Bulimia Nervosa – What it is, Symptoms and Drug Treatments. Additionally, Bulimia Nervosa (boo-LEE-me-uh), commonly called bulimia, is a serious and potentially life-threatening eating disorder.
People with Bulimia Nervosa may secretly abuse — eating large amounts of food — and then purging , trying to get rid of the extra calories in an unhealthy way. For example, someone with Bulimia Nervosa may force themselves to vomit or exercise excessively. Sometimes people cleanse themselves after eating just a small snack or a full-sized meal.
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Types Bulimia Nervosa: Bulimia Nervosa can be categorized in two ways:
- Purging Bulimia: You regularly induce yourself to vomit or abuse laxatives, diuretics or enemas after bingeing.
- Don’t Collapse Bulimia: You use other methods to get rid of calories and prevent weight gain , such as fasting, strict dieting, or excessive exercise.
However, these behaviors often overlap, and trying to get rid of extra calories is often referred to as purging, regardless of the method. If you have Bulimia Nervosa , you are probably worried about your weight and body shape. You can judge yourself harshly and severely for self-perceptive flaws.
Because it’s related to self-image – and not just food – Bulimia Nervosa can be hard to overcome. But effective treatment can help you feel better about yourself, adopt healthier eating patterns, and reverse serious complications.
Causes of Bulimia Nervosa: The exact cause of Bulimia Nervosa is unknown. There are many factors that can play a role in the development of eating disorders, including biology, emotional health, societal expectations, and other issues.
Symptoms of Bulimia Nervosa: The signs and symptoms of Bulimia Nervosa can include:
- Being concerned about your body shape and weight
- Living in fear of gaining weight
- Feeling like you can’t control your eating behavior
- Eating to the point of discomfort or pain
- Eating much more food in a binge episode than in a normal meal or snack
- Forcing yourself to vomit or exercise too much to avoid gaining weight after bingeing
- Misfaction of laxatives, diuretics or enemas after eating
- Restricting calories or avoiding certain foods between binges
- Using dietary supplements or herbal products excessively for weight loss
When to See a Doctor: If you have any problems with Bulimia Nervosa , seek medical help as soon as possible. If left untreated, Bulimia Nervosa can severely affect your health. Talk to your primary care provider or a mental health provider about your Bulimia Nervosa symptoms and feelings .
If you’re reluctant to seek treatment, trust someone about what you’re going through, whether it’s a friend or loved one, a teacher, a faith leader, or someone else you trust. He or she can help you take the first steps towards getting your Bulimia Nervosa treatment successful.
Helping a Loved One with Bulimia Symptoms: If you think a loved one may have symptoms of Bulimia Nervosa , have an open and honest discussion about your concerns.
You cannot force someone to seek professional care, but you can offer encouragement and support. You can also help find a qualified doctor or mental health provider, make an appointment, and even offer to follow up.
Since most people with Bulimia Nervosa are of normal weight or slightly overweight , it may not be obvious to others that something is wrong. Red flags that family and friends may notice include:
- Constantly worrying or complaining about being fat
- Having a distorted and overly negative corporate image
- Repeatedly eating unusually large amounts of food in one sitting, especially foods the person would normally avoid
- Not wanting to eat in public or in front of others
- Going to the bathroom right after eating or during meals
- exercising too much
- Having sores, scars, or calluses on your knuckles or hands
- Having damaged teeth and gums
Risk Factors for Bulimia Nervosa: Factors that increase your risk of Bulimia Nervosa may include:
- Being a Woman: Girls and women are more likely to have Bulimia Nervosa than boys and men.
- Era: Bulimia Nervosa usually starts in late adolescence or early adulthood.
- Biology: People with first-degree relatives (siblings, parents, or children) with an eating disorder may be more likely to develop an eating disorder, suggesting a possible genetic link. It’s also possible that a deficiency in the brain chemical serotonin could play a role. And, being overweight as a child or teenager can increase your risk.
- Psychological and Emotional Issues: Psychological and emotional issues, such as anxiety disorder or low self-esteem, can contribute to eating disorders. Triggers to get in the way can include stress, poor body self-image, food, restrictive dieting, or boredom. In some cases, traumatic events and environmental stress may be contributing factors.
- Media and social pressure: The media, such as TV and fashion magazines, often feature a parade of skinny models and actors. These images seem to equate thinness with success and popularity. But whether the media merely reflect social values or actually drive them is unclear.
