Bulimia nervosa, mostly known as Bulimia is an eating disorder in which the subject engages in recurrent binge eating followed by feelings of guilt, depression, and self-condemnation. The sufferer will then engage in compensatory behaviors to make up for the excessive eating, which are referred to as "purging". Purging can take the form of vomiting, fasting, the use of laxatives, enemas, diuretics or other medications, or overexercising.
Causes:
Types:
Symptoms:
Diagnosis:
Causes:
Bulimia is related to deep psychological issues and feelings of lack of control. Sufferers often use the destructive eating pattern to feel in control over their lives. They may hide or hoard food and overeat when stressed or upset. They may feel a loss of control during a binge, and consume great quantities of food (over 20,000 calories.) After a length of time, the sufferer of bulimia will find that they no longer have control over their binging and purging. The binging becomes an addiction that seems impossible to break. Recovery is very hard and often in the early stages of recovery the patient will gain weight as they are still binging but no longer purging, causing anxiety which will in turn cause the patient to revert back to bulimia.
There are higher rates of eating disorders in groups involved in activities that emphasize thinness and body type, such as gymnastics, dance, cheerleading, acting and figure skating. Bulimia is more prevalent among Caucasians. In one study, diagnosis of bulimia was correlated with high testosterone and low estrogen levels, and normalizing these levels with combined oral contraceptive pills reduced cravings for fat and sugar.
There are higher rates of eating disorders in groups involved in activities that emphasize thinness and body type, such as gymnastics, dance, cheerleading, acting and figure skating. Bulimia is more prevalent among Caucasians. In one study, diagnosis of bulimia was correlated with high testosterone and low estrogen levels, and normalizing these levels with combined oral contraceptive pills reduced cravings for fat and sugar.
Types:
There are two sub-types of bulimia nervosa: purging and non-purging.
Purging type is the more common type of bulimia, and involves any of self-induced vomiting, laxatives, diuretics, enemas, or Ipecac, to rapidly extricate the contents from their body.
Non-purging type occurs in only approximately 6%-8% of bulimia cases, as it is a less effective means of ridding the body of such a large number of calories. It involves doing excessive exercise or fasting after a binge, to counteract the large amount of calories previously ingested. This often occurs in purging-type bulimics, but is a secondary form of weight control.
Purging type is the more common type of bulimia, and involves any of self-induced vomiting, laxatives, diuretics, enemas, or Ipecac, to rapidly extricate the contents from their body.
Non-purging type occurs in only approximately 6%-8% of bulimia cases, as it is a less effective means of ridding the body of such a large number of calories. It involves doing excessive exercise or fasting after a binge, to counteract the large amount of calories previously ingested. This often occurs in purging-type bulimics, but is a secondary form of weight control.
Symptoms:
Some of the most common symptoms of bulimia are:
Eating uncontrollably, Purging, Strict dieting, Fasting, Vigorous exercise, Vomiting or abusing laxatives or diuretics in an attempt to lose weight, Vomiting blood, Using the bathroom frequently after meals, Preoccupation with body weight, Depression or mood swings, Feeling out of control, Swollen glands in neck and face, Heartburn, Bloating, Indigestion, Constipation, Irregular periods, Dental problems, Sore throat, Weakness, Exhaustion, Bloodshot eyes etc.
Eating uncontrollably, Purging, Strict dieting, Fasting, Vigorous exercise, Vomiting or abusing laxatives or diuretics in an attempt to lose weight, Vomiting blood, Using the bathroom frequently after meals, Preoccupation with body weight, Depression or mood swings, Feeling out of control, Swollen glands in neck and face, Heartburn, Bloating, Indigestion, Constipation, Irregular periods, Dental problems, Sore throat, Weakness, Exhaustion, Bloodshot eyes etc.
Diagnosis:
The criteria for diagnosing a patient with bulimia are:
1. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
* Eating, in a fixed period of time (e.g., within any two-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 to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics 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 three months.
4. Self-evaluation is unduly influenced by body shape and weight.
5. The disturbance does not occur exclusively during episodes of anorexia nervosa.
Treatment:
Standard bulimia nervosa treatments include medications (prescription drugs), various psychotherapies, nutrition therapy, other non-drug therapies and supportive or adjunct interventions such as yoga, art, massage, and movement therapy. Some novel treatments are currently under research, such as implantation of a device called a vagus nerve stimulator implanted at the base of the neck. This stimulator is currently in use to treat some forms of depression, and it is under research for treating obesity.
The most commonly used treatments—psychotherapy and medication—are delivered at various levels of inpatient and outpatient care, and in various settings depending on the severity of the illness and the treatment plan that has been developed for a particular patient.
Many types of prescription drugs have been used in treatment of bulimia nervosa, however, only one prescription drug (fluoxetine) actually has a labeled indication for bulimia nervosa.
Most prescription drug therapy used for treatment of the disorder is aimed at alleviating major depression, anxiety, or obsessive-compulsive disorder (OCD), which often co-exist with bulimia nervosa. Some prescription drug therapies are intended to make individuals feel full to try to prevent binge eating.
1. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
* Eating, in a fixed period of time (e.g., within any two-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 to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics 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 three months.
4. Self-evaluation is unduly influenced by body shape and weight.
5. The disturbance does not occur exclusively during episodes of anorexia nervosa.
Treatment:
Standard bulimia nervosa treatments include medications (prescription drugs), various psychotherapies, nutrition therapy, other non-drug therapies and supportive or adjunct interventions such as yoga, art, massage, and movement therapy. Some novel treatments are currently under research, such as implantation of a device called a vagus nerve stimulator implanted at the base of the neck. This stimulator is currently in use to treat some forms of depression, and it is under research for treating obesity.
The most commonly used treatments—psychotherapy and medication—are delivered at various levels of inpatient and outpatient care, and in various settings depending on the severity of the illness and the treatment plan that has been developed for a particular patient.
Many types of prescription drugs have been used in treatment of bulimia nervosa, however, only one prescription drug (fluoxetine) actually has a labeled indication for bulimia nervosa.
Most prescription drug therapy used for treatment of the disorder is aimed at alleviating major depression, anxiety, or obsessive-compulsive disorder (OCD), which often co-exist with bulimia nervosa. Some prescription drug therapies are intended to make individuals feel full to try to prevent binge eating.
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