Bulimia

Bulimia (bull-EE-me-a), sometimes referred to as the "binge-purge" disorder, involves repeated episodes of excessive eating (bingeing) followed by attempting to rid the body of the food by vomiting, using laxatives or enemas (purging), or exercising excessively.

Marlene's Perfect Figure

To her friends and family, Marlene had a perfectly fine figure, and she seemed confident and self-assured. But privately, Marlene suffered from bulimia and could not seem to stop bingeing and purging. Several times a week, she would eat whole batches of cookies, packages of candies, and as much bread and muffins as she could find. Her guilt and fear of overweight always led her to make herself vomit. Marlene stayed at a healthy weight for her size, but she was obsessed with her weight and body shape.

What Is Bulimia?

Eating disorders are habits or patterns of eating that are out of balance and may involve major health and emotional problems. Bulimia is a type of eating disorder in which a person binges, or consumes large quantities of food, and then purges, or attempts to rid the body of the food. When bingeing, people with bulimia often feel like they have little control over their behavior. After a binge, they feel guilty and fearful of becoming fat, so they try to rid the body of the food by vomiting or using laxatives or enemas. They may use diet pills or take drugs to reduce the volume of fluids in the body. Some people with bulimia also exercise excessively in order to burn up some of the calories eaten during binges. People with bulimia have a distorted body image ^* ; even though many people with bulimia stay at a fairly healthy weight, they are fixated on body shape and weight and feel like they are fat.

Most people who develop bulimia are girls and young women of European ancestry, although males and people of all ethnic groups can have it. Bulimia affects at least 1 to 3 percent of middle and high school girls and up to 5 percent of college-age women in the United States.

What Causes Bulimia?

Bulimia often starts out with dieting after a binge, but once the purging begins, the situation worsens. A person eats too much, feels guilty about it, and purges. The purging provides some immediate relief but is followed by shame and guilt. People with bulimia begin to believe that the only way to control their weight is to purge. They often feel intense social and cultural pressure to be thin. Family problems and conflict are also often present in the lives of people with bulimia. Poor self-esteem can also play a role. People with bulimia overemphasize the importance of body shape and size in their overall self-image.

What Are the Signs and Symptoms of Bulimia?

• A person with bulimia can often hide it very well. A girl with bulimia is usually near a healthy weight but is preoccupied with eating and dieting. Bulimia and other eating disorders share many symptoms, such as fatigue, low blood pressure, dehydration, preoccupation with food, and secretiveness about eating. However, because of the purging, bulimia can be associated with additional, serious symptoms that include:
• tooth and other dental problems caused by stomach acids damaging tooth enamel
• rips or tears in the esophagus (the tube that runs from the throat to the stomach) from frequent vomiting
• other gastrointestinal problems
• imbalances in electrolytes (essential body chemicals and minerals) that can lead to heart and other health problems
• feelings of loss of control, shame, depression, irritability, withdrawal, and secretiveness

How Is Bulimia Diagnosed?

Like Marlene, people often keep their bulimia hidden from family, friends, and health care professionals. The shame and embarrassment about purging can be profound. Sometimes a dentist will notice damage to the tooth enamel. A health care professional might ask about a person's weight, diet, nutrition, and body image, and the responses may reveal an eating disorder. If concerned, a physician might order lab tests to study nutritional and medical status. A mental health professional may uncover bulimia when a person is treated for a different symptom, such as anxiety ^* or depression ^* .

How Is Bulimia Treated?

Bulimia, like other eating disorders, is treated most effectively with a combination of therapies. The main treatment for bulimia is psychotherapy ^* . The focus of treatment is on changing eating behaviors and thinking patterns. To help a person overcome bulimia, a therapist will also address the person's distorted body image and fear of fat. Sometimes a physician will prescribe an antidepressant medication to relieve anxiety or depressive symptoms. Nutritional counseling, support groups, and family counseling can also be helpful.