Bulimia: what is it, and what are the symptoms?
Bulimia nervosa, along with anorexia, is one of the most common eating disorders. This can lead to many negative consequences in terms of general and mental health and in terms of performing various life functions. The symptoms of bulimia nervosa can significantly reduce the quality of life and lead to considerable mental suffering. Currently, there are effective methods of treating and helping people suffering from this disease.
What is bulimia
A persistent eating disorder called bulimia nervosa is characterized by episodes of binge eating followed by vomiting or by forcing oneself to follow an extremely rigid diet. Bulimia is associated with a complete lack of control over food intake. Sick people can consume up to several thousand calories per hour. After such an episode, a feeling of shame arises, associated with the need to “get rid” of the food eaten and weight loss.
These cycles of binge eating followed by purging can occur several times a week.
Who can get bulimia
The disease’s first symptoms usually appear later compared to anorexia nervosa (usually around the age of 20). Women are far more likely than men to suffer from bulimia. It is estimated that up to 2% of women may develop symptoms during their lifetime. If left untreated, symptoms can persist for up to 40 years. A correlation between excessive attention to appearance with obsessive sports and a predisposition to bulimia has been found.
Symptoms of bulimia
The primary symptom of bulimia nervosa is binge eating episodes, characterized by eating large amounts of food in a short period, and is also accompanied by a feeling of being out of control.
These episodes are often associated with feelings of shame, so sick people often eat secretly or at night. They may be preceded by a period of fasting or a restrictive diet.
A laxative is often used to prevent weight gain after overeating. People may also induce vomiting, use diuretics, or use appetite suppressants. There are also cases of bulimia, where instead of provoking vomiting or using laxatives, patients resort to strenuous training, which is equally exhausting.
Another essential feature of bulimia nervosa is the focus on the appearance of their body (patients very often make their self-esteem dependent mainly on appearance and weight).
How bulimia differs from anorexia
These two types of eating disorders have a few things in common. These include a fear of gaining weight and obsessive attention to appearance. However, the two diseases differ in that, in the case of bulimia, affected people are most often at the correct weight (they are not too thin or overweight). In addition, anorexia is not associated with episodes of overeating.
How is the diagnosis made?
The diagnosis is made based on a survey of the patient (sometimes his family) and a psychiatric examination. The disorder in question is often not adequately recognized for an extended period. Patients with bulimia nervosa often maintain their weight in the normal range or even exceed it. At the same time, overeating and purging the body are usually hidden from their environment, making diagnosis difficult.
Causes of bulimia
The causes of this disorder are not fully understood, but the following factors are believed to play a role:
• genetic – a family history of eating disorders increases the risk of bulimia,
• personality – people with bulimia nervosa often have traits similar to an emotionally unstable personality, that is, high impulsivity, negative emotionality, and exposure to stress,
• family – it is not uncommon in the families of the sick person there are difficulties in communication between its members, there is more violence or addiction,
• socio-cultural – images of beauty in Western culture and the emphasis on a slim figure can contribute to a distorted body image.
Complications of bulimia nervosa
Bulimia nervosa is associated with a higher risk of depression, anxiety disorders, and addiction. This is often accompanied by common medical problems such as:
• electrolyte disturbances and dehydration, which can cause severe heart rhythm disturbances,
• salivary gland enlargement,
• tooth enamel defects,
• damage to the throat and esophagus (in extreme cases, increased vomiting can even lead to rupture of the esophageal wall, which is an immediate threat to life),
• skin changes in the arms (due to regular vomiting),
• constipation and diarrhea caused by excessive use of laxatives,
• women have fertility problems and menstrual irregularities.
Methods of treatment
The main form of treatment for bulimia nervosa is psychotherapy. Also, various therapeutic approaches can be used in the treatment, but cognitive-behavioral is the most effective. The goal of therapy is to learn to control symptoms and change cognitive models of body image, weight, and self-image.
Medications can also be used in treatment – they can reduce disease symptoms, such as excessive appetite or laxative behavior, and can be used in treating comorbid disorders (e.g., depression or anxiety).
The treatment of bulimia nervosa is most often carried out on an outpatient basis and in cooperation with various specialists – a psychotherapist, therapist, and nutritionist.
Hospital treatment is rarely required. However, there are times when, due to the complications associated with laxative behavior, a significant increase in bulimic symptoms, or the simultaneous occurrence of severe depressive symptoms, a stay in the hospital is the only solution that ensures the safety of the patient. Hospitalization is usually short, and further treatment is carried out on an outpatient basis.
The support of an experienced psychotherapist working with a nutritionist and psychiatrist can bring initial improvement and relief in a relatively short time. Bulimia nervosa is a disease that can be effectively treated and relapses rarely occur after psychotherapy is completed. In treatment, the support of loved ones is invaluable, as they help strengthen healthy habits and improve self-esteem.