What is Bulimia Nervosa?
Bulimia Nervosa, usually referred to as bulimia, is defined as uncontrolled episodes of overeating (bingeing) and usually followed by purging (self-induced vomiting), misuse of laxatives, enemas, or medications that cause increased production of urine, fasting, or excessive exercise to control weight. Bingeing, in this situation, is defined as eating much larger amounts of food than would normally be consumed within a short period of time (usually less than two hours). Eating binges occur at least twice a week for three months and may occur as often as several times a day.
How does it Occur?
The exact cause of this disorder is not known. It may be related to problems with the chemicals in the brain that regulate mood and appetite.
If you have bulimia nervosa you may:
- Have a family history of bulimia or other eating disorders
- Have a family or personal history of mood disorders, such as depression, anxiety, or bipolar disorder.
What are the different types of bulimia?
There are two subgroups of anorexic behavior aimed at reducing caloric intake, including the following:
- Purging Type - regularly engages in self-induced vomiting or misuse of laxatives, diuretics, or enemas, or other cathartics (medications, through their chemical effects, that serve to increase the clearing of intestinal contents).
- Non-purging Type - uses other inappropriate behaviors, such as fasting or excessive exercise, rather than regularly engaging in purging behaviors to reduce caloric absorption of excessive amounts of food by the body.
What are the Symptoms?
Signs and symptoms of bulimia include:
- eating large amounts of food in short periods of time without being able to stop
- making frequent trips to the bathroom after eating
- vomiting, or using laxatives, diuretics, or enemas to purge food
- dieting or fasting
- exercising a lot after eating
- repeatedly losing or gaining more than 10 pounds
- feeling weak, depressed, or guilty after binge eating
- having heartburn or reflux from stomach acid injuring the esophagus or damaged teeth from stomach acid contained in vomit
- having swollen cheeks from repeated vomiting
- having scratches or scars on the back of fingers or hands from self-induced vomiting
- constantly thinking about being thin and feeling that weight is tied to self-esteem
- having menstrual problems.
Bulimia is especially dangerous when vomiting or laxatives are used to remove food from the body. Either habit can cause an electrolyte imbalance that can lead to irregular heartbeats and possibly heart failure and death.
How is it Diagnosed?
Your healthcare provider takes a medical history, orders lab tests, and does a physical exam. He or she will ask about your eating patterns,
looking for such behavior as:
- repeated episodes of binge eating followed by purging
- binging and fasting
- secret eating and binging
- exercising too much to prevent weight gain.
How is it Treated?
If you have bulimia, you must recognize that you are suffering from a dangerous disorder. Treatment involves getting your eating habits back to normal. Your healthcare provider may suggest that you meet with a dietician to create a healthy eating plan. You may also benefit from psychotherapy or family counseling. Psychotherapy, either individual or group therapy, is very important. You may also need medicine used for mood disorders, such as antidepressants, antianxiety medicines, or mood stabilizers.
How long will the Effects Last?
You may stay preoccupied with eating for many years. You may need to continue taking medicine or having therapy for many months. Being under a lot of stress can cause a relapse. The earlier you seek treatment, the more successful it is likely to be.
How can I take Care of Myself?
- Eat healthy meals.
- Schedule regular meals. Avoid irregular eating habits and avoid fasting.
- Take vitamin and mineral supplements, if recommended by your healthcare provider.
- Avoid drinking too much caffeine.
- Do not drink alcohol.
- Do not use laxatives and diuretics. These can have serious side effects.
- Do not use diet pills.
- Seek professional help if you need to lose weight. It is best to lose weight slowly and in a healthy way.
- Limit your exercise program as advised by your treatment team.
Treatment for Bulimia:
Specific treatment for bulimia will be determined by your child's physician based on:
- Your child's age, overall health, and medical history
- Extent of your child's symptoms
- Your child's tolerance for specific medications or therapies
- Expectations for the course of the condition
- Your opinion or preference
Bulimia, in adolescents, is usually treated with a combination of individual therapy, family therapy, behavior modification, and nutritional rehabilitation. Among adults, cognitive behavioral therapy and antidepressant medications have both been shown to be effective. Treatment should always be based on a comprehensive evaluation of the adolescent and family. Individual therapy usually includes both cognitive and behavioral techniques. Medication (usually antidepressants or antianxiety medications) may be helpful if the adolescent with bulimia is also anxious or depressed. The frequent occurrence of medical complications during the course of rehabilitative treatment requires both your child's physician and a nutritionist to be active members of the management team. Parents play a vital supportive role in any treatment process.
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