Bulimia Nervosa As with anorexia, bulimia is also an eating disorder that is linked with emotional problems and self esteem. Sufferers of bulimia are also obsessed with food, calories, gaining weight and getting rid of the food eaten but unlike anorexia where the sufferer actively restricts their calorie intake; bulimia is characterized by binge eating. This binge eating may involve eating three to four times what is considered to be a normal amount of food, this is then followed by what may be considered ‘purging’ such as actively making yourself sick, using laxatives, excessive exercise or periods of fasting. The bingeing is done in secret and as such the disorder is quite a hidden illness and can go unnoticed for a long time period of time. Sufferers find the bingeing and purging processes bring short-term relief from any emotional distress although inevitably these thoughts and feelings soon return. Individuals are often of normal body weight or slightly above unlike anorexics, this does not mean that bulimia is not a serious disorder and its side effects and consequences can be extremely damaging both physically and mentally.
Anyone can develop bulimia, although it is thought to be more in women in their late teens to early twenties. The condition does affect men but is thought that for every 10 women with the disorder one man has the condition, although this may be increasing. Bulimia is more common than anorexia and possibly on the increase although due to it secretive nature it is difficult to give a definitive figure but thought to be approximately 1-2% of women.
Food is used to control feelings, so the sufferer may feel they regain a sense of control in a their life which may blighted by depression, anxiety, low self esteem, loneliness or perhaps a major event in life such death of a loved one or stressful event such as starting a new job. It has also been shown that genetics plays a role, i.e. if a family member has suffered from an eating disorder then this increases your risk, also your family’s attitude to food and weight can also play a role. Some people with bulimia have previously suffered from anorexia and go on to develop bulimia.
Symptoms
Not everyone will suffer exactly the same symptoms as with any illness but the following are common: -
• Binge eating, followed by purging such as vomiting, or taking laxatives.
• Obsession with food, calories, weight gain.
• Going to the toilet straight after meals to vomit food just eaten
• Excessive exercise
• Overwhelming feelings of guilt following a binge
• Depression, anxiety- possible use of drugs or alcohol to help cope
Health Problems
Bulimia can cause significant health problems some of which occur after a short period of time and others are as a result of suffering with the illness over a longer period of time
• Sore throat
• Bad breath, mouth infections and tooth decay from repeated vomiting
• Patches of rough skin on knuckles or fingers if used to make themselves vomit
• Irregular periods
• Difficulty sleeping
• Stomach problems such as constipation or diarrhoea
• Dehydration, which can cause fainting, weakness and if severe kidney damage
• Puffy face as a result of swollen salivary glands
• Dry or poor skin
• Swollen hands and feet
Diagnosis and Treatment
It is outside the scope of this article to discuss in full diagnosis and treatment. The National Institute for Health and Clinical Excellence produced guidelines in 2004 on the treatment of eating disorders and the care that should be provided. But the first port of call needs to be your GP and admitting there is a problem will be one of the hardest steps to make but the most important one. Your GP will need to take a full history regarding your eating habits, thoughts around food and any physical problems associated with the bulimia.
From that point on you may be referred to a psychiatrist or psychologist trained in treating eating disorders, talking therapy such as cognitive behaviour therapy is often used, family therapy and medication such as antidepressants may be needed as depression is often present and these can also help to reduce bingeing episodes.
If you have concerns about yourself or any member of your family and feel there is an issue around food and weight then please contact your doctor. Recovery is more likely to be successful if the condition is identified and treated early.
This article has not covered binge eating disorder or compulsive overeating.
