Bulimia Nervosa

Bulimia Nervosa is a condition most commonly found in girls of later adolescence and early adulthood. Bulimia like anorexia nervosa is psychological in origin and can have dire physical consequences. It is characterized by episodes of binge eating, eating large quantities of food in a short time. In response to the binges, patients purge by vomiting or by taking laxatives, diet pills, or drugs to reduce fluids. Patients may also revert to severe dieting, which cycles back to bingeing if the patient does not go on to become anorexic. In severe conditions, the patients may become withdrawn, moody, intolerant and fail to make normal relationships. Bulimia has increased at a greater rate than anorexia over the past several years. Estimates of the prevalence of bulimia nervosa among young women range from about 3% to 10%. Some experts claim this problem is grossly underestimated because many people with bulimia are able to conceal their purging and do not become noticeably underweight. Younger people are also at risk. For example, a European study detected bulimic behavior in 14.4% of adolescents 14 to 16 years old and bulimia itself in 1.8% of girls and 0.3% of boys. Young people who occasionally force vomiting after eating too much, however, are not considered bulimic, and most of the time this occasional unhealthy behavior does not continue beyond youth.

• Recurrent episodes of binge eating and purging i.e. eating very large amounts of food in a short period of time. Eating binges prior to purging average about 1,000 calories, but intake during a binge can be as high as 20,000 or as low as 100 calories. Patients diagnosed with bulimia average about 14 episodes of binge purging per week. 
• Unrealistic fear of becoming fat i.e. fasting or vigorous exercise to prevent weight gain
• Weight fluctuation i.e. weight gain or loss of 10 pounds or more
• Food cravings
• Overuse of laxatives
• Depression
• Physical changes including salt and fluid imbalance, menstrual problems, hair loss, chronic sore throat, swollen parotid glands or severe tooth decay 
• Gastrointestinal upset
• Regular self-induced vomiting

In an attempt to understand eating disorders, scientists have studied the biochemical functions of people with the illnesses. They have focused recently on the neuroendocrine system--a combination of the central nervous and hormonal systems. Through complex but carefully balanced feedback mechanisms, the neuroendocrine system regulates sexual function, physical growth and development, appetite and digestion, sleep, heart and kidney function, emotions, thinking, and memory--in other words, multiple functions of the mind and body. Many of these regulatory mechanisms are seriously disturbed in people with eating disorders. In some cases, prevention may not be possible. Encouraging healthy, realistic attitudes toward weight and diet may be helpful. Sometimes, counseling can help.

The exact cause of Bulimia is unknown, but a number of psychological, social, cultural and biochemical theories are being considered. Pressures and conflicts within the family are thought to be the primary cause of bulimia, which is most often found in Caucasians. A bulimic is apt to be an overachiever and perfectionist who feels she can't live up to her parents' expectations. She has low self-esteem and often suffers from depression. She may have been physically or sexually abused as a child: About half of all bulimics report a history of abuse. People who develop bulimia and binge eating disorder typically consume huge amounts of food--often junk food--to reduce stress and relieve anxiety. With binge eating, however, comes guilt and depression. Purging can bring relief, but it is only temporary. Individuals with bulimia are also impulsive and more likely to engage in risky behavior such as abuse of alcohol and drugs. Eating disorders appear to run in families--with female relatives most often affected. This finding suggests that genetic factors may predispose some people to eating disorders; however, other influences--both behavioral and environmental--may also play a role. A recent study found that parents and siblings who are overly concerned about their daughters' weight and physical attractiveness might put the girls at increased risk of developing an eating disorder.

There are five basic criteria in the diagnosis of bulimia:

Eat foods that are readily available that are visually appealing and healthy. Cut up fresh fruits, vegetables and yogurt are a few examples. Stay healthy by consuming low fat foods. Skipping meals only increases and promotes binge eating. Keep hunger in control by nibbling on foods that will prevent you from binging later.

Often bulimic patients are encouraged to keep a record of their anger and depression. If you crave a particular food wait at least twenty minutes before eating it. Often if the craving does not result from real hunger it will pass. Take a walk or arrange for another activity that is incompatible with eating.

Bulimia is a disorder that is shrouded by feelings of shame and guilt. Consequently the bulimic may become preoccupied with becoming withdrawn and isolated in order to ensure the privacy needed to binge and vomit. Professional counseling is highly recommended as it helps the patient to relax and get rid of the distress and feelings of anger and depression.