Bulimia Nervosa
Bulimia Nervosa
Bulimia Nervosa
Bulimia nervosa, also called bulimia, is an extreme and potentially fatal eating disorder characterized by separate episodes of binge eating followed by “makeup” measures taken to avoid gaining weight and/or to induce weight loss, such as purging.
Binge eating in the context of bulimia nervosa refers to the uncontrollable and ravenous consumption of a large quantity of food in a short period of time.
Purging vs Non-purging
The two categories of bulimia are purging and non-purging. Although there can be an overlap in the methods used, roughly 90% of people with bulimia fall into the category of purging bulimia, which involves self-induced vomiting and/or the use of diuretics and laxatives.
With non-purging bulimia, the individual will engage in extreme exercise or diets, use of diet pills or stimulants, as well as fasting — as alternative methods to purging — to shed the excess calories and to prevent weight gain.
Prevalence
Bulimia nervosa tends to develop during adolescence and early adulthood, and the male to female ratio is 1:10. People who have a family history of bulimia nervosa are more likely to develop this condition.
Bulimia Nervosa vs Anorexia Nervosa
Anorexia nervosa is a syndrome of self-starvation involving significant weight loss, whereas patients with bulimia nervosa are, by definition, at normal weight or above.
Symptoms of Bulimia Nervosa:
Compared to binge eating, which normally is not accompanied by purging, bulimia can be more difficult to spot or diagnose because the person may not exhibit weight changes.
Common symptoms may include some of the following:
Physical symptoms
Psychological symptoms
Behavioral symptoms
Those with bulimia routinely judge themselves very harshly in relation to what they see as flaws in their appearance; and in attempts to minimize that internal narrative, individuals can engage in behaviors that impact their reproductive, digestive, circulatory, and central nervous systems.
Causes of Bulimia Nervosa:
Factors that render an individual more vulnerable to developing bulimia nervosa can be psychological, emotional, social, genetic, and biological, and can include:
While there is no direct genetic link to the disorder, there might be a genetic link between inheriting traits like perfectionism, obsessiveness, anxiety, and inhibition and their potential to leave someone predisposed to developing the disorder.
Bulimia Nervosa complications:
The complications of bulimia nervosa include:
The complications of bulimia nervosa include:
Bulimia is frequently associated with other mental disorders such as depression, anxiety, and addiction problems like alcohol dependence syndrome.
The twofold complications of bulimia are a result of either the malnourished state and/or the compensatory efforts taken in order to feel better physically or emotionally, or both.
Diagnosing Bulimia Nervosa:
A doctor will usually do physical exams and lab work — to rule out any other illnesses and assess the damage usually caused by bulimia — and conduct a psychological evaluation through a set of questionnaires and conversations to determine the person’s thoughts and feelings about food or eating.
The criteria for a bulimia nervosa diagnosis from the American Psychiatric Association’s DSM-5 (Diagnostic and Statistical Manual of Mental Disorders – version 5), includes the following:
Bulimia is rated in relation to its severity using the DSM-5 Severity Indicator and by the number of inappropriate purging or weight compensation behaviors in a weekly period.
- Mild – 1 to 3 weekly episodes
- Moderate – 4 to 7 weekly episodes
- Severe – 8 to 13 weekly episodes
- Extreme – more than 14 weekly episodes
Even if someone doesn’t qualify for a bulimia diagnosis, he/she may still have an eating disorder that could damage their body physically, as well as have a profound negative impact on their mental and emotional health. Professional help should be sought out.
Treatment of Bulimia Nervosa:
The primary treatment for bulimia is typically a combination of psychotherapy and medication. A case manager is usually assigned to coordinate care between the doctor, nutritionist or dietician, and mental health professionals.
If the bulimia has caused severe health problems, the person might initially be admitted to a hospital or attend a day center, and treatment options include:
Medications for Bulimia Nervosa can include:
Medication alone is rarely considered effective, but antidepressants are often prescribed in combination with psychotherapy.
Antidepressants
Sometimes younger people react badly to antidepressants, experiencing suicidal thoughts and severe mood symptoms. For this reason, they should be closely monitored for any possible reaction to the medication over the first few weeks.
Certain antidepressants can react badly to other medications the person is on, and to alcohol, so be sure to check for any listed drug combination warnings.
Symptoms of Bulimia Nervosa:
Compared to binge eating, which normally is not accompanied by purging, bulimia can be more difficult to spot or diagnose because the person may not exhibit weight changes.
Common symptoms may include some of the following:
Physical symptoms
Psychological symptoms
Behavioral symptoms
Those with bulimia routinely judge themselves very harshly in relation to what they see as flaws in their appearance; and in attempts to minimize that internal narrative, individuals can engage in behaviors that impact their reproductive, digestive, circulatory, and central nervous systems.
Causes of Bulimia Nervosa:
Factors that render an individual more vulnerable to developing bulimia nervosa can be psychological, emotional, social, genetic, and biological, and can include:
While there is no direct genetic link to the disorder, there might be a genetic link between inheriting traits like perfectionism, obsessiveness, anxiety, and inhibition and their potential to leave someone predisposed to developing the disorder.
Bulimia Nervosa complications:
The complications of bulimia nervosa include:
Bulimia is frequently associated with other mental disorders such as depression, anxiety, and addiction problems like alcohol dependence syndrome.
The twofold complications of bulimia are a result of either the malnourished state and/or the compensatory efforts taken in order to feel better physically or emotionally, or both.
Diagnosing Bulimia Nervosa:
A doctor will usually do physical exams and lab work — to rule out any other illnesses and assess the damage usually caused by bulimia — and conduct a psychological evaluation through a set of questionnaires and conversations to determine the person’s thoughts and feelings about food or eating.
The criteria for a bulimia nervosa diagnosis from the American Psychiatric Association’s DSM-5 (Diagnostic and Statistical Manual of Mental Disorders – version 5), includes the following:
Bulimia is rated in relation to its severity using the DSM-5 Severity Indicator and by the number of inappropriate purging or weight compensation behaviors in a weekly period.
- Mild – 1 to 3 weekly episodes
- Moderate – 4 to 7 weekly episodes
- Severe – 8 to 13 weekly episodes
- Extreme – more than 14 weekly episodes
Even if someone doesn’t qualify for a bulimia diagnosis, he/she may still have an eating disorder that could damage their body physically, as well as have a profound negative impact on their mental and emotional health. Professional help should be sought out.
Treatment of Bulimia Nervosa:
The primary treatment for bulimia is typically a combination of psychotherapy and medication. A case manager is usually assigned to coordinate care between the doctor, nutritionist or dietician, and mental health professionals.
If the bulimia has caused severe health problems, the person might initially be admitted to a hospital or attend a day center, and treatment options include:
Medications for Bulimia Nervosa can include:
Medication alone is rarely considered effective, but antidepressants are often prescribed in combination with psychotherapy.
Antidepressants
Sometimes younger people react badly to antidepressants, experiencing suicidal thoughts and severe mood symptoms. For this reason, they should be closely monitored for any possible reaction to the medication over the first few weeks.
Certain antidepressants can react badly to other medications the person is on, and to alcohol, so be sure to check for any listed drug combination warnings.