- Sports, work, or artistic pressures: Athletes, actors, dancers, and models are at increased risk for eating disorders. Coaches and parents can inadvertently increase the risk by encouraging young athletes to lose weight, maintain a low weight , and restrict eating for better performance.
Complications of Bulimia Nervosa: Bulimia Nervosa can cause numerous serious and even life-threatening complications. Possible complications include:
- Dehydration, which can lead to major medical problems such as kidney failure
- Heart problems, such as an irregular heartbeat or heart failure
- Severe Dozia and Gum Disease
- Absent or irregular periods in women
- Digestive problems, and possibly a dependence on laxatives to have bowel movements
- anxiety and depression
- Misuse of alcohol or drugs
Diagnosis of Bulimia Nervosa: If your doctor suspects you have Bulimia Nervosa , he or she will usually perform:
- A complete physical exam
- Blood and urine tests
- A psychological assessment, including a discussion of your eating habits and attitude towards food
Your doctor may also order additional tests to help identify a diagnosis, rule out medical causes for weight changes, and check for related complications.
Criteria for Diagnosis: For a diagnosis of Bulimia Nervosa , the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, lists these points:
- You repeatedly have episodes of eating an unusually large amount of food – more than most people would eat in a similar amount of time and under similar circumstances, for example, in a two-hour period
- You feel a lack of control during bingeing, such as how much you are eating and whether you can stop eating
- You get rid of the extra calories from bingeing to prevent weight gain from vomiting , excessive exercise, fasting, or misuse of laxatives, diuretics, or other medications
- You swallow and purge at least once a week for at least three months
- Your body shape and weight greatly influence your feelings of self-esteem.
- You don’t have anorexia, an eating disorder with extremely restrictive eating behaviors
The severity of Bulimia Nervosa is determined by the number of times a week you purge. Even if you don’t meet all of these criteria, you could still have an eating disorder. Don’t try to diagnose yourself – get professional help if you have an eating disorder.
Bulimia Nervosa Treatments: When you have Bulimia Nervosa , you may need several types of treatment, although combining psychotherapy with antidepressants may be the most effective for overcoming the disorder.
Treatment usually involves a team approach that includes you, your family, your primary care physician or other health care provider, as well as a mental health provider and a nutritionist experienced in treating eating disorders. You may have a case manager to coordinate your care.
Psychotherapy: Psychotherapy, also known as talk therapy or psychological counseling, involves discussing your Bulimia Nervosa and related issues with a mental health provider. Evidence indicates that these types of psychotherapy help improve symptoms of Bulimia Nervosa :
- Cognitive behavioral therapy to help you identify unhealthy, negative beliefs and behaviors and replace them with healthy, positive ones
- Family therapy to help parents intervene to stop their teen’s unhealthy eating behaviors, then help the teen regain control of their own eating, and ultimately help the family deal with issues that Bulimia Nervosa can have on adolescent development and the family
- Interpersonal psychotherapy, which addresses difficulties in your intimate relationships, helping to improve your communication and problem-solving skills.
Antidepressants can help reduce the symptoms of Bulimia Nervosa when used along with psychotherapy. The only antidepressant specifically approved to treat Bulimia Nervosa is fluoxetine (Prozac), a type of selective serotonin reuptake inhibitor (SSRI), which can help even if you’re not depressed.
Nutrition Education and Healthy Weight: Dietitians and other health care providers can design an eating plan to help you achieve a healthy weight , normal eating habits, and good nutrition. If you have Bulimia Nervosa , you may benefit from a medically supervised weight loss program.
Hospitalization: Bulimia Nervosa can usually be treated outside the hospital. But if you have a severe form and serious health complications, you may need treatment in a hospital. Some eating disorder programs may offer daily treatment instead of a hospital stay.
Treatment Problems in Bulimia Nervosa: Although most people with Bulimia Nervosa recover, some find that the symptoms do not go away completely. Periods of bingeing and purging can come and go over the years depending on your life circumstances, such as recurrence in times of high stress.
If you find yourself back in the binge-purging cycle, “booster” sessions with your health care providers can help you get through the crisis before the eating disorder unravels again. Learning positive ways to cope, create healthy relationships, and manage stress can help prevent a relapse.
Alternative Medicine: Dietary supplements and herbal products intended to suppress appetite or aid in weight loss can be abused by people with eating disorders. Weight loss supplements or herbs can have serious side effects and interact dangerously with other medications.
If you use dietary supplements or herbs, discuss potential risks with your doctor. Ask your mental health provider what psychotherapy he or she will use and what evidence there is that shows it is beneficial in treating Bulimia Nervosa .