Bulimia nervosa

Bulimia nervosa

A recent survey of teenage girls, carried out in Dublin, found that four out of five tried to slim by avoiding sugary foods, exercising and dieting. Fifty-two percent skipped meals, 19% smoked, 15% induced vomiting, 5% took laxatives or fasted, and 4% took diet pills. Therefore it is clear that there is a huge level of interest and concern among adolescents about food and dieting. In a minority of cases this can manifest itself as a more serious medical condition, the best known of which are anorexia nervosa and bulimia nervosa.

What is bulimia nervosa?

Bulimia nervosa is a specific fat phobia with added complexity. People with bulimia are afraid of becoming fat. It is a psychological eating disorder characterised by repeated episodes of overeating and a preoccupation with the control of body weight. It is based on the patient's dissatisfaction with their body image. While they fear food, they consume it in huge quantities. Binge eating is in response to depression, stress and other feelings related to body weight and shape. Compulsive eating brings a feeling of calmness but the self-loathing brought on by the overeating soon replaces the short-lived euphoria.

What causes bulimia nervosa?

The precise cause is unknown but factors in the person's social environment play a role, along with low self-esteem. Anorexia or obesity can lead to bulimia. Brain scans have found abnormalities in the area of the brain that governs how we perceive ourselves. It is believed that this difficulty in defining size and shape is a risk factor in the development of the disorder.

What are the symptoms of bulimia?

What can people with bulimia do to help themselves?

People with bulimia can benefit from recognising that they are suffering from bulimia and need to seek help from their doctor, family and friends.

What does the doctor look for?

The doctor will firstly take a blood-test. These will indicate dehydration, depletion of electrolytes and other important nutrients. There will also be evidence of tooth decay caused by erosion by stomach acid due to vomiting; low blood pressure; constipation; swollen neck glands; and swollen hormonal glands.

How is bulimia treated?

Psychotherapy can be used to heighten the sufferer's awareness of their eating habits. Cognitive behavioural therapy is also an effective way of tackling the problem. This form of treatment enables the patient to understand how their thoughts contribute to the symptoms of their anxiety disorder. It also helps them to concentrate on how to change their thought patterns to reduce the likelihood of occurrences as well as the intensity of the reaction. The person with bulimia replaces their fearful thoughts with more realistic, positive ways. Behavioural therapy uses techniques to reduce the undesired behaviour associated with the disorder.

Antidepressant medication can also be effective at treating the symptoms of bulimia nervosa by helping to cut down on food craving and on the frequency of bingeing and purging. Often a combination of psychological therapy and drug therapy is used.

Treatment is aimed at low-self esteem, the main contributor to the problem. Group therapy provides the opportunity to discuss the problem with others who share the same problem, helping to reduce feelings of isolation. Family therapy may assist where depression is caused by family difficulties.

Why should I seek help?

If left untreated, bulimia can have severe consequences. As with other phobias, with proper and effective treatment people with bulimia can learn to overcome their problem and lead a normal life.

What does the future hold?

The long-term outlook for people with bulimia is slightly better than for anorexics, and the recovery rate is thought to be higher. However many bulimics continue to retain slightly abnormal eating and dieting habits, even after the recovery period. The disease can persist for years, and in severe cases, all their lives. Bingeing and vomiting can cause physical problems including damage to teeth from stomach acid, and heart problems due to the body being depleted of salts.

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