Bulimia nervosa, or simply bulimia, is an eating disorder, characterized by two main symptoms: irresistible food addiction followed by attempts to get rid of the consumed food. People suffering from bulimia tend to either vomit the food they’ve eaten, or take laxatives (in some cases both methods are used); some of them do excessive exercise after eating or start water fasting. Studies show that most people with bulimia are having normal weight (Bulik et al. 6). However, they are not able to adequately evaluate their body, have low self-esteem, desperately want to lose weight.
In case of bulimia food addiction can manifest itself in different forms: sudden attacks of uncontrollable hunger, nighttime overeating or even continuous eating (when the person eats without stopping). After overeating the person feels guilt instead of satisfaction. Without proper treatment such behavior can lead to depression and attempts of self-harming or even suicide (Smink et al. 14).
There are several reasons why people start suffering from bulimia. Around 90% of bulimia victims are young women. The most common reason of developing bulimia is the culture that surrounds a person. Nowadays the ideal of beauty is a thin female with no signs of excess weight. Fashion show models promote a body that is even skinnier. Women, looking at images of thin models in magazines, encountering flawless photos of them in the Internet, start feeling uncomfortable with their body and aim to lose weight, using not only healthy methods. This is how they may develop bulimia. Another reason may be having a parent or relative suffering from bulimia. People with bulimia can become critical of how their friends and relatives look. If a person has a mother or a sister having bulimia, it can provoke the same behavior in themselves (Office of Women’s Health 2). Other reasons include stressful events in life, biological background (genes, chemicals or hormones); for teenagers it can be bullying in school etc.
There is a wide range of physiological effects that bulimia causes. These include chronic gastric reflux after eating, imbalance of electrolytes, dehydration, oral inflammations, constipation, enlarged glands, severe dental erosion causing breakdown of teeth, peptic ulcers and other effects. Moreover, people with bulimia suffer from constant weight fluctuations. Bulimia may also lead to infertility and problems with menstrual cycle in women.
Besides physiological harm, bulimia causes psychological problems. People suffering from bulimia are experiencing mood swings, they can become overemotional. Often such people suffer from loneliness, which develops as a result of fear of disapproval. Such people are very sensitive to the way others refer about their weight or appearance. Constant insatisfaction with the way they look leads to depression, self-disgust, feeling of guilt. In some cases suicidal behavior or attempts of self-harm are observed.
There are noticeable signs that help to diagnose bulimia in medical settings. A person suffering from bulimia is usually having damaged teeth or gums, caused by frequent episodes of forced vomiting. Also, it is important to pay attention to the hands of the patient: thickened skin on the knuckles can tell that the person stimulates vomiting as well. During the doctor’s examination swollen salivary glands or enlarged glands in the neck may be revealed. Also, because the patients often are ashamed of their disorder and do not want their behavior to be disclosed, it is very important to talk with the relatives of the patient. Constant complaints about weight, having a very negative body image, not wanting to eat in public places, going to the bathroom after eating may reveal bulimia. A doctor will typically perform a blood and urine test, complete physical examination and psychological assessment to make a diagnosis (American Psychiatric Association 345).
With an integrated approach to treatment the negative effects of bulimia can be reversed. The treatment should be controlled by a psychotherapist or psychiatrist. In most cases bulimia is being treated ambulatory, and hospitalization is used in cases when the disorder poses a threat to the person’s life. Cognitive behavioral therapy (CBT) has recommended itself as one of the most effective ways of bulimia treatment. Within this approach, the patient is asked to accurately record the amount of food they eat and episodes of vomiting they have to determine the emotional fluctuations causing such behavior. After that the psychiatrist is working with the illogical, wrong or damaging thoughts and attitudes of the patient, aiming at replacing them with positive and healthy patterns. Agras et al. state that 40% - 60% of people who used CBT for bulimia treatment became symptoms-free (12).
Medication is also used for bulimia treatment, and antidepressants of the selective serotonin reuptake inhibitors show benefits over the other types of antidepressants (McElroy et al. 2). Nevertheless, they should be used under control of the doctor and along with psychotherapy. As to alternative methods of bulimia treatment, some researchers say that positive effects were reached through the use of hypnotherapy (Barabasz 35).
As a conclusion it should be mentioned that bulimia nervosa is a serious and dangerous eating disorder affecting both physiological and psychological health. Modern mass media promotes an unattainable beauty image that can provoke eating disorders and bulimia in particular. It is important to diagnose bulimia at early stages when the patient has more chances to recover. The treatment of bulimia is difficult and not always shows positive results.
Works Cited
Agras Stewart W., Scott J. Crow, Katherine A. Halmi, James E. Mitchell, G. Terence Wilson, and Helena C. Kraemer. "Outcome Predictors for the Cognitive Behavior Treatment of Bulimia Nervosa: Data from a Multisite Study". The American Journal of Psychiatry 157 (8): 1302–8. Print.
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (Fifth ed.). Arlington, VA: American Psychiatric Publishing. Print.
Bulik, Cynthia M., Marsha D. Marcus, Stephanie Zerwas, Michele D. Levine, and Maria La Via. “The changing "weightscape" of bulimia nervosa”. The American Journal of Psychiatry 169(10): 1031–6. Print.
Barabasz, Marianne. "Efficacy of Hypnotherapy in the Treatment of Eating Disorders". The International Journal of Clinical and Experimental Hypnosis 55 (3): 318–35. Print.
Smink, Frédérique R. E., Daphne van Hoeken, and Hans W. Hoek. "Epidemiology of eating disorders: incidence, prevalence and mortality rates." Current psychiatry reports 14(4): 406–14. Print
