Bulimia

What is bulimia?

Bulimia is eating a lot of food at once (called bingeing), and then throwing up or using laxatives to remove the food from the body (called purging). After a binge, some bulimics fast (don't eat) or over exercise to keep from gaining weight. People with bulimia may also use water pills, laxatives or diet pills to "control" their weight. People with bulimia often try to hide their bingeing and purging. They may hide food for binges. Bulimics are usually close to normal weight, but their weight may go up and down.

 

How do I know if I have bulimia?

If you have bulimia (boo-LEEM-ee-uh), you may eat a lot of food at one time. This is called bingeing (BIN-jing). You may feel like you don't have control of your eating. You may try to lose weight by throwing up after you eat, using laxatives or diet pills, exercising a lot, or not eating for a long time. You may do these things in private and not tell anyone. You may feel bad about yourself because you don't like your body.

What are signs that may suggest a person has bulimia?

It is not always possible to tell whether a person has bulimia. Those affected may be overweight, underweight, or of normal body weight. However, some warning signs may be present, although these do not confirm the diagnosis of bulimia:

· going to the bathroom after every meal (to induce vomiting)

· compulsive or excessive exercising

· physical signs arising from excessive vomiting such as swollen cheeks or jaws, broken blood vessels in the eyes, or teeth that appear clear due to damage to tooth enamel excessive preoccupation with body image or weight

What medical complications and long-term effects can bulimia have?

The medical complications that result from bulimia are generally due to continual bingeing and purging. The type of purging behavior used can have varied effects on different body systems.

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.

As with anorexia nervosa and other eating disorders, irregular menstrual periods or amenorrhea (the absence of menstrual periods) may result from malnutrition or weight fluctuations associated with bulimia.

There are a number of intestinal and systemic complications. The misuse of diuretics can create an abnormal buildup of fluid (edema). Continual use of laxatives can result in dependency on them and can cause the normal elimination process to become dysfunctional. Loss of normal colonic function can necessitate surgical intervention in some cases. Restoration of normal bowel function may take weeks after the misuse has been discontinued. The misuse of diuretics and laxatives combined can place the bulimic at great risk for electrolyte imbalance, which can have life-threatening consequences. The complex physical and chemical processes involved in the maintenance of life can be disrupted with serious consequences by the continuation of bulimic and purging behaviors. Additional complications can affect an unborn fetus of a practicing bulimic or the infant of an active bulimic mother. Psychological problems can escalate to serious levels if untreated and interfere with the restoration of normal body functions.

How is bulimia treated?

Patients with bulimia present a variety of medical and psychological complications which are usually considered to be reversible through a multidisciplinary treatment approach. Treatment can be managed by either a physician, psychiatrist, or in some cases, a clinical psychologist. The extent of the medical complications generally dictates the primary treatment manager. A psychiatrist, with both medical and psychological training, is perhaps the optimum treatment manager. 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 patient needs to identify internal feelings and distorted beliefs that led to the disorder initially. An appropriate treatment approach addresses underlying issues of control, self-perception, and family dynamics. Nutritional education and behavior management provides the patient with healthy alternatives to weight management. Group counseling or support groups can assist the patient in the recovery process as well.  Contact your family physician for help.

 

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