Conditions and Disorders
Bulimia Nervosa is a disorder characterized by excessive eating followed by a necessity to rid oneself of the calories through an unhealthy method. Many bulimics purge the contents of the stomach by vomiting but some choose to abuse laxatives or engage in unhealthy excessive exercise. People with bulimia are usually obsessive about their body image and view their bodies in a very critical way.
Symptoms of bulimia include:
- The sense of lack of control of eating
- Binging food (eating much more than a usual meal or snack)
- Forcing self to regurgitate food after one eats
- Exercising to excess
- Abuse of laxatives, diuretics or enemas
- Preoccupation with body shape and weight
- Having an inaccurate, extremely negative self-image
- Teeth and gum damage
- Sores in throat or mouth
- Swollen salivary glands
- Irregular heartbeat
- Menstrual irregularity or complete loss of menstruation
- Depression, anxiety
Some people with bulimia purge their food after a binge, however, others purge after only a regular sized snack or meal. A binge is eating a much larger amount than would be considered normal for the situation. For instance, during a binge one might eat an entire pizza as oppose to one or two slices. The consumption may continue until the person is full to the point of discomfort or pain. Many people with bulimia carry out their binges in private for fear of being judged for eating. Right after the binging commences, purging follows. This could come in different forms including inducing vomiting, working out for hours on end, or restricting food for a long period of time. This disorder may be a difficult disorder to spot because not all bulimics are skinny as one might imagine. Many of them are normal weight or slightly overweight.
Bulimia nervosa is mainly categorized in two different ways: purging bulimia and nonpurging bulimia.
Purging bulimia is the type that involves forcing oneself to vomit or ingesting laxatives, diuretics or enemas after a binge.
Nonpurging bulimia is the other methods to compensate for a binge including fasting or overexercise. Some bulimics exhibit behaviors of both types and they are both considered forms of purging, no matter the method.
The first step in seeking help for bulimia is to reach out to someone. This would ideally be a doctor or a mental health professional but could be another trusted individual.
There are many factors that could play a role in the development of bulimia nervosa. These include genetics, behaviors, emotional wellbeing, and the pressures of society. Genetics of an individual has been shown to be a possible cause for bulimia. People with first degree relatives with the disorder are more likely to develop it themselves. It has also been suggested that those with bulimia may be lacking the chemical serotonin in their brain.
Behaviors that are usually thought of as healthy may lead to bulimia. These may include dieting or an obsession with exercise. For instance, dieting may lead to the obsession of losing weight and rules concerning eating. When these rules are broken, one might feel disappointed or ashamed and try to compensate through a method of purging.
Emotional health may also be a contributing factor for bulimia. Those with the disorder may have low self-esteem, perfectionism, impulsive behavior, family issues or problematic interpersonal relationships.
There are some societal influences for the development of bulimia. The modern Western culture often equates being thin with success and power. Pressure from what one sees in the media as being important may lead to a preoccupation with weight which could lead to bulimia.
Risk factors for the development of bulimia are being female, youth, family history, dieting, overly critical family, emotional disorders, and sports, or artistic professions. Some professions or artistic activities which may be a risk factor are athletics, acting, dancing, and modeling. Bulimia is also common among ballerinas, gymnasts, runners and wrestlers.
Some repercussions of bulimia nervosa are heart problems, tooth decay, absence of menstrual cycle, digestive disorder, drug or alcohol abuse and even death.
Treatment for bulimia is usually done through a team of professionals to provide many different therapeutic options. Psychotherapy is instrumental in the recovery of bulimia. Cognitive behavioral therapy, which stresses the idea that your own thoughts determine your actions, not the thoughts of others, has been utilized with success. Cognitive behavioral therapy also challenges negative beliefs and helps replace them with healthy ones. This may include the idea that restricting diet is key to weight loss when in reality it may lead to binging. Family therapy is another psychotherapy method that has been beneficial for the treatment of this disorder.
Medications are also a powerful tool in the recovery from bulimia. The only medication approved for this use is fluoxetine (Prozac). However, other medications may be administered. These may help the underlying mental disorders that lead or fuel the bulimia.
Weight restoration and nutrition education is also helpful for the bulimic. If the bulimic is underweight, reaching a healthy weight is the goal of this treatment option. No matter the weight of the individual, dietitians and other health professionals can provide information on healthy eating and set up a plan for eating well. There are even medically supervised weight loss programs that may be implemented.
Bulimia is usually accessed outside of a hospital setting. However, some severe cases require hospitalization. This may be in a psychiatric or medical ward. The bulimic may also benefit from enrollment in an eating disorder clinic, either inpatient or outpatient depending on the individual case.