Beating Bulimia

You love a tasty dish of burgers and fries. Only after devouring this meal, you excuse yourself and go to the bathroom to up chuck it all. You are suffering from bulimia.

Bulimia nervosa is a type of eating disorder. Bulimics frequently gorge themselves on food, then use a variety of means—laxatives, diuretics or induced vomiting—to “purge” their systems. In addition, bulimics may undertake a program of excessive exercise to burn off the calories that come with these binges.

Approximately 4.7 million females and 1.5 million males have experienced bulimia in their lifetimes. This disease is more common in women than men. It is often accompanied by obsessive-compulsive behavior, depression or substance abuse and it can have devastating effects on the body.

The term bulimia is derived from the Greek boulimia, meaning ravenous hunger. Though bulimic-like eating habits were noted as early as the second century by Roman author Aulus Gellius, it wasn’t until 1979 that bulimia nervosa was defined as a distinct syndrome.

Characterized as a mental health disorder, bulimia comprises binge eating followed by “compensatory behavior” to prevent weight gain. That includes self-induced vomiting, which can cause sore lips and knuckles; fasting; excessive use of enemas, laxatives or diuretics, and compulsive exercise.

Bulimia is more common than anorexia, another eating disorder that involves endless dieting to the point of starvation. Some patients have both diagnoses.

Bulimics have a strange relationship with food, skipping meals, changing food likes and dislikes, making excuses not to eat. To make vomiting easier, they may consume lots of water and diet soda, take small bites and chew excessively.

Bulimia can damage a person’s stomach and kidneys as a result of constant vomiting and cause a person’s teeth to decay because of the acids that come up into the mouth while vomiting. The person may also develop “chipmunk cheeks” which occur when the salivary glands permanently expand from throwing up so often.

Like girls with anorexia, girls with bulimia may stop getting their periods. And most dangerous of all, the constant purging can lead to a loss of the mineral potassium, which can contribute to heart problems and even death.

Researchers feel that there is a genetic tie-in and a neurochemical component. Bulimia is different than anorexia nervosa. In bulimia, the body weight tends to be within the normal range. People are more aware of their behavior and are more likely to seek treatment.

This is good because bulimia is more difficult to diagnose on the basis of symptoms—no excessive weight loss and limited menstrual problems. Sometimes blood tests can show evidence of dehydration.

Women with bulimia tend to be high achievers. Although they are more outgoing and impulsive, people with bulimia are also more prone to depression. Psychological symptoms include obsessive fear of obesity, high concern about sexual attractiveness and feelings of shame, self-reproach and guilt.

The most common medical complications are dehydration and electrolyte imbalance. But changes in bone and the brain are often significant. Repeated vomiting can play havoc with the digestive system and the walls of the intestine.

Binge eating is often accompanied by a sense of lack of control and symptoms of depression. People with bulimia may have a drug or alcohol problem.

Group therapy may be particularly helpful, by providing an opportunity to talk about the condition without feeling judged or isolated. Family therapy may help with younger people and their families. But cognitive behavioral therapy is standard for treating eating disorders like bulimia.

But regardless of what psychological support is obtained, people with bulimia should also retrain their thinking in a couple of very important ways. The first is to acknowledge that physical appearance is only a small part of who one is and not what really matters. Secondly, a better way to control appearance is through appropriate exercise and rational eating.

A class of antidepressants, known as selective serotonin reuptake inhibitors, may reduce binge eating and purging, as well as obsessive food thoughts. Unfortunately, the drugs can cause weight gain in some and rekindle the cycle of purging. Though the road to recovery can be challenging, the 5-year clinical recovery rate has been reported at 55 percent.

Most of all, once the unhealthy eating habits are addressed, you can learn to love the body you are blessed with. You can do this by loving yourself from the inside out, which may be the first step to a cure.