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.
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.
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.
are the symptoms of bulimia?
- Preoccupation with food and eating.
- Patients have episodes of craving for food.
- Bingeing may take place in private and is caused by sufferer's guilty feelings
for having eaten so much.
- Obsessive fear of obesity.
- Feelings of shame and guilt.
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.
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.
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
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.
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.
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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