Bulimia Nervosa

Bulimia nervosa is an eating disorder characterized by episodes of bingeing and purging. A large percentage of both women and men are developing bulimia or bulimic tendencies, though women account for the majority of sufferers. If you are bulimic or know someone who is, seek treatment as soon as possible. Bulimia can be cured, especially if it is caught early.


What is Bulimia Nervosa?
Bulimia nervosa is an eating disorder that causes numerous psychological and physical issues. First diagnosed in the 1980s, bulimia was thought to be part of anorexia. However, this eating disorder differs from anorexia in that it involves a binge-purge cycle. Sufferers of bulimia will eat large amounts of food in a short time and then, due to feelings of extreme guilt and shame, will attempt to purge the food from their body.

Unlike anorexics, most bulimics are aware that they have an eating disorder. They will often go unnoticed though because they tend to hide their disorder. Additionally, bulimics can be of normal weight, underweight, or overweight, making it even more difficult to notice the disorder.

Who is Affected by Bulimia?
Bulimics tend to be women in their late adolescence or early adult years. It is commonly found in college age women, but it can also affect men and women of all ages. Bulimia usually occurs after a particularly traumatic event, such as physical or sexual abuse, or after an episode of stress or change in life. For instance, a relationship breakup, a move to another city, or heading off to college can often trigger bulimic behaviors. Additionally, 50% of anorexics will develop bulimia.

Bulimia is a highly prevalent eating disorder, affecting up to 10% of college age women. Bulimia is often thought of as a female disorder, but 10% of bulimics are men, who also tend to be entering early adulthood. Bulimia is a treatable disorder, but 10% of bulimics will die if they don't seek help for their condition. The most common causes of death in bulimics are cardiac arrest, starvation, and suicide.

The Binge-Purge Cycle
Bulimia is characterized by an ongoing cycle of bingeing and purging. This cycle is difficult to break and is often triggered by feelings of depression, boredom, or anger. Bulimics rarely binge or purge in front of others. Instead, they tend to do it in secret, usually when they are alone. Binge-purge episodes can occur a few times a week or numerous times a day, depending upon the severity of the illness. Without treatment, binge-purge sessions usually get worse and will increase in frequency.

Bulimia and binge eating go hand in hand. Binge eating occurs when a large amount of food is eaten during a very short period of time. Everyone has times when they tend to eat a little more than normal holidays, vacations, or family gatherings but bingeing involves a much greater intake of food. Binges can range from consuming 1,000 calories to 20,000 calories in one sitting, and will cause great discomfort and bloating. Typical binge foods are high in carbohydrates and calories, however, any food can be a binge food. During a binge, the bulimic will feel out of control and unable to stop the desire to eat.

Purging usually occurs immediately after a binge, though it can occur up to an hour or two later. Purging refers to any method used to compensate for a binge or any intake of food. Typical purging methods include vomiting or the use of diuretics, laxatives, or enemas. Other types of purging include excessive exercise or self-imposed periods of starvation. Non-purging bulimics generally rely on exercise and starvation to lose the unwanted calories. Purging is typically not effective in weight loss, as some calories will be absorbed by the body before purging can take place. Moreover, bulimics may eat more during a binge when they anticipate being able to purge later.

Causes of Bulimia
Bulimia causes are still unknown, although recent research has shown that the disorder may be caused in part by biological factors. Bulimics tend to have lower levels of tryptophan, a chemical found in food, which controls the production of serotonin in the brain. Serotonin is responsible for regulating both mood and appetite. Bulimia is probably also the result of society's drive for thinness and a lack of self esteem in the individual.

Signs of Bulimia
Because this eating disorder tends to go undetected so much of the time, it is important to be aware of bulimia symptoms. If you notice that someone you know is exhibiting some of these signs, talk to them about it and encourage them to get help.

  • uncontrolled eating
  • eating large amounts of food with little weight gain
  • frequent visits to the bathroom, especially after meals
  • unusual and unexplained dental problems
  • bloodshot eyes (caused by excessive vomiting)
  • swollen neck glands or frequent sore throat
  • bad breath
  • cuts or blisters on the back of the hand or knuckles

Consequences of Bulimia
Though bulimia is rarely associated with extreme weight loss, this eating disorder is just as dangerous as anorexia. The effects of bulimia are scary and uncomfortable. Continued purging can cause a number of health-related issues and can even lead to death if they are not treated.

Bulimics tend to suffer from complaints such as a continued sore throat, bloating, and heartburn. Excessive vomiting causes acid from the stomach to rise up the esophagus, which can lead to infection and even a ruptured esophagus. Acid in the stomach can produce severe ulcers. Continued vomiting can also lead to loss of the enamel and dentin on your teeth, making you susceptible to cavities and gum disease.

Perhaps more serious are the other effects that vomiting, laxatives, enemas, and diuretics can have on the system. Long-term effects of bulimia can include the loss of fluid and electrolytes in the body. Electrolytes, including potassium, sodium, and chloride, help your nerves and muscles to function. Severe electrolyte imbalance can cause heart and kidney failure.

Because of the extreme stress that comes along with bulimia, many sufferers become very depressed and even suicidal. Suicide remains one of the main causes of death in eating disorder sufferers.

Bulimia Treatment Options
Like anorexia, bulimia is treatable but requires time and patience. It can take years to overcome the disorder, but most who receive treatment for bulimia do recover and resume a healthy lifestyle. It is important to seek treatment as early as possible, especially if you are pregnant, as this will increase your chances of a successful recovery from bulimia.

Bulimics with mild symptoms can usually be treated on an outpatient basis, with nutritional and psychological counseling. Cognitive behavior therapy is the most effective treatment for bulimia; it helps the bulimic to reshape negative thoughts and replace negative behaviors with positive ones. Those with more severe symptoms may require inpatient or day hospital treatment. For those severely underweight, weight gain is imperative to restore health. Regular eating will help to improve mood, and binge-purge urges. Psychotherapy and medication is also available to those in an inpatient or day hospital program.



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