Bulimia Nervosa

It is an illness that involves a cycle of binge eating followed by purging, and like anorexia, bulimia is greatly influenced by weight and body shape. Purging in most cases is done by self-induced vomiting.  This can occur several times a week or even within a day and lasts for a period of months. Bulimia’s symptoms include:

• Episodes of bingeing and purging
• Lack of control over eating during an episode
• Self-induced vomiting
• Misuse of laxatives, diuretics, enemas, diet pills or other medications
• Fasting or excessive exercise
• Depression
• Anxiety

The number of symptoms experienced and the severity of each will vary with individuals and varies over time.

Binge episodes are often used as a coping mechanism for stress, depression, and self-esteem issues.  During an episode, an individual with bulimia will binge on sweet, high calorie foods and will consume an amount of food far greater than what he or she would normally eat during a short period of time.  The person cannot control how much is eaten nor stop in the middle of a binge, resulting in feelings of shame and disgust with oneself.

The purging relieves the individual of the guilt from binging and restores a sense of relief and control.  Purging is usually done in secrecy in order to conceal the behavior from family and loved ones. 

Bulimia is difficult to detect since most people with this disorder maintain a normal body weight and hide their purging from those around them.  They consider their behavior embarrassing, thus, making it difficult for them to seek treatment.

Bulimia is often accompanied by depression and anxiety disorder. Furthermore, these are complicated by other medical conditions including erosion of tooth enamel, tooth decay, swollen cheeks due to enlargement of the salivary / parotid glands, dehydration, constipation, esophageal tears, gastric rupture,  ulcers of the stomach and esophagus, metabolic acidosis from diarrhea and  metabolic alkalosis from vomiting.  These serious mental health and medical illnesses must also be included in the treatment plan.

“I’m not sure why I do it.  I found myself eating a dozen doughnuts, too many cupcakes, chocolate bars, whipped cream, ice cream, potato salad, jelly bean…I just couldn’t stop eating…I felt so bad that I knew I had to let it out of my body.  I remembered to turn on the faucet in the bathroom so nobody would hear me while I vomited.  And whatever I didn’t vomit, the laxative took care of. I felt much better afterwards.”