Bulimia nervosa, also known as bulimia, is one of a number of serious eating disorders that occurs in Anguilla and many other countries. Bulimia can be a deadly disease if not diagnosed and treated correctly.
What is bulimia?
Bulimia nervosa is an eating disorder characterized by frequent episodes of binge eating, followed by frantic efforts to avoid gaining weight. It affects women and men of all ages, although it is more common in females.
When you are struggling with bulimia, life is a constant battle between the desires to lose weight or stay thin and the overwhelming compulsion to binge eat.
You do not want to binge—you know you will feel guilty and ashamed afterwards—but time and again you give in. During an average binge, the individual suffering from bulimia may consume from 3,000 to 5,000 calories in one short hour.
When it ends, panic sets in and the individual turns to drastic measures to “undo” the binge, such as taking laxatives, inducing vomiting, or going for a ten-mile run. During this time they feel increasingly out of control.
It is important to note that bulimia does not necessarily involve purging—physically eliminating the food from your body by throwing up or using laxatives, enemas or diuretics. If you make up for your binges by fasting, exercising to excess, or going on crash diets, this also qualifies as bulimia.
Bulimia can be categorized in two ways:
• Purging bulimia. You regularly self-induce vomiting or misuse laxatives, diuretics or enemas after bingeing.
• Nonpurging bulimia. You use other methods to rid yourself of calories and prevent weight gain, such as fasting, strict dieting or excessive exercise.
However, these behaviors often overlap, and the attempt to rid yourself of extra calories is usually referred to as purging, no matter what the method.
What causes bulimia?
The exact cause of bulimia is unknown. There are many possible factors that could play a role in the development of eating disorders, but biology, emotional health, societal expectations and other factors increase your risk.
Factors that increase your risk of bulimia may include:
• Being female. Girls and women are more likely to have bulimia than boys and men.
• Age. Bulimia often begins in the late teens or early adulthood.
• Biology. People with first-degree relatives (siblings or parents) with an eating disorder may be more likely to develop an eating disorder, suggesting a possible genetic link. It’s also possible that a deficiency in the brain chemical serotonin may play a role.
• Psychological and emotional issues. People with eating disorders may have psychological and emotional problems that contribute to the disorder. Examples include low self-esteem, perfectionism, impulsive behavior, anger management problems, depression, anxiety disorders or obsessive-compulsive disorder. In some cases, traumatic events may be a contributing factor.
• Societal pressure. Peer pressure and what people see in the media may fuel a desire to be thin, particularly among young women.
• Performance pressure in sports. Eating disorders are particularly common among athletes, such as gymnasts, runners and wrestlers.
Are you suffering from bulimia?
Ask yourself the following questions. (The more “yes” answers, the more likely you are suffering from bulimia or another eating disorder.):
• Are you obsessed with your body and your weight?
• Does food and dieting dominate your life?
• Are you afraid that when you start eating, you would not be able to stop?
• Do you ever eat until you feel sick?
• Do you feel guilty, ashamed, or depressed after you eat?
• Do you vomit or take laxatives to control your weight?
What are some symptoms of bulimia?
The signs and symptoms might vary in severity from one individual to another but they might include the following:
• Being preoccupied with your body shape and weight
• Living in fear of gaining weight
• Feeling that you can’t control your eating behaviour
• Eating until the point of discomfort or pain
• Eating much more food in a binge episode than in a normal meal or snack
• Forcing yourself to vomit or exercise too much
• Misusing laxatives, diuretics or enemas after eating
• Using dietary supplements or herbal products for weight loss
When to see your doctor?
If you have any bulimia symptoms, seek medical help as soon as possible. If left untreated, it may get worse and take over your life.
Talk to your primary care provider or a mental health provider about your symptoms or concerns. If you are reluctant to seek treatment, confide in someone about what you are going through, whether it’s a friend or loved one, a teacher, a faith leader or someone else you trust. He or she can help you take the first steps to successful bulimia treatment.
Helping a loved one with bulimia symptoms
If you think a loved one or someone you know, such as co-worker, may have symptoms of bulimia, have an open and honest discussion about your concerns. You cannot force someone to seek professional care, but you can offer encouragement and support. You can also help find a qualified doctor or mental health provider, make an appointment and even offer to go along with him/her to his/her healthcare provider.
As most people with bulimia are of normal weight, or even slightly overweight, it may not be apparent to others that something is wrong. Red flags that family and friends may notice include:
• Constantly worrying or complaining about being fat
• Having a distorted, excessively negative body image
• Repeatedly eating unusually large quantities of food in one sitting, especially high-fat or sweet foods
• Not wanting to eat in public or in front of others
• Going to the bathroom right after eating or during meals
• Exercising too much
• Having sores, scars or calluses on the knuckles or hands
• Having damaged teeth and gums
Complications of bulimia
Bulimia may cause numerous serious and even life-threatening complications. Possible complications include:
• Dehydration, which can lead to major medical problems, such as kidney failure
• Heart problems, such as an irregular heartbeat and heart failure
• Severe tooth decay and gum disease
• Absence of a period in females
• Digestive problems, and possibly a dependence on laxatives to have bowel movements
• Anxiety and depression
• Drug and alcohol abuse
Treatment
Once the diagnosis is made and the individual seeks treatment, there are a number of treatment options available. The individual with bulimia may need several types of treatment, although combining psychotherapy with antidepressants may be the most effective for overcoming the disorder. Treatment generally involves a team approach that includes the affected individual, the entire family, primary care doctor or other medical provider, as well as a mental health provider and a dietitian experienced in treating eating disorders.
Although most people with bulimia do recover, some find that symptoms do not go away entirely. Periods of bingeing and purging may come and go through the years, depending on life circumstances such as times of high stress. If you find yourself back in the binge-purge cycle, “booster” sessions with your health care providers may help you weather the crisis before your eating disorder spirals out of control again. Learning positive ways to cope, creating healthy relationships and managing stress can help prevent a relapse.
Conclusion
Bulimia is an eating disorder that can affect anyone, but appears to be more common in females during the teen and young adult years. Serious complications can occur if the disorder is not treated. Treatment options are now available for bulimia. If you notice a relative or friend who seems to have food issues that could lead to or indicate an eating disorder, consider supportively talking to the person about these issues and ask how you can help.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor who has over thirty years in clinical practice. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).
