Bulimia Nervosa

Bulimia Nervosa

Q. What is bulimia nervosa?

Bulimia Nervosa is a psychological and severe life-threatening eating disorder described by the ingestion of an abnormally large amount of food in short time period, followed by an attempt to avoid gaining weight by purging what was consumed. 

Bulimia nervosa is an eating disorder characterized by frequent episodes of binge eating, followed by frantic efforts to avoid gaining weight. It affects women and men of all ages.

Q. Write the types of bulimia nervosa.

There are two common types of bulimia nervosa, which are as follows:

• Bulimia Nervosa Purging type -This type of bulimia nervosa accounts for the majority of cases of those suffering from this eating disorder.  In this form, individuals will regularly engage in self-induced vomiting or abuse of laxatives, diuretics, or enemas after a period of bingeing.
• Bulimia Nervosa Non-purging type -In this form of bulimia nervosa, the individual will use other inappropriate methods of compensation for binge episodes, such as excessive exercising or fasting.  In these cases, the typical forms of purging, such as self-induced vomiting, are not regularly utilized.

Q. What is binge eating?

Binge eating involves two key features:

• Eating a very large amount of food within a relatively short period of time (e.g. within two hours)
• Feeling a sense of loss of control while eating (e.g. feeling unable to stop yourself from eating)

Q. What are the warning signs of Bulimia?

Having awareness about Bulimia and its warning signs and symptoms can make a marked difference to the severity and duration of the illness. Seeking help at the first warning sign is much more effective than waiting until the illness is in full swing. If you or someone you know is exhibiting some or a combination of these signs it is vital to seek help and support as soon as possible.

The warning signs of Bulimia can be physical, psychological and behavioural. It is possible for someone with Bulimia to display a combination of these symptoms.

Physical signs:

• Frequent changes in weight (loss or gains)
• Signs of damage due to vomiting including swelling around the cheeks or jaw, calluses on knuckles, damage to teeth and bad breath
• Feeling bloated, constipated or developing intolerances to food
• Loss of or disturbance of menstrual periods in girls and women
• Fainting or dizziness
• Feeling tired and not sleeping well

Psychological Signs:

• Preoccupation with eating, food, body shape and weight
• Sensitivity to comments relating to food, weight, body shape or exercise
• Low self esteem and feelings of shame, self loathing or guilt, particularly after eating
• Having a distorted body image (e.g. seeing themselves as overweight even if they are in a healthy weight range for their age and height)
• Obsession with food and need for control
• Depression, anxiety or irritability
• Extreme body dissatisfaction

Behavioural Signs:

• Evidence of binge eating (e.g. disappearance or hoarding of food)
• Vomiting or using laxatives, enemas, appetite suppressants or diuretics
• Eating in private and avoiding meals with other people
• Anti social behaviour, spending more and more time alone
• Repetitive or obsessive behaviours relating to body shape and weight (e.g. weighing themselves repeatedly, looking in the mirror obsessively and pinching waist or wrists)
• Secretive behaviour around food (e.g. saying they have eaten when they haven’t, hiding uneaten food in their rooms)
• Compulsive or excessive exercising (e.g. exercising in bad weather, continuing to exercise when sick or injured, and experiencing distress if exercise is not possible)
• Dieting behaviour (e.g. fasting, counting calories/kilojoules, avoiding food groups such as fats and carbohydrates)
• Frequent trips to the bathroom during or shortly after meals which could be evidence of vomiting or laxative use
• Erratic behaviour (e.g. spending large amounts of money on food)
• Self harm, substance abuse or suicide attempts

Q. What are the risks associated with Bulimia?

The risks associated with Bulimia are severe. People with Bulimia may experience:

• Chronic sore throat, indigestion, heartburn and reflux
• Inflammation and rupture of the oesophagus and stomach from frequent vomiting
• Stomach and intestinal ulcers
• Chronic irregular bowel movements, constipation and/or diarrhoea due to deliberate misuse of laxatives
• Osteoporosis– a condition that leads to bones becoming fragile and easily fractured
• Loss of or disturbance of menstrual periods in girls and women
• Increased risk of infertility in men and women
• Irregular or slow heart beat which can lead to an increased risk of heart failure

