In our fourth column with Kat James, she answers a reader question about bulimia. A self-proclaimed "informed layman," James' rare personal perspective on self-transformation and real (as opposed to merely apparent) victory over an eating disorder has given her insight into compulsive self-sabotage — and freedom from it — beyond what most doctors and nutritionists can grasp. As someone who actually transformed herself beyond recognition (beyond dropping ten dresses, she reversed a serious liver disorder, chronic eczema and myriad other problems, in addition to banishing a twelve-year eating disorder) she has faithfully translated her principles, and the copious medical references that now support it, into a book and a cruise experience that are as exciting to experience as they are physically rewarding. (To see pictures of Kat's transformation, click here).

Dear Kat: I have an obsession with food and I am also bulimic... I really need help on how to control it. I would like any suggestions you could give me.

Kat James: The bingeing and purging has been going on ever since I was in seventh grade (I am 25yrs old now). In sixth grade I weighed 175 lbs and was teased and humiliated terribly by my family and 5 older brothers. In the 7th grade I moved to a bigger town and was so scared that I dieted heavily and lost 40 lbs. Everyone liked me and I swore I would never be heavy again. Later that year I started to gain weight and didn't know how to lose it so the binging/purging started. I couldn't stop. I thought about food non-stop, I would eat a whole pizza myself, a whole bag of chocolate and then some just so I could throw up. It later became a control thing. When I was under stress, I would do it more and more.. It got so bad that I was throwing up at least 25 times a day and sometimes more. It was just built into my normal routine. I know it is affecting my health because my stomach hurts all the time, I always have headaches. I am now married with two children and I have tried to talk to my husband about the problem but he doesn't understand at all. I feel like I am going at it alone. In college I did go to a therapist but felt so humiliated and embarrassed about my condition that I quit. I don't feel comfortable enough to go to anyone and I don't know how to go about it. I don't feel like male doctor's understand because I view them much like my husband. What do you suggest?

T.P., South Dakota

Dear T.P.,

Kat James: The first thing you must do if you haven't already is find a good doctor to keep an eye on your condition. You might check out HealthWorld’s Referral Network to find an integrative physician in your neck of the woods, so you get a full picture of both your underlying health issues and the full spectrum of options with which to address them. Second, you must use time alone to explore and uncover your emotional issues and triggers, as well as connect with the inner strength to give yourself emotional padding and sanctuary from harsh self-judgment. Limit your exposure to negativity; allow yourself to be selfish and apologize in advance to others about needing space. Don't avoid facing your problem by distracting yourself with activities or by not saying no to social obligations.

Now picture your life without the problem. Are you ready for life without your "handicap" to focus on? Don't indulge in if-only-I-were-thin dreams. Love the you that has the problem.