Bulimia Nervosa: Types, Signs, Symptoms, and Treatment

Bulimia Nervosa

Bulimia nervosa, it is an eating disorder characterized by binge eating and purging, or consuming a large amount of food in a short amount of time followed by an attempt to rid oneself of the food consumed, typically by vomiting, taking a laxative, diuretic, or stimulant, and/or excessive exercise, because of an extensive concern for body weight. Bulimia can be dangerous. It may lead to serious medical complications over time. A person with bulimia has not made a lifestyle choice, they are actually very unwell and need help.

Causes of Bulimia Nervosa

Many more women than men have bulimia. The disorder is most common in adolescent girls and young women. The person usually knows that her eating pattern is abnormal and may feel fear or guilt with the binge-purge episodes. 

The exact cause of bulimia is unknown. Genetic, psychological, trauma, family, society, or cultural factors may play a role. Bulimia is likely due to more than one factor.

Warning Signs 

The warning signs of Bulimia can be physical, psychological and behavioural. It is possible for someone with Bulimia to display a combination of these symptoms.

Physical signs:

  • Frequent changes in weight (loss or gains)
  • Signs of damage due to vomiting including swelling around the cheeks or jaw, calluses on knuckles, damage to teeth and bad breath
  • Feeling bloated, constipated or developing intolerances to food
  • Loss of or disturbance of menstrual periods in girls and women
  • Fainting or dizziness
  • Feeling tired and not sleeping well

Psychological Signs:

  • Preoccupation with eating, food, body shape and weight
  • Sensitivity to comments relating to food, weight, body shape or exercise
  • Low self esteem and feelings of shame, self loathing or guilt, particularly after eating
  • Having a distorted body image (e.g. seeing themselves as overweight even if they are in a healthy weight range for their age and height)
  • Obsession with food and need for control
  • Depression, anxiety or irritability
  • Extreme body dissatisfaction

Behavioural Signs:

  • Evidence of binge eating (e.g. disappearance or hoarding of food)
  • Vomiting or using laxatives, enemas, appetite suppressants or diuretics
  • Eating in private and avoiding meals with other people
  • Anti social behaviour, spending more and more time alone
  • Repetitive or obsessive behaviours relating to body shape and weight (e.g. weighing themselves repeatedly, looking in the mirror obsessively and pinching waist or wrists)
  • Secretive behaviour around food (e.g. saying they have eaten when they haven’t, hiding uneaten food in their rooms)
  • Compulsive or excessive exercising (e.g. exercising in bad weather, continuing to exercise when sick or injured, and experiencing distress if exercise is not possible)
  • Dieting behaviour (e.g. fasting, counting calories/kilojoules, avoiding food groups such as fats and carbohydrates)
  • Frequent trips to the bathroom during or shortly after meals which could be evidence of vomiting or laxative use
  • Erratic behaviour (e.g. spending large amounts of money on food)
  • Self harm, substance abuse or suicide attempts

Complications of Bulimia Nervosa

Bulimia nervosa can be extremely harmful to the body.  The recurrent binge-and-purge cycles can damage the entire digestive system and purging behaviors can lead to electrolyte and chemical imbalances in the body that affect the heart and other major organ functions.  Some of the health consequences of bulimia nervosa include:

  • Electrolyte imbalances that can lead to irregular heartbeats and possibly heart failure and death.  Electrolyte imbalance is caused by dehydration and loss of potassium and sodium from the body as a result of purging behaviors.
  • Inflammation and possible rupture of the esophagus from frequent vomiting.
  • Tooth decay and staining from stomach acids released during frequent vomiting.
  • Chronic irregular bowel movements and constipation as a result of laxative abuse.
  • Gastric rupture is an uncommon but possible side effect of binge eating.

Treatment for Bulimia Nervosa

People with bulimia rarely have to go to the hospital, unless they:

  • Have anorexia
  • Have major depression
  • Need drugs to help them stop purging

Most often, a stepped approach is used for patients with bulimia. Treatment depends on how severe the bulimia is, and the person’s response to treatments:

  • Support groups may be helpful for mild bulimia without other health problems.
  • Cognitive-behavioral therapy (CBT) and nutritional therapy are the first treatments for bulimia that does not respond to support groups.
  • Antidepressants known as selective serotonin-reuptake inhibitors (SSRIs) are often used for bulimia. A combination of CBT and SSRIs is very effective if CBT does not work alone.

Patients may drop out of programs if they have unrealistic hopes of being cured by therapy alone. Before a program begins, you should know that:

  • You will probably need to try many different therapies to overcome this difficult disorder.
  • It is common for bulimia to return (relapse), and this is no cause for despair.
  • The process is painful, and you and your family will need to work hard.

Lifestyle and Home Remedies

Although you can’t treat bulimia on your own, you can build on your treatment plan. In addition to professional treatment, follow these self-care tips for bulimia:

  • Stick to your treatment plan. Don’t skip therapy sessions and try not to stray from meal plans, even if they make you uncomfortable.
  • Get the right nutrition. Talk to your doctor about appropriate vitamin and mineral supplements. If you aren’t eating well or you’re frequently purging, it’s likely your body isn’t getting all of the nutrients it needs.
  • Learn about bulimia. Education about your condition can empower you and motivate you to stick to your treatment plan.
  • Stay in touch. Don’t isolate yourself from caring family members and friends who want to see you get healthy. Understand that they have your best interests at heart and that nurturing, caring relationships are healthy for you.
  • Be kind to yourself. Resist urges to weigh yourself or check yourself in the mirror frequently. These may do nothing but fuel your drive to maintain unhealthy habits.
  • Be cautious with exercise. Talk to your health care providers about what kind of physical activity, if any, is appropriate for you, especially if you exercise excessively to burn off post-binge calories.

When To Contact A Medical Professional

If you suspect that you or someone you know has Bulimia, it is important to seek help immediately. The earlier you seek help the closer you are to recovery. While your GP may not be a specialist in eating disorders, they are a good first base. A GP can provide a referral to a practitioner with specialized knowledge in health, nutrition and eating disorders.

If Your Loved One Has Bulimia

Although there’s no sure way to prevent bulimia, you can steer someone toward healthier behavior or professional treatment before the situation worsens. Here’s how you can help:

  • Offer compassion and support. Keep in mind that the person may get defensive or angry. But if he or she does open up, listen without judgment and make sure the person knows you care.
  • Avoid insults, scare tactics, guilt trips, and patronizing comments. Since bulimia is often caused and exacerbated by stress, low self-esteem, and shame, negativity will only make it worse.
  • Set a good example for healthy eating, exercising, and body image. Don’t make negative comments about your own body or anyone else’s.
  • Accept your limits. As a parent or friend, there isn’t a lot you can do to “fix” your loved one’s bulimia. The person with bulimia must make the decision to move forward.
  • Take care of yourself. Know when to seek advice for yourself from a counselor or health professional. Dealing with an eating disorder is stressful, and it will help if you have your own support system in place.

Prognosis

Pulimia is a long-term illness. Many people will still have some symptoms, even with treatment.

People with fewer medical complications of bulimia and those willing and able to take part in therapy have a better chance of recovery.

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