Getting Help For Bulimia Nervosa

Bulimia nervosa is a potentially life-threatening eating disorder. Read about the symptoms and treatment options.

Bulimia nervosa is a serious eating disorder characterised by frequent episodes of binge eating followed by extreme purgative efforts to avoid gaining weight, often by vomiting or exercising to excess.

Bulimia nervosa can be diagnosed when a person eats an excessive quantity of food in a single sitting, and invokes purgative behaviour, at least twice a week for three months.

A subtype of bulimia, called non-purgative bulimia nervosa, excludes the use of purgation, but most of the other signs, symptoms and consequences apply.

Differences Between Bulimia and Anorexia

Bulimia nervosa and anorexia nervosa are the two main eating disorders. They are similar in the sense that both involve weight control and purgation tactics, as well as the paradox of binge eating. However, there are major differences between them:

1. Anorexics focus mainly on starvation by avoiding food and engaging in purgation. They are unable to recognise their excessively skinny appearance and persist with efforts to lose more and more weight. In the process they become visually emaciated.
2. Bulimics engage primarily in binge eating cycles, followed by purgation, and at times they also try to diet or fast, but they try to maintain their normal weight and usually do not look emaciated.

Both disorders are more intense than normal dieting efforts and both lead to serious health problems. Although bulimics may not look emaciated, their behaviour depletes proteins, vitamins, enzymes, and other vital resources needed to maintain their health.

Some people with anorexia nervosa may develop obsessive binge eating, on top of their obsession with starvation. When that happens they will not be reclassified as bulimic, as the classification of anorexia supersedes that of bulimia.

What Causes Bulimia Nervosa?

Risk factors for acquiring bulimia nervosa include:

• Difficulty managing emotions.
• Major life changes that cause stress.
• Developmental trauma or childhood abuse.
• Negative self-esteem or relationship problems.
• An abnormal desire to be accepted as “normal”.
• The affected person linking success to leanness.
• Compulsive, impulsive, perfectionist tendencies.
• A career that does not allow being overweight.
• A “normal” diet that develops into an obsession.
• Mass media depiction of leanness being a virtue.
• Society linking responsibility with healthy eating.
• Problematic hormones and/or neurotransmitters.
• A family history of bulimia (inheritable genes).

Signs of Bulimia Nervosa

Persons with bulimia nervosa may not have an emaciated appearance, because they are not obsessed with becoming thin – they are only obsessed with keeping their weight normal. This makes it difficult for outsiders to identify the presence of bulimia. However, there are certain signs indicating the disorder, including these:

• A tendency to eat too much.
• Eating secretly between meals.
• Picking food based on calories.
• A preoccupation with weight.
• Worrying about over-eating.
• Enforced vomiting after eating.
• Excessive, compulsive exercising.
• Frequently buying, using laxatives.
• Abusing diuretics and diet pills.
• Frequently dieting or fasting.
• Frequent weight changes.
• Frequent mood changes.
• Social isolation.

Symptoms of Bulimia Nervosa

• Nausea and vomiting.
• Difficulty concentrating.
• Dizziness and fainting.
• Blood sugar fluctuations.
• Numbness, tingling in limbs.
• Fatigue and muscle spasms.
• Swollen glands in neck and jaw.
• Acid reflux and throat inflammation.
• Stomach cramps and abdominal pain.
• Intestinal obstruction, perforation, infection.
• Lack of vital minerals, enzymes, vitamins.
• Dehydration and electrolyte imbalance.
• Heart and other organ dysfunctions.
• Compromised immune system.
• Irregular menstruation.
• Low body temperature.
• Low blood cell counts.
• Low thyroid levels.
• Low bone density.
• Kidney damage.
• Risk of seizures.

Comorbid disorders are often encountered in bulimic patients. These vary from undetected, pre-existing mental disorders, to substance use disorder (alcohol and drug abuse).

Treatment Methods for Bulimia Nervosa

The following methods, or combinations of them, are available:

Medical Care: Ensures that physical illnesses are cured and may include prescriptions for medications required for physical and mental ailments. Prescribed medications are usually for short-term use only.

Psychotherapy: Psychological treatment, usually a combination of cognitive and behavioural therapies. Available on an inpatient or outpatient basis. Treatment in a residential rehabilitation centre is recommended, as it provides ideal ambience and facilities for recovery.

Dietary plans: Changes in types of food and upheavals in eating patterns can cause complications. A professionally designed recovery diet is important. Dynamic residential rehabilitation centres usually prepare prescribed dietary meals for patients.

Eating Disorder Treatment Services

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Eating disorder treatment is determined by the type of disorder and the symptoms you are experiencing. It typically includes a combination of psychological counselling or psychotherapy, nutrition instruction, medical monitoring, and, in some cases, medication.

Other health issues caused by an eating disorder must also be addressed as part of eating disorder therapy, as they can be severe or even fatal if left untreated for too long. If your eating disorder does not improve with conventional treatment or poses a health risk, you may require hospitalization or another type of inpatient program.

A systematic approach to eating disorder treatment can assist you in managing symptoms, regaining a healthy weight, and maintaining your physical and emotional health.