Q. Write the treatment of bulimia nervosa.

Therapies to be considered for the treatment of Bulimia Nervosa include:

• Psychological Treatments
• Evidence-based self-help programs
• Cognitive behavioural therapy for Bulimia Nervosa
• Interpersonal psychotherapy
• Maudsley family-based treatment (for children and adolescents)
• Dialectical behaviour therapy
• Guided imagery
• Crisis intervention
• Stress management

Other treatments

Antidepressants (specifically selective serotonin reuptake inhibitors; e.g. SSRI) may also be prescribed for someone who is suffering from Bulimia Nervosa.

Q. Write the Complications of bulimia nervosa.

Bulimia may 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 tooth decay and gum disease
• Absent or irregular periods in females
• Digestive problems, and possibly a dependence on laxatives to have bowel movements
• Anxiety and depression
• Misuse of alcohol or drugs
• Suicide

Q. Write the risk factors of bulimia nervosa.

Factors that increase your risk of bulimia may include:

• Being female:  Girls and women are more likely to have bulimia than boys and men are.
• Age: Bulimia often begins in the late teens 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 may play a role. And, being overweight as a child or teen may increase the risk.
• Psychological and emotional issues:  Psychological and emotional problems, such as anxiety disorder or low self-esteem, can contribute to eating disorders. Triggers for bingeing may 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 societal pressure: The media, such as TV and fashion magazines, frequently 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 isn't clear.
• Sports, work or artistic pressures: Athletes, actors, dancers and models are at a higher risk of eating disorders. Coaches and parents may inadvertently raise the risk by encouraging young athletes to lose weight, maintain a low weight and restrict eating for better performance.

Q. What are the Effects of Bulimia Nervosa?

Bulimia complications are potentially life-threatening, and the disease requires medical attention from an experienced eating disorder treatment professional. Bulimia treatment centers often see women facing severe effects from advanced bulimia nervosa. These may include:

• Extreme social isolation
• Inability to sleep
• Fractured relationships with family and friends
• Loss of spiritual connection to one’s faith, religion, or higher power
• Forced withdrawal from school or college
• Job loss
• Bankruptcy, often resulting from excessive spending on binge foods
• Infertility
• Internal bleeding
• Drug and alcohol addiction, especially if these substances are used to self-medicate for uncontrolled emotions or deal with physical complications
• Suicide
• Self-injury behavior
• Heart attack
• Death

Q. Write the symptoms of bulimia nervosa.

1. Purging

2. eating uncontrollably

3. strict dieting

4. fasting

5. indigestion

6. dental problem

7. constipation

8. heart burn

9. using the bathroom frequently after meal.

10. irregular menstruation

Is it possible to recover? 

Yes. It is possible to recover from Bulimia Nervosa, even if you have been living with the illness for many years. The path to recovery can be very challenging. People with Bulimia Nervosa can become entangled in a vicious cycle of eating and exercise behaviours that can impact their ability to think clearly and make decisions. However, with the right team and a high level of personal commitment, recovery is an achievable goal. Treatments for Bulimia Nervosa are available; seek help from a professional with specialised knowledge in eating disorders.

Steps to bulimia recovery

• Admit you have a problem. Up until now, you’ve been invested in the idea that life will be better—that you’ll finally feel good—if you lose more weight and control what you eat. The first step in bulimia recovery is admitting that your relationship to food is distorted and out of control.
• Talk to someone. It can be hard to talk about what you’re going through, especially if you’ve kept your bulimia a secret for a long time. You may be ashamed, ambivalent, or afraid of what others will think. But it’s important to understand that you’re not alone. Find a good listener—someone who will support you as you try to get better.
• Stay away from people, places, and activities that trigger the temptation to binge or purge. You may need to avoid looking at fashion or fitness magazines, spend less time with friends who constantly diet and talk about losing weight, and stay away from weight loss web sites and “pro-mia” sites that promote bulimia. You may also need to be careful when it comes to meal planning and cooking magazines and shows.
• Seek professional help. The advice and support of trained eating disorder professionals can help you regain your health, learn to eat normally again, and develop healthier attitudes about food and your body.