title: The "double life" of bulimia: patients' experiences in daily life interactions.
abstract: This qualitative study, using interviews with 38 subjects, explored how and why they conceal bulimic symptoms and the understanding of concealing in terms of social interaction. A "double life" was described as a dichotomy between being active and outgoing versus performing shameful bulimic behaviors and constantly living with fear of stigmatization, and striving against exposure. Concealing was well planned to avoid such fear, and to preserve dignity. Bulimia may be understood as volitional exertion of interaction control, not just as a result of poor impulse regulation. Understanding the meaning of secrecy and "double life" may facilitate help seeking behavior and guide treatment.
authors.affiliation: Department of Research and Development, University Hospital, Northern Norway, Tromsø, Norway. Gunn.Pettersen@unn.no
authors.forename: Gunn
authors.initials: G
authors.lastname: Pettersen
authors.forename: Jan H
authors.initials: JH
authors.lastname: Rosenvinge
authors.forename: Borgunn
authors.initials: B
authors.lastname: Ytterhus
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000328:Adult; D002032:Bulimia / Q000523:psychology; D052018:Bulimia Nervosa / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D003219:Confidentiality; D003469:Culture; D008192:Deception; D005215:Fasting / Q000523:psychology; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D007406:Interview, Psychological; D010342:Patient Acceptance of Health Care; D012649:Self Concept; D012752:Shame; D012803:Sick Role; D012919:Social Behavior; D012934:Social Isolation