Bulimia

 

Brenna Leah Cashman BHSc., RNCP

 

 

What is Bulimia?

 

Bulimia is an eating disorder characterized by cycles of binging and purging. Episodes of binge eating may happen as often as several times a day and are then followed by a strong desire to get rid of all the calories consumed. 

Like those suffering from anorexia, people with bulimia are overly concerned about their weight and body shape.  They may use laxatives, diuretics, strict exercise regimes, fasting, and self-induced vomiting in an effort to lose weight.  Unlike anorexics, bulimics are generally a normal weight and can in fact, eventually become overweight.

 

Signs and Symptoms of Bulimia

Those suffering from bulimia usually feel a lack of control when it comes to eating.  While most of us stop eating when we feel full, those with bulimia keep on eating to the point of feeling pain.  This inability to control their eating can be very embarrassing and typically bulimics try to hide their binging and purging.  Some typical symptoms that may indicate bulimia are:

• Wanting to eat alone

• Eating very little in public

• Frequent trips to the bathroom after meals

• Disappearance of food

• Hidden stashes of junk food

• Eating large amounts of food without putting on weight

• Excessive exercising

• Using laxatives, enemas or diuretics

People with bulimia may also have physical symptoms caused by purging.  These include:

• Puffy cheeks caused by repeated vomiting

• Discoloured teeth caused by exposure to stomach acid when throwing up

• Frequent fluctuations in weight

• Calluses or scars on knuckles and hands caused by putting fingers down the throat to induce vomiting

 

Physical Consequences of Bulimia

The chronic cycle of binging and purging can lead to a variety of health problems.  The purging (in the form of vomiting, laxatives, and diuretics) can lead to electrolyte imbalances, usually in the form of low potassium levels.  Low potassium results in symptoms such as lethargy, confusion, irregular heartbeat, and cardiac and kidney dysfunction.  In severe cases it can even cause death.

Other effects of bulimia include:

• Weight gain

• Constipation caused by chronic laxative use

• Abdominal pain and bloating

• Tooth decay

• Chronic sore throat and hoarseness

• Broken blood vessels in the eyes

• Weakness and dizziness

• Loss of menstrual periods

• Acid reflux

 

Risk Factors

Bulimia generally begins in adolescence and 90 – 95% of those with the disease are women.  There is no single cause for bulimia but low self-esteem and poor body image are often contributing factors.  Some of the more common risk factors for bulimia are:

Dieting – people who diet on a regular basis are more likely to develop an eating disorder than those who don’t.

Involvement in professions/activities that emphasize weight control – the pressure placed on gymnasts, dancers, models, actors, and other athletes to maintain a certain weight can lead to the development of eating disorders.

Low self esteem – this can be a result of abuse, depression, a critical home environment, and a desire for perfection.

Poor body image – young women are often influenced by our culture’s glorification of thinness and beauty.

Major life changes – bulimia is sometimes a reaction to stress.  Examples of life changes are moving away from home, puberty, divorce, and the break-up of relationships.

Biological factors – since eating disorders run in families there is likely a genetic component.  In addition, research indicates that low serotonin levels play a role in bulimia.

 

Treatment

Psychotherapy is the main form of treatment for bulimia.  Specifically, cognitive behavioural therapy is often used to break the binge-and-purge cycle and change unhealthy thought patterns. 

Medication such as anti-depressants may also be used.  These help to reduce binge eating and treat the depression that is often a part of bulimia.