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bulimia nervosa

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.
visit milestones in recovery

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 include:
  • Tooth decay
  • Dehydration
  • Stomach & intenstical ulcers
  • Inflammation & rupture of the esophagus
  • Irregular or slow heart beat
  • Heart failure
What these symptoms mean

Diagnostic criteria (DSM IV)

1. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
  • 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).
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.

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 disorders

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.