Bulimia is a psychological eating disorder. Patients practice binge eating followed by purging either via self-induced, enemas, laxatives, excessive exercise diuretics or a combination of all of these.
Individuals with bulimia consume large amounts of food and then purge their bodies through vomiting, laxative, etc. The binge and purge behavior is almost always done in secret. The weight of individuals with Bulimia does not drop dramatically as with anorexia nervosa patients. Therefore it is possible to not notice any symptoms. Bulimia patients may hide their behavior from others for years. The diagnostic criteria also refer to specific symptoms, which are behaviors of bulimics.
Side effects of Bulimia:
• Teeth erosion and cavities, gum disease
• Muscle atrophy
• Electrolyte imbalance
• Vitamin and mineral deficiencies
• Sialadenosis (salivary gland swelling)
• Esophageal reflux
• Laxative dependence
• Peptic ulcers
• Emetic toxicity due to ipecac abuse
• Swelling of the face and cheeks, especially apparent in the lower eyelids due to the high pressure of blood in the face during vomiting.
• Callused or bruised fingers
• Dry or brittle skin, hair, and nails, or hair loss
• Decreased/increased bowel activity
• Digestive problems that may be triggered, including Celiac, Crohn's Disease
• Low blood pressure, hypotension
• Orthostatic hypotension
• High blood pressure, hypertension
• Iron deficiency, anemia
• Hormonal imbalances
• Polycystic Ovary Syndrome
• High risk pregnancy, miscarriage, still-born babies
• Elevated blood sugar or hyperglycemia
• Chronic Fatigue Syndrome
• Cancer of the throat or voice box
• Liver failure
• Kidney infection and failure
• Heart failure, heart arrhythmia, angina
There is no single cause of bulimia. Bulimia Nervosa is less about food and eating, but more of a feeling of lack of control and deep psychological issues.
According to the DSM-IV-TR, the following five criteria should be met for a patient to be diagnosed with bulimia:
1. Uncontrollable urge to binge
2. Purging after a binge – via vomiting, laxatives, diuretics, exercise
3. Binging and purging pattern occurs at least three times per week for three months.
4. Self-image is influenced abnormally by body shape and weight.
5. Criteria for anorexia nervosa is not met.
Please note that, in general, diagnostic criteria are considered a guide. A legitimate clinical diagnosis can be made when the majority of the criteria are met.
There are two types of bulimia – purging type and non-purging type. Purging type means a patient regularly engages in self-induced vomiting or the abuse of laxatives, diuretics and enemas. The non-purging type of bulimia means a patient uses other behaviors to purge – such as fasting, excessive exercise, but does not regularly make themselves vomit or use laxatives, enemas or diuretics.
Most bulimia patients are females aged ten to twenty five years old. About five percent of bulimia patients are male.
Treatment is most successful when begun early in the stage of the disease. Unfortunately, unlike anorexia, bulimia does not have dramatic physical characteristics. Bulimia sufferers may hide their disease for so long that it becomes ingrained into their lives and is more difficult to cure. In the past patients have been hospitalized until the binge-purge pattern has been broken. This method is not used today, since it fails to address the psychological aspects of the disease.
Residential treatment offers counseling, pattern interruption and long term support. Group therapy and cognitive behavior therapy are the most used forms of treatment. The underlying issues are addressed. In some cases anti-depressants may be prescribed.
Bulimia Nervosa was not recognized as a clinical condition until Gerald Russell's paper published in the UK in 1979.
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