BULIMIA NERVOSA

What is Bulimia nervosa?

Bulimia nervosa is an eating disorder characterized by binge eating and purging, or consuming a
large amount of food in a short amount of time, followed by vomiting, taking a laxative or diuretic,
and/or excessive exercise, in an attempt to purge oneself of the food consumed, because of an
extensive concern for body weight.
Bulimia has been found to occur more frequently with women than with men; a shocking statistic of
90-95% of patients with Bulimia are women! Adolescent girls are the highest at risk, although older
women have also been found to be affected by the eating disorder, in a smaller number of cases.
Bulimia happens to be one of the most culturally specific psychological disorders to have been
discovered yet. A large factor involved in the causation of the disorder involves social perceptions of
ideal body image, especially with regard to women. A growing emphasis on a slender figure as the
ideal body type for women has been leading to an increase in cases of the disorder, especially in
countries where such attitudes about body weight are greatly propagated through the media.
Symptoms
The binge-and-purge cycles that are characteristic of Bulimia often involve rapid and out-of-control
eating, which may stop when the person with bulimia is interrupted by another person or the
stomach hurts from over-extension, followed by self-induced vomiting or other forms of purging.
This cycle may be repeated several times a week or, in more serious cases, several times a day and
may directly cause:
Chronic gastric reflux after eating
Dehydration and hypokalemia caused by frequent vomiting
Electrolyte imbalance, which can lead to cardiac arrhythmia, cardiac arrest, and even death
Esophagitis, or inflammation of the esophagus
Boerhaave syndrome, a rupture in the esophageal wall due to vomiting
Oral trauma, in which repetitive insertion of fingers or other objects causes lacerations to
the lining of the mouth or throat
Gastroparesis or delayed emptying
Constipation
Mallory-Weiss tears
Infertility
Enlarged glands in the neck, under the jaw line
Peptic ulcers
Calluses or scars on back of hands due to repeated trauma from incisors
Constant weight fluctuations are common
The frequent contact between teeth and gastric acid, in particular, may cause:
Severe dental erosion
Perimolysis, or the erosion of tooth enamel
Swollen salivary glands
Constant vomiting can lead to gastroesophageal reflux
Treatment
Generally a combination of pharmacological treatment and psychotherapy is administered as
treatment.
Cognitive behavioural therapy (CBT), which involves teaching clients to challenge automatic
thoughts and engage in behavioural experiments (for example, in session eating of "forbidden
foods") has demonstrated efficacy both with and without concurrent antidepressant medication.
Maudsley Family Therapy a.k.a. Family Based Treatment (FBT), developed at the Maudsley Hospital
in London for the treatment of anorexia nervosa (AN) has been shown to have positive results for
the treatment of bulimia nervosa.
Adolescents with Bulimia nervosa who are either resistant to change or have not been successful
with treatments such as CBT (Cognitive Behavioral Therapy) or IPT (Interpersonal Psychotherapy)
could get recommended to try Cue Exposure (CE) by therapists.