What is bulimia nervosa?

Bulimia nervosa, usually referred to as bulimia, is defined as uncontrolled episodes of overeating (bingeing) and usually followed by purging (self-induced vomiting), misuse of laxatives, enemas, or medications that cause increased production of urine, fasting, or excessive exercise to control weight. Bingeing, in this situation, is defined as eating much larger amounts of food than would normally be consumed within a short period of time (usually less than two hours).

What causes bulimia?

The cause of bulimia is not known. Factors believed to contribute to the development of bulimia include cultural ideals and social attitudes toward body appearance, self-valuation based on body weight and shape, and family problems.

Who is affected by bulimia?

The majority of bulimics are female, adolescent, and from a high socioeconomic group. All westernized industrial countries have reported incidence of bulimia. An estimated 0.1 to 1.5 percent of the U.S. population are reported to have bulimia. Adolescents who develop bulimia are more likely to come from families with a history of eating disorders, physical illness, and other mental health problems, such as mood disorders or substance abuse. Other mental health problems, such as anxiety disorders, or mood disorders, are commonly found in persons with bulimia.

Family, friends, and doctors may have difficulty detecting bulimia in someone they know because they binge and purge in secret. Often, they are able to maintain normal or above normal body weight, but hide their problem from others for years. Many individuals with bulimia do not seek help until they reach the ages of 30 or 50--when their eating behavior is deeply ingrained and more difficult to change.

What are some common characteristics of persons with bulimia?

Most people with eating disorders share certain personality traits and use abnormal eating rituals as a means of handling stress and anxiety. These personality traits often include, but are not limited to, the following:

  • Low self-esteem

  • Feelings of helplessness

  • Fear of becoming fat

People with 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 brings relief that is only temporary.

  • Individuals with bulimia are usually impulsive and more likely to engage in risky behaviors, such as abuse of alcohol and drugs.

What are the different types of bulimia?

There are two subgroups of anorexic behavior aimed at reducing caloric intake, including the following:

  • Purging type. This type regularly engages in self-induced vomiting or misuse of laxatives, diuretics, or enemas, or other cathartics (medications, through their chemical effects, that serve to increase the clearing of intestinal contents).

  • Nonpurging type. This type uses other inappropriate behaviors, such as fasting or excessive exercise, rather than regularly engaging in purging behaviors to reduce caloric absorption of excessive amounts of food by the body.

What are the symptoms of bulimia?

The following are the most common symptoms of bulimia. However, each individual may experience signs differently. Symptoms may include:

  • Usually a normal or low body weight (sees self as overweight)

  • Recurrent episodes of binge eating (rapid consumption of excessive amounts of food in a relatively short period of time; often secretive) , coupled with fearful feelings of not being able to stop eating during the bingeing episodes

  • Self-induced vomiting (usually secretive)

  • Excessive exercise or fasting

  • Peculiar eating habits or rituals

  • Inappropriate use of laxatives, diuretics, or other cathartics

  • Irregular or absence of menstruation

  • Anxiety

  • Discouraged feelings related to dissatisfaction with themselves and their bodily appearance

  • Depression

  • Preoccupation with food, weight, and body shape

  • Scarring on the back of the fingers from the process of self-induced vomiting

  • Overachieving behaviors

The symptoms of bulimia may resemble other medical problems or psychiatric conditions. Always consult your doctor for a diagnosis.

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