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Bulimia and TCM

Dear Dr.Nisters,
As I study dieting (from TCM standpoint) I encountered a forum of bulimia suffering girls, and I felt very sorry for them.  Is it stomach heat or heart qi dysfunction (as I feel it is physiological problem too) or what?

Thank you,

Dear Tatiana,
In terms of bulimia.  It actually gets quite complex.  There are the factors and patterns that lead to the bulimia and then the patterns caused by the bulimia.

At the core of the initial problem that triggers the bulimia there will be liver depression qi stagnation.  Liver depression is engendered emotionally by “unfulfilled desires” which would certainly be the case in someone that goes to such drastic measures to change their appearance or weight.  They are unhappy with what is and have a desire, unfulfilled, to change it.  Often they are seeking some cultural or familial idea of a normative appearance that they cannot attain.

The sources of the liver depression, other than the unfulfilled desires, can be manifold.  According to Liu Wan-Su’s “theory of similar transformations” any of the historical six depressions (now given different terms) WILL transform to other of the depressions unless it is corrected.  The depressions are qi, blood, phlegm, damp, food, food

Then these depressions will eventually engender heat, as human beings are warm by nature.  This will cause a stirring of ministerial fire which will flare up to  vex the heart, among other problems.  This would often be a condition of yin fire, coming from the lower burners and blocking or interfering with the arisal of clear qi and yang upward.  This would make clear thinking difficult and obsessive behaviors could predominate.  The original problem of liver depression qi stagnation will eventually create depressive heat. So, a lot of things go wrong.

The bulimia itself then causes further significant stomach/spleen qi disturbance often with heat or damp heat that will be permanent, unless properly treated, even after the bulimia is stopped.

Essentially, every system is injured and imbalanced, according to TCM theory and my clinical observations.

Be well,

– Dr. John Nieters, L.Ac. DAOM, FABORM

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