Bulimia Nervosa

Bulimia Nervosa is an eating disorder that is characterized by episodes of binge eating- which means eating a lot of food very quickly- followed by vomiting or ‘purging’ which can include the use of laxatives and diuretics.

This cycle of bingeing and purging usually occurs multiple times a week. Bulimic people struggle to control their eating and can eat up to 20,000 calories in 8 hours. People with this disorder tend to feel a sense of shame related to their eating habits, therefore carrying out their binges in secret. Unlike with anorexia, bulimic people are able to maintain a normal weight for their age, but they too fear gaining weight, want to lose weight, and are unhappy with their body image. 

DISCLAIMER: This information is for educational purposes only and not to be used for self-diagnosis. If you or a loved one can relate to a number of features listed below, then please do use our therapist directory to find a psychiatrist, psychologist or therapist that is right for you to receive a professional diagnosis.

• Recurrent episodes of binge eating, characterized by eating within a certain period of time — say, two hours — an amount of food substantially larger than most people would eat.
• A feeling that one cannot stop eating or control what or how much one eats.
• Recurrent compensatory behaviour to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, enemas, or other medications; fasting; and excessive exercise
• Self-esteem is overly influenced by body shape and weight.
• Does not occur exclusively with anorexia nervosa
• Chronically inflamed and sore throat
• Swollen glands in the neck and below the jaw
• Worn tooth enamel and increasingly sensitive and decaying teeth as a result of exposure to stomach acids.
• Acid reflux disorder (gastroesophageal reflux disorder, or GERD)
• Intestinal distress and irritation from laxative abuse
• Kidney problems from diuretic abuse
• Severe dehydration from the purging of fluids
• Bulimia is categorized as mild, moderate, severe, or extreme based on the number of inappropriate compensatory behaviours that happen each week.

Please Note: This information is for educational purposes only and not to be used for self-diagnosis. If you or a loved one can relate to a number of features listed below, then please do use our therapist directory to find a psychiatrist, psychologist or therapist that is right for you to receive a professional diagnosis.

What factors can be contributing causes?

• Bulimia is more than just a problem with food. A binge can be triggered by dieting, stress, or uncomfortable emotions, like anger or sadness. Purging and other actions to prevent weight gain are ways for people with bulimia to feel more in control of their lives and to ease stress and anxiety. There is no single known cause of bulimia, but there are some factors that may play a part.
• Culture. Women are under constant pressure to fit a certain ideal of beauty. Images of flawless, thin females everywhere make it hard for women to feel good about their bodies. Increasingly, men are also feeling pressure to have a perfect body.
• Families. Those with a mother or sister who has bulimia are more likely to have bulimia. Parents who think looks are important, diet themselves or criticize their children’s bodies are more likely to have a child with bulimia.
• Life changes or stressful events. Traumatic events, like rape, as well as stressors, such as starting a new job, can trigger bulimia.
• Personality traits. Those with bulimia may have low self-esteem and feel hopeless. They may be very moody and have difficulty expressing anger or controlling impulsive behaviours.
• Biology. Genes, hormones, and other biological factors may contribute to developing bulimia.

• A general practitioner (GP) or psychologist can usually diagnose bulimia nervosa by asking questions about a person’s medical history and symptoms.
• The GP/psychologist will also inquire about a patient’s physical health to ensure that the binge-eating/purging behaviour is not caused as a result of underlying medical conditions or by factors such as drug or alcohol use.
• The GP/psychologist will check the symptoms that the patient presents with against the standard criteria for bulimia nervosa before making a diagnosis.

What is the recommended treatment?

• As with anorexia, treatment for bulimia often involves a combination of options and depends on individual needs.
• To reduce or eliminate bingeing and purging, a patient may undergo nutritional counseling and psychotherapy, especially cognitive-behavioral therapy, and be prescribed medication. Some antidepressants—such as fluoxetine (Prozac), the only medication approved by the FDA for treating bulimia—may help patients who also suffer from depression and anxiety. Prozac improves eating habits and helps to reduce binge-eating, purging and the chances of relapse.
• Cognitive-behavioral therapy tailored to the treatment of bulimia has also been shown to be effective in changing bingeing and purging behaviour and improving attitudes towards eating. Therapy may be done one-on-one or in a group setting.
• Eating disorders are complex and challenging, and behavioural, psychological, and neuroscience research on eating disorders is ongoing into causes and treatments. Researchers are also working to define the basic processes involved in the disorders, to understand risk factors, to identify biological markers of the disorder, and to develop medications that target specific pathways affecting eating behaviour. Neuroimaging and genetic studies may provide clues for individual responses to specific treatments.

Sourced from breakbingeeating.com

• The lifetime prevalence of bulimia nervosa for adult women ranges from 1.7%-2.0% and for men ranges from 0.5-0.7%.
• 8% may cross-over to a diagnosis of anorexia nervosa and 9% may cross-over to a diagnosis of binge-eating disorder.
• The average age of onset is 18 years, although the age of onset is declining in more recent studies.
• Around 35% are expected to fully recover following psychotherapy.

If you are experiencing any of these signs, here are some activities you can do at home until you are able to consult a professional

• Engage in creative outlets such as writing, painting, or music.
• Keep a gratitude journal
• Talk to a family member or friend about how you are feeling.
• Practice Mindfulness
• Practice Yoga
• Maintain a good sleep schedule 
• Recognise what you can and can’t handle