towel. Instead consider having a debrief – What happened? What was the cue? How did the binge and purge provide a reward/benefit in the moment? What techniques did you try when the urge arose? What was different than before? What might you do differently next time?

Download the Emotional Eating Tracker.

Tiny wins matter. Delayed by one minute. Watched TV instead of acting on the urge. Rinsed instead of brushing. Ate breakfast after a nighttime binge. Texted for support. Each small win weakens the loop. Harm-reduction is a very valid approach in recovery.

I can’t tell you the positive impact that adopting a learning mindset instead of a critical one can have on people’s motivation, self-compassion and speed at which they reduce purging.

Gentle body care if you do make yourself vomit.

Over the 7 years that I’ve worked with clients, there have been a few who stopped making themselves vomit absolutely cold-turkey.

More often than not, purging reduces over time as people learn how to avoid or address triggers, find appropriate rewards, shift their mindset around food and themselves, and to process traumas.

Looking after yourself post purge can benefit your physical health and also soften the guilt or shame that often emerges.

• Rinse your mouth with water to clear acid. Avoid brushing your teeth right away because enamel is softened by acid. If you want extra protection, a fluoride mouthwash or dabbing a little fluoride toothpaste with a finger could help. Brush later, about an hour after, when things have neutralised.
• Hydrate if you can – I found drinking a lot to be a trigger for another round of bingeing and purging, but a few sips of water helped.
• A neutral temperature shower can help you reset.

If you want help applying this in real life

My Nourish 1-1 program offers a way out of the restrict-binge-purge cycle. Together, we can build a detailed picture of your habits, how to break them, and build healthier ones. You get accountability 7 days a week so you don’t feel alone when urges spike and can access coaching between sessions. This isn’t a surface level program, it’s tailored to your specific needs, with trauma work and hypnotherapy to rewire old beliefs about control, safety, and enoughness.

If you are ready to stop purging after a binge and commit full bulimia recovery, or a harm reduction approach, then I am ready to help. Click here to book a free 30 minute clarity call.