Bulimia Nervosa

What is Bulimia Nervosa (better know as Bulimia)?**

It's an eating disorder characterized by binge-eating and purging. Binge-eating is uncontrolled consumption of large amounts of food. Binges may last from a few minutes to several hours. The person may consume a few hundred calories -- or tens of thousands. Purging is the act of getting rid of food eaten during a binge. The most common method of purging is self-induced vomiting. Other methods include fasting, vigorous exercise, taking laxatives, and going on severe diets.

**The word 'bulimia' comes from a Greek word meaning 'the hunger of an ox.' But binges are usually triggered by emotional upset, not by physical hunger.

Why is it important to know about Bulimia?

Because bulimia is a threat to health. Many young women are affected with bulimia nervosa. Bulimia causes serious medical problems, and people with bulimia many times do not seek help. Bulimia Nervosa IS treatable!

How Bulimia Nervosa develops

Bulimia can strike anyone, but the most typical cases are young women who are emotionally insecure, lack confidence, and/or are perfectionists. The development of bulimia usually follows this pattern:

1. A diet is started to help the person lose weight and improve self-esteem, but dieting leads to hunger and cravings for rich, sweet food.
2. Overeating begins as a reaction to anxiety, depression, anger, frustration, or loneliness. Food is a comfort, and relieves the cravings.
3. Guilt develops about gaining too much weight. In a society where everyone is supposed to be thin, this guilt may turn into fear.
4. Purging is discovered, and it seems to be the ideal solution. The person can now binge without fear of gaining weight.
5. A habit takes hold as binge-eating and purging become a part of daily life. People with bulimia fear discovery because they worry that others will think their habit is disgusting.

Learn to recognize signs of the disorder

Signs of bulimia nervosa aren't always noticable, because people with bulimia will probably try to hide their problem, but be alert for these things:

• ABUSE OF PURGATIVES
  If excessive quantities of laxatives, diuretics (substances that increase urine output), or diet pills are being taken, there is cause for concern.
• ABNORMAL INTEREST IN FOOD
  People with bulimia nervosa, anorexia, or bulimarexia (a combination of both eating disorders) spend an unusal amount of time thinking and talking about food, dieting, and their weight. Some may even go on food-buying sprees or even steal food, or money to buy food.
• SIGNS OF SECRECY
  People with bulimia may attempt to hide their binges by eating in their car, alone, etc. They will go to great lenghts to keep their frequent vomiting a secret.
• WEIGHT CHANGES
  Frequent binge-eating an purging may cause weight to fluctuate dramatically.
• DEPRESSION
  Because people with bulimia nervosa have a poor self-image, they may isolate themselves. Some people with bulimia may talk about suicide; a few may actually attempt suicide.
• CHANGES IN APPEARANCE
  Purging may cause skin rashes and dry skin; changes in the texture and quality of fingernails and hair; and swollen salivary glands.
• SEVERE DIETING AND EXERCISE
  People with bulimia nervosa may combine strict restrictions on eating with extreme physical exercise.
• SUBSTANCE ABUSE
  It's not uncommon for people with bulimia to turn to alcohol or other drugs in an effort to control their eating or to relieve their depression and guilt.

Side effects of Bulimia Nervosa

Bulimia nervosa can lead to many serious health problems, even though it is primarily an emotional problem. The disorder may affect:

• TEETH - frequent vomiting can destroy tooth enamel, cause severe tooth decay and damage gums
• SALIVARY GLANDS - these glands, which produce saliva to aid in swallowing and digesting food, may become swollen or infected
• ESOPHAGUS - vomiting may also damage the esophagus, (the tube that carries food to the stomach) causing pain, internal bleeding and sometimes perforation. Sore throats are common
• HEART - if the body's fluid balance is upset, an irregular heart rhythm, and even heart failure and death may result
• DIGESTIVE ORGANS - problems range from nausea, stomach cramps, ulcers and colitis to a fatal rupturing of the stomach
• MUSCLES - muscle weakness may result from a loss of potassium. The person may experience cramps, stiffness, or numbness in the arms and legs
• OTHER ORGANS - bulimia nervosa may result in damage to other vital organs, including the liver and the kidneys. This disorder can also lead to diabetes
• MENSTRUAL CYCLE - bulimia nervosa may lead to amenorrhea - an absence of the menstrual period - due to reduced female hormone levels

Treatment

People with bulimia must realize their problem and and be willing to be helped. Treatment may involve a combination of methods...

• A medical evaluation can detect any physical problems that require special care
• Individual psychotherapy can help the person understand why they binge, and what they can do in stressful situations instead of binging
• Hospitalization may be necessary to control the binge-eating and purging cycle, to replace nutrients, and to treat any anxiety/and or depression
• Family therapy may be advised if the person's condition seems to be the result or cause of tension within the family
• Group therapy is often helpful because it provides support from people who have had similar experiences
• Other methods may include nutrition counseling and cognitive-behavioral therapy, a method that helps the person think about eating in more positive ways. Medication may be helpful in some cases, such as Prozac, Pamelor, or Lithium

Similarities:                              Differences:
* Both disorders cause extreme concern            * To achieve thinness, people with
about body image and gaining weight.              anorexia eat almost nothing; people
* Both disorders usually start during             with bulimia binge, then purge. 
the teenage years, (although they can             * People with bulimia mantain near-normal
start at any age) and affect mostly females.      weight and appear to be healthy; people
                                                   with anorexia become shockingly thin.
                                                  * People with bulimia often realize that 
                                                  something is wrong; people with anorexia 
                                                  refuse to believe that their behavior 
                                                  is abnormal.        

Sources of help and information

National Association of Anorexia Nervosa and Associated Disorders, Inc. (ANAD)
P.O. Box 7
Highland Park, IL 60035
(708) 831-3438

Anorexia Nervosa and Related Eating Disorders, Inc.
P.O. Box 5102
Eugene, OR 97405
(503) 344-1144

National Anorexic Aid Society, Inc.
1925 East Dublin-Granville Road
Columbus, OH 43229
(614) 436-1112

American Anorexia/Bulimia Association, Inc.
418 East 76th Street
New York, NY 10021
(212) 734-1114

Center For the Study of Anorexia and Bulimia
1 West 91st Street
New York, NY 10024
(212) 595-3449

AABA -- The American Anorexia/Bulimia Association, Inc
Anorexia and Bulimia Family Support Group
MEDA -- Massachusettes Eating Disorder Association
"LOST FOR WORDS" The Psychoanalysis of Anorexia and Bulimia
Something Fishy Website on Eating Disorders
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