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Eating Disorder 101: What is Bulimia Nervosa?

Nov 19, 2021

Eating Disorder 101: What is Bulimia Nervosa?

Bulimia nervosa is one of the most common eating disorders in which a person goes through episodes of binge eating, or eating large amounts of food in one sitting, and then purges that food. In bulimia nervosa, a person goes through many binge-purge episodes per week. They typically eat junk food and high calorie foods in a short time frame and then compensate by purging through self-induced vomiting, purgatives or diuretics, compulsive exercise or fasting.

People with bulimia nervosa feel that they are unable to control their appetite, so they eat uncontrollably resulting in feelings of guilt and shame. These emotions lead the individual to purge the extra calories from the cycle of bingeing. However, once they start this pattern, it becomes hard for them to stop eating excessively even though they feel guilty afterwards. This binge-eating disorder can be a serious threat to a person's physical health and overall wellbeing.

Bulimia nervosa is more common in women, with 90% of bulimics being female. It is less common in men, with only 10% of bulimics being male. Most individuals with bulimia nervosa first noticed a change in their behaviour between early teenage years and mid-20s, though bulimia usually begins during adolescence or college years, most commonly after a major weight gain or obesity episode.

Anyone can be affected by this condition, regardless of age, race, sexual orientation, socioeconomic level or religion. However, the rates are higher among Caucasian females than any other group.

Symptoms of Bulimia Nervosa

People with bulimia nervosa exhibit different behaviours, but the most common symptoms of the condition include a cycle of extreme weight loss and weight gain. The binge-purge cycle causes them to lose a large amount of body weight and become malnourished or underweight. After their bulimic episode, they exhibit compensatory behaviours to try to make up for what they have done by increasing their food intake in order to regain their normal weight. Here are the warning signs or criteria for bulimia nervosa:

  • Recurrent episodes of binge eating
  • Preoccupation with food or finding ways to get rid of it after a binge
  • Frequent trips to the bathroom
  • Irrational dieting
  • Excessive exercise
  • Self-induced vomiting
  • Sore throat as a result of frequent vomiting
  • Swollen salivary glands
  • Misuse of laxatives/diuretics/enemas to lose weight
  • Anxiety disorder
  • Thoughts of distorted body image
  • Depressive symptoms
  • Social withdrawal
  • Suicidal ideations
  • Intense fear of eating

There can also be complications that arise from bulimic episodes, including electrolyte imbalances, which can affect the heart and other organs, resulting in death if not treated properly by a doctor. Such complications occur more often in bulimics who abuse laxatives. Moreover, people with bulimia nervosa seem to be more prone to substance abuse and contracting sexually transmitted diseases than those who don't have the condition.

Causes and Risk Factors for Bulimia Nervosa

There is no known single cause for bulimia nervosa; it is a combination of social, cultural and environmental factors. Bulimia in childhood may result from direct influences from family or friends or from personality traits such as perfectionism.

People with mental health conditions, such as obsessive-compulsive disorder, or who suffer from substance use disorders are also at risk of developing bulimia nervosa. Other risk factors that have been identified to increase the chance for developing bulimia nervosa include low self-esteem, body weight issues or fear of weight gain, and the lack of body development during one's teenage years.

There is no conclusive evidence as to why bulimia starts but there is certainly evidence that it can be overcome.

Treatment Options for Patients With Bulimia Nervosa

Antidepressants or inpatient procedures are often recommended by doctors in the treatment of bulimia nervosa. However, if you fear the side effects that come with conventional treatments, there are natural ways to address the problem. Bulimia nervosa is usually treated through cognitive behaviour therapy (CBT) to help patients get rid of the negative thought patterns that they have surrounding food and weight.

CBT helps bulimic individuals identify their thoughts, feelings and resulting behaviours when it comes to the vicious cycle of disordered eating. It also teaches coping skills like problem solving and stress management. By developing a tailored individual therapy plan, a qualified therapist can assist people with bulimia in changing their distorted perceptions about themselves, their bodies and weight, effectively curbing food binges.

People with bulimia may also receive family therapy, interpersonal therapy as well as nutritional rehabilitation, which includes vitamin supplementation and monitoring of eating patterns. A family-based treatment may be beneficial to improve communication between family members and reduce risk factors that contribute to bulimia.

An effective treatment can help patients regain normal eating habits, achieve a healthy weight by reducing their caloric intake, reduce the risk for mental disorders, and improve their relationships and outlook in life.

Long-Term Effects of Bulimia Nervosa

A person with bulimia nervosa can rupture their stomach or oesophagus as a result of frequent vomiting. If their behaviour persists for a longer period of time, it can also lead to metabolic alkalosis, which creates an imbalance in bodily pH levels and eventually leads to heart failure or kidney problems if left untreated.

Bulimia nervosa can be prevented by early detection of the physical signs in people with binge eating issues. It's also important to provide teenagers who are at risk of the condition with self-help programs to reduce the risk of bulimia nervosa occurring in adolescence.

It is every parent's responsibility to monitor their children's eating habits, especially during puberty when bulimia most commonly occurs among adolescents. Eating disorders are very dangerous and should not be ignored or procrastinated as treatment is needed as soon as possible. The longer a person remains undiagnosed and untreated, the lower their chances for recovery become. 

The long term outlook for bulimia nervosa patients is positive as they could achieve full recovery with successful treatment. However, the severity and duration of this eating disorder, as well as the treatment outcome, will depend on the age at which bulimic symptoms first began, and the frequency and severity of the person's bulimic episodes.

FAQs About Bulimia Nervosa

Do you need a diagnosis for bulimia?

A person's background story is crucial for diagnosing bulimia. By interviewing the patient and their family, the healthcare professional can identify the root cause of the problem. To rule out problems associated with vomiting and laxative usage, they may also perform a physical exam and recommend blood tests.

How does a person with bulimia nervosa feel?

Bulimia nervosa sufferers constantly feel guilt, shame and lack of control. Trying to keep their condition a secret leads to emotional symptoms such as anxiety, depression and fear.

Is throwing up once a week bulimia?

In the expert opinion of a mental health professional, a person who vomits after eating but doesn't binge is not bulimic. Binging and purging should be evident to meet the diagnostic criteria for bulimia nervosa.

Related Topics

Personal Development,  Nutrition,  Dieting,  Binge Eating

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