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DEFINITION OF BULIMIA NERVOSA
Men and Women who suffer from Bulimia Nervosa can often times seek their "binge-purge" episodes (a compulsion to eat a large amount of food in a short time, and then get rid of the food by self-induced vomiting, laxative use or compulsive exercise) in order to punish themselves for something they feel they should unrealistically blame themselves for.
This can be in direct relation to how they feel about themselves, or how they feel over a particular event or series of events in their lives.
The Bulimic will also seek episodes of bingeing and purging to avoid and let out feelings of anger or depression. Stress, anxiety or unhappiness may precipitate an episode.
Men and women suffering Bulimia are usually aware they have an eating disorder.
Fascinated by food they sometimes buy magazines and cook-books to read recipes, and enjoy discussing dieting issues.
In many cases the Bulimic may be Anorexic between binge-purge episodes thus presenting the same dangers in addition to the ones presented by the bingeing and purging.
Recurring episodes of rapid food consumption followed by tremendous guilt and often purging, a feeling of lacking control over their eating behaviors, regularly engaging in stringent diet plans and exercise, the excessive use of laxatives, diuretics, and/or diet pills and a persistent concern with body image can all be warning signs someone is suffering with Bulimia Nervosa.
It is important to realize that Bulimia shows symptoms in diverse ways. The Bulimic as defined, has binge and purge episodes where as purging can be different things to different people. Some victims, after a binge, will exercise compulsively, such as excessive jogging or aerobics, to attempt to burn off the calories of a binge. Others will force themselves to throw up or take laxatives, or to "fast" for days following a binge. It is not uncommon for a person suffering with Bulimia to take diet pills in an attempt to keep from bingeing, or to use diuretics to try to lose weight. A victim will often hide or "store" food for later binges, will often eat secretly and can suffer with great fluctuations in their weight.
SIGNS/SYMPTOMS OF BULIMIA
THE EFFECTS OF STARVING
Starts by not eating enough or at all.
Then begins by losing water and salts, glycogen, protein from muscle, organs, and finally, stored fat.
After a while, the body's "furnace" doesn't use as much as it used to (kicks down to save energy).
Right away, other changes begin to occur besides weight loss - changes we can't see at first.
Very loose stools, thin hair, and baggy skin may appear over time.
Anemia (not enough red blood cells, which carry oxygen) may make one feel weak, dizzy, and confused.
The kidney decreases urine formation, fluid often builds up in the tissues, making fingers and ankles swollen.
Impulse to not eat must be dealt with. Food as an energy source for every healthy body is important.
Other changes may occur. Social activity may decrease; often there is no energy to study or date.
New attitude and habits must be started to get healthy again. Normal weight CAN and MUST be reached.
Krause & Nahan, Goodhart & Shils
It is important to point out that there can be a number of ways a person suffering from Anorexia can portray their disorder. The inherent trait of a person suffering Anorexia is to attempt to maintain strict control over food intake. Periods of starvation, obsessive counting of calories and/or fat grams, compulsive exercising, and/or purging after regular meals are the most common symptoms. In a number of cases a man or woman suffering will seem to eat normal meals with only periods of restriction. Anorexics are sometimes known to eat junk food, particularly candy, to drink a lot of coffee or tea, and/or to smoke. They also can try to use diet pills to control their appetite, or laxatives to attempt to rid their body of food, both of which are dangerous and basically useless in producing weight loss results. A victim will deny hunger, make excuses to avoid eating (such as, "I already ate" or "I don't feel good"), will often hide food they claim to have eaten, or attempt to purge the food away with self-induced vomiting, or by taking laxatives.
Both Anorexia and Bulimia...
There are many similarities in both illnesses, the most common being the cause. There seems to be an underlying communality of sexual and/or physical and emotional abuse in direct relation to eating disorders, but not all people suffering Anorexia or Bulimia have endured this kind of abuse. There also seems to be a direct correlation in some people to clinical Depression, whether diagnosed or not, with the eating disorder sometimes causing the depression or the depression leading to the eating disorder. All in all, eating disorders are very complex emotional issues. Though they may seem to be nothing but a dangerously obsessive dietary concern on the surface, for most men and women suffering with an eating disorder there are deeper emotional conflicts to be resolved.
