|What is bulimia nervosa?
Bulimia nervosa is a psychological illness characterized by
the sufferer binging and then purging themselves of food. It is often related
to both anorexia nervosa and binge-eating disorder. However,
the sufferer may not always have a morbid fear of weight gain
and there are those who purge without binging, a condition that has been
identified (but not officially diagnosed) recently as purging disorder.
There are many methods of purging, although self-induced vomiting
is the most common. Other methods include laxative and diuretic
abuse, over-exercise and periods of starvation as a means of
compensating for calories consumed.
Eating disorders, particularly anorexia and bulimia, usually
affect females but the number of male anorectics is on the
increase. Somebody can develop anorexia at any age, in any
place and in any situation.
Facts and statistics for bulimia
Causes of bulimia nervosa
As with other eating disorders, there is no pre-determined cause
of bulimia and the reasons for the onset of the disorder may
vary from person to person. Is it common for anorectics to progress
to bulima. The concept of trying keep control is not as strong
with bulimia as anorexia (although there are still some elements
of it). Bulimia is much more spontaneous illness. Because of
this, perhaps it is not surprising that suicide attempts are
common among bulimics.
Causes of eating disorders
Behavioral signs and symptoms
Somebody suffering from bulimia may make frequent trips to the
bathroom, especially after eating. The length of time taken
for these bathroom trips can depend on the amount of food consumed
and the need felt by the sufferer to purge themselves of it.
Many bulimics may try to avoid consuming food. This may because
of a fear of gaining weight (as in anorexia) and it may also
be to avoid the unpleasant ritual of purging afterwards.
Other signs include fluctuations in weight, eratic behavior
and mood swings. Most bulimics are not underweight and the disorder
can often go unnoticed for much longer than anorexia.
Physical signs and symptoms
There are many physical symptoms associated with bulimia, many
of which are similar to the effects of anorexia. Rupture of
the esophagus is of particular concern and, while rare, it is
not unknown for a sufferer to die the first time they purge.
Some of the physical signs and symptoms associated with bulimia
What these symptoms mean
- Tooth decay
- Stomach & intenstical ulcers
- Inflammation & rupture of the esophagus
- Irregular or slow heart beat
- Heart failure
Diagnostic criteria (DSM IV)
1. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
2. Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, enemas, or other medications; fasting; or excessive exercise.
- Eating, in a discrete period of time (e.g. within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances.
- A sense of lack of control over eating during the episode (e.g. a feeling that one cannot stop eating or control what or how much one is eating).
3. The binge eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for 3 months.
4. Self-evaluation is unduly influenced by body shape and weight.
5. The disturbance does not occur exclusively during episodes of anorexia nervosa.
Diagnostic criteria for all eating
Purging and non-purging type bulimia
Purging type bulimia involves the physical expelling of food and calories from the body. For example, self-induced vomiting, laxative and diuretic abuse, and the misuse of enemas are all purging type bulimic behaviors.
Non-purging tyype bulimia involves inappropriate compensatory behaviors but the sufferer has not engaged in self-induced vomiting or laxative, diuretic and enema abuse. Typical non-purging type behaviors include fasting and excessive exercise.