What is Bulimia Nervosa
Bulimia nervosa is an eating disorder and mental illness. People with bulimia nervosa go through cycles of eating a very large amount of food in a short period (binge eating), then taking steps to get rid of the food (purging), such as exercising, vomiting, or other methods.
People with bulimia nervosa usually know something is wrong, but they are unable to control themselves. They may be embarrassed by their behavior and try to hide it from others.
Bulimia nervosa usually starts in the late teenage or early adult years. People with this illness often develop a mood disorder, such as depression. They also have a higher risk for suicide, anxiety disorders, and substance abuse. Bulimia nervosa can lead to a variety of physical problems.
What are the causes?
The cause of this condition is not known. However, emotional stress often triggers binge eating. The condition is influenced by hereditary and social factors.
What increases the risk?
You are more likely to develop this condition if:
- You are a woman, especially a young woman or adolescent.
- You have family members who have bulimia nervosa or anorexia.
- You are concerned about your body weight and shape.
- You are in the middle or upper socioeconomic classes.
- You show certain obsessive or compulsive behaviors.
What are the signs or symptoms?
Symptoms of this condition include:
- Binge
eating as much as several times a day. Binge eating involves:
- Eating an unusually large amount of food in a short amount of time, usually within 2 hours. The types of foods eaten are usually high in fat and sugar, such as cake or ice cream. The food often consists of thousands of calories.
- Feeling a loss of control when eating during that time period, such as not being able to stop.
- Purging,
which may be done by:
- Making yourself vomit. This can lead to teeth marks and scarring on the knuckles, damage to tooth enamel caused by stomach acid, and enlargement of the salivary glands.
- Using a lot of laxatives.
- Abusing medicines that get rid of excess water in the body (diuretics) or diet pills.
- Not eating for a long period of time (fasting) or starving yourself between binge-eating periods.
- Exercising too much in an effort to lose weight.
- Depression. Many people with this disorder have low self-esteem and feel stress, shame, secrecy, and guilt associated with their behavior.
How is this diagnosed?
This condition may be diagnosed based on:
- Your
symptoms. Your health care provider may ask questions about:
- Your binge eating and purging cycles.
- Your self-image and concerns you have about your body’s weight and shape.
- Changes in your weight.
- Any diarrhea or abdominal cramps you experience.
- A physical exam. Your health care provider may check for swollen salivary glands, scars on your knuckles, or tooth enamel that is wearing down (eroding).
- Blood tests to check mineral levels in your blood. Low mineral levels may be a sign that you are not getting enough nutrients (malnutrition).
You may be referred to a mental health care provider.
How is this treated?
The treatment for this condition is usually provided by mental health professionals and focuses on creating normal nutrition and eating habits. Treatment may include:
- Counseling
or talk therapy, such as:
- Cognitive behavioral therapy. This is the most effective form of talk therapy. The goal is to help you recognize and change the thoughts, beliefs, and emotions that lead to your unhealthy eating habits. Cognitive behavioral therapy lasts 4–5 months and requires weekly visits.
- Interpersonal therapy. This type of therapy helps you define and change issues related to your relationships, how you see yourself in relation to others, and how you communicate (interpersonalissues). This therapy does not deal directly with bulimia nervosa, but rather with interpersonal issues that may lead to the disorder.
- Dialectical behavioral therapy. This type of therapy focuses on being mindful and accepting of your emotions, and changing your behavior based on this acceptance. This can be helpful for treating certain personality disorders or depression.
- Antidepressant
medicines to help reduce symptoms. These medicines are especially helpful
if you:
- Have symptoms that have not improved with talk therapy.
- Are very depressed and have severe anxiety.
Follow these instructions at home:
- Take over-the-counter and prescription medicines only as told by your health care provider.
- Follow instructions from your health care provider or counselor about a healthy eating plan and appropriate physical activity.
- Keep all follow-up visits as told by your mental health care provider. This is important.
Contact a health care provider if:
- Your symptoms get worse or you develop new symptoms.
- You are unable to take prescription medicine as directed.
- You have constipation.
- You have tingling in your hands or feet.
- You have pain in your mouth, gums, or abdomen.
- Your menstrual period has stopped.
Get help right away if:
- You have serious thoughts about hurting yourself or others.
- You have severe pain in your chest or abdomen.
- Your heart is beating very fast, and you feel dizzy or faint.
- You have stiff, weak muscles.
- You cannot stop vomiting, or you have blood in your vomit.
If you ever feel like you may hurt yourself or others, or have thoughts about taking your own life, get help right away. You can go to your nearest emergency department or call:
- Your local emergency services (911 in the U.S.).
- A suicide crisis helpline, such as the National Suicide Prevention Lifeline at 1-800-273-8255. This is open 24 hours a day.
- The National Eating Disorders Association Helpline at 1-800-931-2237.
Summary
- People with bulimia nervosa go through cycles of eating a very large amount of food in a short period (binge eating), then taking steps to get rid of the food (purging).
- People with this illness often develop a mood disorder. They also have a higher risk for suicide, anxiety disorders, and substance abuse.
- Treatment is usually provided by mental health professionals. Treatment may involve talk therapy and antidepressant medicines.
- Contact a health care provider if your symptoms get worse or you get new symptoms.