MYTHS
Every person suffering from an eating disorder is extremely underweight.
-Not True! There are a lot of anorexic, bulimic and compulsive overeaters suffering that are average weight or above.
Eating disorders are a vanity issue.
-Dieting is a vanity issue. Many eating disorders may start out as dieting, but the behavior turns quickly to a coping mechanism for dealing with stress, self hate, hurt, etc.
Compulsive Overeaters are lazy and have no will power.
-False and sad. People suffering with compulsive overeating use food as a way to fill a void they feel. They have low self-esteem and use food to cope with stress, and to comfort themselves.
An eating disorder is a woman's illness.
-Absolutely not. 1 in 10 eating disorders currently are men and it is expected that the number is much higher
SIGNS OF SOME FORM OF AN EATING DISORDER:
Use of Food...Healthy or Not?
Can you imagine these celebrations occurring without food as an integral part of the festivities? In general, consider your perception of many social activities. Does food play a significant role in these gatherings?
It is interesting that typically in our culture much planning exists around what food to make or what restaurant to choose. We have developed a strong sense of the need to gather around food. We need food to maintain our physiological demands and to survive, but is that the primary purpose food serves? Or does it meet other needs as well?
In America, 80 million people are at least 10 percent overweight, and 1 out of 4 is more than 22 pounds over his/her ideal weight. It is difficult to pick up most magazines and not see advertisements or articles about dieting.
Yet if we used food solely in a healthy way, we would not have to deal with being overweight and all of its negative ramifications.
What Is Healthy Food Use?
Mental health professionals who have investigated healthy food use determined that it's best to use food only to satisfy hunger needs to meet the body's nutritional requirements.
That means that ideally we would refuse food when we are not receiving cues from our body that we are hungry. On the flipside, we would not resist or deny ourselves food when there are physiological signs that our bodies are in a hunger state. These signs might include a hollow feeling in or growling of the stomach, a headache, light-headedness, etc.
We would be a culture that is more aware of distinguishing physiological needs from other needs that might cause people to eat. Using food like this leaves room for us to enjoy what we eat. It's healthiest when pleasure serves a complimentary role rather than being the primary focus of eating.
The Difference Between Unhealthy Food Use and Eating Disorders
Eating use/misuse fits on a continuum that ranges from the healthiest use of food to meet physiological needs to a problem of a potentially fatal form of an eating disorder. Although specific criteria determine a psychiatric diagnosis of one of the eating disorders, there are many variances between these two extremes of unhealthy eating patterns.
This is important because many people convince themselves that their eating behaviors are healthy because they do not fit the criteria for an accepted clinical eating disorder diagnosis.
Frequently an eating disorder develops from an insidious process of moving from healthy to unhealthy food use without the individual's conscious intent or awareness of choosing to use food in that manner. A person with an eating disorder may be surprised to view the severity of his/her current problem compared to how innocently it began.
At-Risk Signs
What are some of the effects on the body?
Binge-purge behavior can harm many different areas of the body.
With the increased awareness and education about eating disorders and their harmful effect, is the number of cases decreasing?
No. This continues to be a significant problem, especially with adolescent girls. Teenagers do not see the long-term implications of engaging in these behaviors.
What advice would you give to parents or others who know someone with an eating disorder?
Get help fast. It's important that the therapist and dietitian work together. Sometimes the patient isn't willing or ready to address food issues. However, it's important the dietitian control the food issues so the therapist can work on other issues in the patient's therapy.
It's also important that the therapist and dietitian have a good relationship. Eating disorder patients can be secretive and say one thing to the therapist and something else to the dietitian. Professionals have to be willing to confront patients if they revert to old coping mechanisms.
You cannot force an anorexic to eat, keep a bulimic from purging or make a compulsive overeater stop overeating. Do not concentrate on the food, eating disorders are emotionally based and the behaviors are only a symptom to emotional and stress related problems.