Bulimia Nervosa

Bulimia Nervosa is characterized by recurrent and frequent episodes of eating unusually large
amounts of food and feeling a lack of control over the eating. This binge-eating is followed by a type of
behavior that compensates for the binge, such as purging, fasting and/or excessive exercise.
A person with Bulimia can become lost in a dangerous cycle of eating out of control and
attempts to compensate which can lead to feelings of shame, guilt and disgust. These behaviors can
become more compulsive and uncontrollable over time, and lead to an obsession with food, thoughts
about eating (or not eating), weight loss, dieting and body image.
A person with bulimia has not made a lifestyle choice, they are actually very unwell and need
help.
In addition, people with bulimia place an excessive emphasis on body shape or weight in their
self-evaluation. This can lead to the persons sense of self-esteem and self-worth being wholly defined
by the way they look.
Many people with Bulimia experience weight fluctuations and do not lose weight; they can
remain in the normal weight range, be slightly underweight, or may even gain weight.

Bulimia can be categorized in two ways:
Purging bulimia. You regularly self-induce vomiting or misuse laxatives, diuretics or enemas
after bingeing.
Non purging bulimia. You use other methods to rid yourself of calories and prevent weight
gain, such as fasting, strict dieting or excessive exercise.

Symptoms
Bulimia signs and symptoms may include:
Being preoccupied with your body shape and weight
Living in fear of gaining weight
Feeling that you can't control your eating behavior
Eating until the point of discomfort or pain
Eating much more food in a binge episode than in a normal meal or snack
Forcing yourself to vomit or exercise too much
Misusing laxatives, diuretics or enemas after eating
Using dietary supplements or herbal products for weight loss


Risk factors
Factors that increase your risk of bulimia may include:

Being female. Girls and women are more likely to have bulimia than boys and men are.
Age. Bulimia often begins in the late teens or early adulthood.
Biology. People with first-degree relatives (siblings or parents) with an eating disorder may be
more likely to develop an eating disorder, suggesting a possible genetic link. It's also possible
that a deficiency in the brain chemical serotonin may play a role.
Psychological and emotional issues. People with eating disorders may have psychological and
emotional problems that contribute to the disorder. Examples include low self-esteem,
perfectionism, impulsive behavior, anger management problems, depression, anxiety disorders
or obsessive-compulsive disorder. In some cases, traumatic events may be a contributing factor.
Societal pressure. Peer pressure and what people see in the media may fuel a desire to be thin,
particularly among young women. People who are in the public eye, such as actors, dancers and
models, are at higher risk of eating disorders.
Performance pressure in sports. Eating disorders are particularly common among athletes,
such as gymnasts, runners and wrestlers. Coaches and parents may unknowingly contribute to
eating disorders by encouraging young athletes to lose weight, maintain a low weight and
restrict eating for better performance.

Complications

Bulimia may cause numerous serious and even life-threatening complications. Possible complications
include:
Dehydration, which can lead to major medical problems, such as kidney failure
Heart problems, such as an irregular heartbeat and heart failure
Severe tooth decay and gum disease
Absence of a period in females
Digestive problems, and possibly a dependence on laxatives to have bowel movements
Anxiety and depression
Drug and alcohol abuse




Treatment
Therapies to be considered for the treatment of Bulimia Nervosa include:
Psychological Treatments
Evidence-based self-help programs
Cognitive behavioral therapy for Bulimia Nervosa
Interpersonal psychotherapy
Maudsley family-based treatment (for children and adolescents)
Dialectical behavior therapy
Guided imagery
Crisis intervention
Stress management