Bulimia Nervosa
Bulimia Nervosa 
How serious is Bulimia Nervosa?
What are the symptoms of Bulimia Nervosa?
What will comfirm a diagnosis of Bulimia Nervosa?
How is Bulimia Nervosa treated?
Where can someone get help for Bulimia Nervosa?
What is Bulimia Nervosa?Bulimics 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. Bulimic crisis tends to be episodic (two to three time a week), but they may also occur several times a day.
Bulimia is a syndrome characterized by repeated bouts of overeating and an excessive preoccupation with the control of body weight, leading the patient to adopt extreme measures so as to mitigate the "fattening" effects of ingested food.
The disorder may be viewed as a sequal to persistent anorexia nervosa.
Who gets Bulimia Nervosa?Bulimia nervosa begins most often in females of adolescent or young adult age when they attempt restrictive diets, fail, and react by binge eating. The incidence is 2 in 10,000 people. In response to the binges, patients purge by taking laxatives, diet pills, drugs to reduce fluids, or they induce vomiting.
Patients may also revert to severe dieting, which cycles back to bingeing if the patient does not go on to become anorexic.
The eating binges average about 1,000 calories but canbe as high as 20,000 calories or as low as 100. Patients diagnosed with bulimia average about 14 episodes per week. In general, people with bulimia have a normal to high-normal bodyweight, but it may fluctuate by more than 10 pounds because of the binge-purge cycle.
The greater majority of patients-about 90%- are women. Estimates of the prevalence of bulimia nervosa among young women range from 4% to 10%. Some experts claim this problem is grossly underestimated because many people with bulilmia are able to conceal their purging and do not become noticeably underweight. Bulimia is most often diagnosed after age 18.
What causes Bulimia Nervosa?The exact cause of bulimia is unknown, but factors thought to contribute to its development are family problems, maladaptive behavior, self-identity conflict, and cultural overemphasis on physical appearance. Bulimia may be associated with depression. The disorder is usually not associated with any underlying physical problem although the behavior may be associated with neurological or endocrine diseases.
How serious is Bulimia Nervosa?Self-induced vomiting can result in oral complications. Repeated exposure to acidic gastric contents can erode tooth enamel, increase dental cavities, and create a sensitivity to hot or cold food. Swelling and soreness in the salivary glands (such as the parotid glands in the cheeks) from repeated vomiting can also be a concern.
The esophagus and the colon are the areas most affected by bulimic behaviors. Repeated vomiting can result in ulcers, ruptures, or strictures of the esophagus. Acid that backs up from the stomach (reflux) can also become a problem.
Women with bulimia are prone to depression and are also at risk for dangerous impulsive behaviors, such as kleptomania and sexual promiscuity. Alcohol and drug abuse are more common in women with bulimia than in the general population.
Sore throat, buring of the tongue, bleeding gingiva, decreased salivary flow and enlarged salivary glands.
What are the symptoms of Bulimia Nervosa?Some of the symptoms of bulimina nervosa are binge-eating episodes, purging behavior such as self-induced vomiting, laxative use, diuretic use, or excessive exercise. There are also mood swings, unusual swelling around the jaw, an increased withdrawal from normal activities, fear of becoming fat and distorted body image.
The strain of vomiting can sometimes cause broken blood vessels in the eyes and swollen saliva glands that appear as puffy areas below the corners of the mouth. Teeth are prone to cavities and erosion of enamel from excessive acid, gums may be diseased, and rashes and pimples may break out on the skin.
What will comfirm a diagnosis of Bulilmia Nervosa?There are five basic criteria in the diagnosis of bulimia:
1. Recurrent episodes of binge eating. This is characterized by eating within a two-hour period an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances.
2. A sense of lack of control over the eating during the episode, or a
feeling that one cannot stop eating.
3. In addition to the binge eating, there is an inappropriate compensatory
behavior in order to prevent weight gain. These behaviors can include
self-induced vomiting, misuse of laxatives, diuretics, enemas or other
medications, fasting, or excessive exercise.
4. Both the binge eating and the compensatory behaviors must occur at
least two times per week for three months and must not occur exclusively
during episodes of anorexia.
5. Finally, the behavior above is unduly influenced by body image.
How is Bulimia Nervosa treated?Treatment in bulimia nervosa is focused on breaking the binge-purge cycles of behavior since the person is usually aware that the behavior is abnormal. Outpatient treatment may include behavior modification techniques and individual, group, or family counseling.
The primary goals of treatment should address both physical and psychological needs of the patient in order to restore physical health and normal eating patterns. The ultimate goal should be for the patient to accept herself and lead a physically and emotionally healthy life. Restoration of physical and mental health will probably take time, and results will be gradual. Patience is a vital part of the recovery process. A positive attitude coupled with much effort on the part of the affected individual is another integral component to asuccessful recovery.
Other types of treatment are nutritional therapy, behavioral therapy, cognitive therapy, interpersonal therapy, family therapy, drup therapy and hipnosis.
Possible preventive measures are: rinsing with tap water, chewing antacid tablets, oral magnesium hydroxide and sodium bicarbonate rinses, daily flouride treatment, vitamin supplements, saliva substitutes, and immediate brushing.
Where can someone get help for Bulimia Nervosa?American Anorexia/Bulimia Association, Inc. (AABA)
293 Central Park West
Ste. 1R
New York, NY 10024
Call 212-501-8351
Offers a basic information package. Send self-addressed stamped
envelope with a check for $3.00.
National Eating Disorders Organization
6655 South Yale
Tulsa, OK 74136
Call 918-481-4044
Offers infromation and referral service
Anorexia Nervosa and Related Eating Disorders (ANRED)
Box 5102
Eugene, OR 97405
Call 541-344-1144.
Offers free and low-cost information packets on eating disorders.
