Bulimia Nervosa

What is bulimia nervosa?

Bulimia nervosa is an eating disorder in which the person gorges on large amounts of food, and then tries to get rid of the food by inducing vomiting, exercising excessively or other methods such as using laxatives. When they feel upset they binge, i.e. eat large amounts of food, often in secret. Immediately after, they feel guilty and ashamed about having binged; so they purge, i.e. try to get rid of the food they have consumed by vomiting, over-exercising, etc. These feelings of guilt are a result of their body image issues and desire to be thin. Their misplaced self-image also leads to a low self esteem. Purging gives them a misguided sense of control over their lives; they feel that even though things around them may be out of control, they are able to control the way they look and their body image.

The physical implications of bulimia can be severe, but timely treatment can help a person feel better about themselves and develop healthier eating habits. They also learn to cope with their anxiety and stress in healthier ways.

Note: Some people rely on food as a source of comfort and may engage in binge-eating when they are going through emotional turmoil. However, unlike people suffering from bulimia, they do not try to compensate for the excess weight by purging or excessive exercise. Such people, who lose control of the amount of food they eat when they are distressed, may suffer from binge-eating disorder.

What are the symptoms of bulimia?

The main behavioral symptoms of bulimia are:

  • People with bulimia are obsessed with their body image and shape, and live with a fear of gaining weight.
  • They eat large amounts of food when they are upset (binge).
  • They tend to eat secretly to avoid being found out by friends and family.
  • If they regularly visit the bathroom soon after meals, it might be a sign of purging. They may be forcing themselves to vomit or misusing laxatives and diuretics. Some people also misuse herbal supplements for weight loss.
  • They often do too much exercise, or are unreasonably obsessed with exercise, for instance wanting to go for a run even when its pouring outside.

Some of the physical signs are:

  • There may be scarring on the fingers and knuckles; this happens when they induce vomit forcefully on a regular basis.
  • Vomit also exposes teeth to stomach acids, which if done regularly, causes discoloration of teeth.
  • Frequent vomiting also causes swelling in the jaw and cheeks.
  • The repeated cycle of binging and purging causes frequent changes in weight.

What causes bulimia?

There is no known cause for bulimia and it is usually a combination of factors in person's life that leads them to develop the disorder. Like most other eating disorders, people suffering from bulimia use these habits to cope with other deep seated emotional issues. Some of the factors that may lead to a person developing bulimia are:

  • Stressful life events: Events such as the death of a loved one, loss of a job or a divorce can trigger symptoms of bulimia. The person tends to binge-eat to cope with the stress and then punish themselves for the binging episode by purging.
  • A past history of trauma, sexual or physical violence is often found in persons with bulimia.
  • Having a distorted body image due to stereotypes created by media or peer pressure may play a role in the onset of this problem.
  • In some cases, people develop symptoms of bulimia because their fear of gaining weight is related to their profession, for instance models, actors, gymnasts, etc.
  • Sometimes people suffering from depression, anxiety or other emotional issues may develop bulimia. Their emotional distress makes everything seem out of control. Purging after an episode of binging gives them a sense of control over their body image.

Getting treatment for bulimia

Bulimia is a severe problem but it can be treated and you can recover fully if you seek timely help. Treatment mainly involves counseling and therapy to teach you how to cope with stress and anxiety better. Sometimes, you may be prescribed some medication such as antidepressants.

If there are physical complications you may be admitted for inpatient care until your condition stabilizes. If you are underweight, then a team of specialists will help get you back to healthy weight and follow a healthy diet. It is essential that you stick to your treatment plan at all times. Contact your doctor or caregiver immediately if you feel the urge to binge.

Caring for someone with bulimia

People suffering from bulimia have a great sense of shame associated with their problem so they may be reluctant to talk about it. However, bulimia causes severe damage to a person both physically and emotionally.

As a caregiver, you need to be extremely supportive. Encourage them to talk about their problem and seek treatment. They may be reluctant at first but you need to be patient; do not be pushy or use scare tactics, such as citing harmful consequences of the disorder. During the treatment phase, it is important that you ensure that everyone around maintains a healthy eating habit, and avoid conversations regarding weight and body image. Encourage your loved one to stick to the treatment plan and offer your full support in their time of weakness.

Coping with bulimia

Living with bulimia can be an extremely stressful experience. The emotional stress along with the physical punishment can severely hamper your overall life. However, it is treatable and the first step to getting better is to accept that you have a problem and seek help. Treatment for bulimia can take time so patience and perseverance are important, and sticking to your treatment and diet plan is essential for your recovery. At any point if you are feeling low or feel the urge to binge, reach out to someone and talk to them. Develop better coping mechanisms for such times; go out for a run, talk to friends and family, etc. 


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