Bulimia Nervosa

Definition

Definition of Bulimia Nervosa
Bulimia nervosa is an eating disorder characterized by binge eating and purging or consuming a large amount of food in a short amount of time, followed by an attempt to rid oneself of the food consumed, usually by purging (vomiting) and/or by laxative, diuretics or excessive exercise. Bulimia nervosa is considered to be less life threatening than anorexia, however the occurrence of bulimia nervosa is higher. Bulimia nervosa is nine times more likely to occur in women than men (Barker 2003). The vast majority of those with bulimia nervosa are at normal weight. Antidepressants, especially SSRIs, are widely used in the treatment of bulimia nervosa (Newell and Gournay 2000). Patients who have bulimia nervosa are often linked with having impulsive behaviors involving over spending and sexual behaviors as well as having family histories of alcohol and substance abuse, and mood and eating disorders.

Symptoms

Symptoms of Bulimia Nervosa
People with bulimia may have the following signs and symptoms:

1. Binge eating of high-carbohydrate foods, usually in secret
2. Exercising for hours
3. Eating until painfully full
4. Going to the bathroom during meals
5. Loss of control over eating, with guilt and shame
6. Body weight that goes up and down
7. Constipation, diarrhea, nausea, gas, abdominal pain
8. Dehydration
9. Missed periods or lack of menstrual periods
10. Damaged tooth enamel
11. Bad breath
12. Sore throat or mouth sores
13. Depression

Causes

Causes of Bulimia Nervosa
No one knows what causes bulimia, although there are several theories. Genes may play a part - there is some evidence that women who have a sister or mother with bulimia are at higher risk of developing the condition. Families may put an too much emphasis on achievement, or may be overly critical. Psychological factors may also play a part including having low self-esteem, not being able to control impulsive behaviors, and having trouble expressing anger. Some people with bulimia may have a history of sexual abuse. People with bulimia may also experience depression, self-mutilation, substance abuse, and obsessive-compulsive behavior. Cultural pressures to look thin can also play a part, particularly among dancers and athletes.

Diagnosis

Diagnosis of Bulimia Nervosa
When doctors suspect you have bulimia, they typically perform:

1. A complete physical exam
2. Blood and urine tests
3. A psychological evaluation, including a discussion of your eating habits and attitude toward food

Treatment

Treatment of Bulimia Nervosa
The most successful treatment combines psychotherapy, family therapy, and medication. It is important for the person with bulimia to be actively involved in their treatment.

Drug Therapies: Antidepressants are often prescribed for bulimia. The most common antidepressants prescribed are selective serotonin reuptake inhibitors (SSRIs). They include:

1. Fluoxetine (Prozac)
2. Sertraline (Zoloft)
3. Paroxetine (Paxil)
4. Fluvoxamine (Luvox)

Prozac is the only antidepressant approved by the Food and Drug Administration to treat bulimia, although some studies suggest that other SSRIs, such as Luvox, may be even more effective.

Some studies indicate that Prozac and other antidepressants may cause some children and teenagers to have suicidal thoughts. Children who are taking these drugs should be monitored very carefully for signs of suicidal behavior.

People with bulimia may not be getting the nutrients their bodies need. Your health care provider may prescribe potassium or iron supplements, or other supplements to make up for any deficiency.

Complementary and Alternative Therapies: Psychotherapy is a cornerstone of bulimia treatment. Cognitive behavioral therapy, which teaches you to replace negative thoughts and behaviors with healthy ones, is a common treatment method.

Other mind-body and stress-reduction techniques, such as yoga, tai chi, and meditation, may help you become more aware of your body and have a more positive body image. A 6-week clinical trial showed that guided imagery helped people with bulimia reduce bingeing and vomiting, feel more able to comfort themselves, and improved feelings about their bodies and eating. More studies are needed to see if guided imagery has long-term benefits.

Always tell your health care provider about the herbs and supplements you are using or considering using.

Prognosis

Prognosis of Bulimia Nervosa
Many people with bulimia relapse after treatment and need long-term care. Possible complications from repeated bingeing and purging include problems with the esophagus, stomach, heart, lungs, muscles, or pancreas. People with suicidal thoughts or severe symptoms may need to be hospitalized. Women with bulimia may find pregnancy emotionally difficult because of the changes in their body shape. The mother's poor nutritional health can affect the baby. Women who have stopped having periods because of bulimia will be unable to become pregnant.

Prevention

Prevention of Bulimia Nervosa
Although there's no sure way to prevent bulimia, you can steer someone toward healthier behavior or professional treatment before the situation worsens.