What is Bulimia Nervosa?
Bulimia is a serious mental illness where people worry about their weight and shape, and are concerned with their body image. They may feel that they have lost control over their eating. People with bulimia often have periods of time when they eat large quantities of food (called ‘bingeing’), and then vomit, take laxatives or diuretics (called purging), in order to prevent gaining weight. Usually people hide this behaviour pattern from others and their weight is often in a healthy range.
There are an estimated 1.6 million Britons suffering from some form of eating disorder. As with all eating disorders, bulimia is more common in women but reports estimate that up to 25% may be male.
Recent studies suggest that as many as 8% of women have bulimia at some stage in their life. The condition can occur at any age, but mainly affects women aged between 16 and 40 (on average, it starts around the age of 18 or 19).
What causes it?
There is no single cause of bulimia. It is common to have a fear of getting fat, however it is usually more complicated than that. The act of bingeing and purging can be a way of dealing with complicated emotions such as low self-esteem, depression and stress.
Bulimia, like many other eating disorders, is often linked to feeling out of control and people with bulimia may use the binge-purge cycle to feel in control of something in their life. Bulimia may also be triggered by hormonal changes in puberty or genetic factors.
What are the symptoms?
Bingeing – binge eating is repeatedly eating vast quantities of food, without necessarily feeling hungry or needing to eat. The urge to binge can begin as an attempt to deal with emotional problems, but can quickly become obsessive and out of control. It is usually a quick process followed by feeling uncomfortable afterwards.
Purging – After a binge, the person may feel bloated and uncomfortable which increases feelings of guilt and self-hatred. This is accompanied by the main impulse to purge which is a fear of putting on weight. This is usually in the form of vomiting or taking laxatives. Less common methods of purging include taking diet pills, over-exercising, extreme dieting or periods of starvation.
Other behavioural signs include a preoccupation with thoughts of food and life may be organised around shopping, eating and purging behaviour; mood swings; distorted perception of body shape or weight. Bulimia can be associated with depression, low self-esteem, misuse of alcohol and self-harm.
There are a number of complications associated with bulima such as dental problems and swollen glands from vomiting or bowel damage if laxatives are used. Periods can also become irregular in girls. The use of laxatives and vomiting can also cause abnormalities in a persons blood, some of which can be life threatening. They can also lead to heart problems, and again this can be life threatening if not treated.
How is it diagnosed?
People with bulimia may be reluctant to seek help so if you think you know someone who has bulimia it is important to talk to them and be understanding without criticising. Encourage them to go to their GP and offer to go with them.
Likewise if you think that you might have bulimia, try talking to someone you trust first. If you want, you could ask them to come with you to see the GP.
Your GP will look at your weight for your age and might monitor significant weight changes, ask about concerns you have over your weight or body shape, talk about eating disorder behaviours and might also take some blood for testing. If your GP thinks you might have an eating disorder they should refer you for an assessment and possible treatment by a person who has specialist eating disorder knowledge.
How is it treated?
The first step that GPs will usually offer you is self-help. This might mean that you are recommended books and your primary care team (doctors, dieticians, psychologists, counsellors, nurses) can help you to follow this course.
Cognitive behavioural therapy (CBT) is often offered to those who do not find self-help treatment works for them. Treatment should comprise of up to 20 sessions and last for around four or five months. People with a diagnosis of bulimia may also be offered interpersonal therapy (IPT), which might follow CBT if it is not successful or if this is the treatment that the person prefers.
At the same time, physical health will also be monitored. Some people diagnosed with bulimia may be prescribed medication as a part of their treatment plan.
Someone diagnosed with bulimia is usually treated at home, but if they do not show signs of improvement or if they are seen to be at risk of hurting themselves then they may have to stay in hospital or a specialist clinic.
Want to know more?
Want to know more?