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Bulimia: Causes, Symptoms, Diagnosis & Treatment

Bulimia nervosa, also called bulimia, is a serious, life-threatening eating disorder characterized by episodes of binge eating. Eminent personalities like Princess Diana, Britney Spears, Lady Gaga, Lindsay Lohan, and Demi Lovato have battled bulimia.

What Is Bulimia?

Bulimia involves binge eating large amounts of high-calorie foods in a short amount of time. A person can eat up to 3,000 calories or more. After binging, the person feels bloated, guilty, ashamed, and regretful. To prevent weight gain they overexercise, fast or go on a diet.

The onset of bulimia generally happens in late childhood or in early adulthood. It affects mostly women than men [1] .

What Are The Causes Of Bulimia?

The exact cause of bulimia is unknown. However, other factors could play a role in causing bulimia like genes, emotional health, biology, societal expectations and other issues.

Symptoms Of Bulimia [2]

  • Eating uncontrollably followed by purging
  • Exercising excessively
  • Using the bathroom a lot after meals
  • Depression or mood swings
  • Being preoccupied with your body shape and weight
  • Fasting, restricting calories or avoiding certain foods between binge eating
  • Living in fear of gaining weight and forcing yourself to vomit or exercise too much to prevent gaining weight after binging
  • Irregular menstruation
  • Weakness and broken blood vessels in the eyes.
  • Acid reflux disorder

Risk Factors Of Bulimia [3]

  • Biology
  • Psychological or emotional issues
  • Dieting
  • Complications Of Bulimia
  • Severe tooth decay and gum disease
  • Digestive problems
  • Dehydration
  • Low self-esteem
  • Heart problems
  • Anxiety, depression, personality disorders or bipolar disorder
  • Suicidal thoughts
  • Swelling and soreness in the salivary glands
  • Lower sex drive
  • Poor skin, hair and brittle nails

Diagnosis Of Bulimia [4]

Diagnosis starts by asking the patient about their mental and physical health, lifestyle, medical history and then a physical examination is conducted.

Diagnostic tests like blood tests, urine tests and electrocardiogram are also done to rule out the underlying condition.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, to be diagnosed with bulimia, the patient must meet the following criteria:

  • Recurrent episodes of binge eating that the patient feels unable to control.
  • Binging and purging have taken place at least once a week during the last 3 months.
  • Purging the excess intake by vomiting, fasting, overexercising, and misusing other drugs.
  • The feeling of self-worth is influenced too much by their body shape and weight.

Treatment Of Bulimia

  • Psychotherapy: Also known as talk therapy, this involves discussing your bulimia issue with a mental health professional. Different types of psychotherapy that would help in the treatment of bulimia include cognitive behavioural therapy, interpersonal therapy, and family-based treatment [5] .
  • Nutritional requirement: Consulting a dietitian can help you achieve healthy eating habits to avoid hunger and unhealthy food cravings. Eating healthy nutritious foods daily and not restricting your food intake is important in overcoming bulimia.
  • Medications: Antidepressants can lower the symptoms of bulimia when used along with psychotherapy. Fluoxetine, a type of selective serotonin reuptake inhibitor (SSRI), is an antidepressant that has been approved by the Food and Drug Administration [6] .
  • Hospitalization: If the symptoms of bulimia are severe and serious health complications arises, you will have to be hospitalized for treatment.
View Article References
  1. [1] Striegel-Moore, R. H., Rosselli, F., Perrin, N., DeBar, L., Wilson, G. T., May, A., & Kraemer, H. C. (2009). Gender difference in the prevalence of eating disorder symptoms.The International journal of eating disorders,42(5), 471–474.
  2. [2] Levinson, C. A., Zerwas, S., Calebs, B., Forbush, K., Kordy, H., Watson, H., … Bulik, C. M. (2017). The core symptoms of bulimia nervosa, anxiety, and depression: A network analysis.Journal of abnormal psychology,126(3), 340–354.
  3. [3] Fairburn, C. G., Welch, S. L., Doll, H. A., Davies, B. A., & O'Connor, M. E. (1997). Risk factors for bulimia nervosa: A community-based case-control study.Archives of General psychiatry,54(6), 509-517.
  4. [4] Eddy, K. T., Dorer, D. J., Franko, D. L., Tahilani, K., Thompson-Brenner, H., & Herzog, D. B. (2008). Diagnostic crossover in anorexia nervosa and bulimia nervosa: implications for DSM-V.The American journal of psychiatry,165(2), 245–250.
  5. [5] Freeman, C. P., Barry, F., Dunkeld-Turnbull, J., & Henderson, A. (1988). Controlled trial of psychotherapy for bulimia nervosa.British medical journal (Clinical research ed.),296(6621), 521–525.
  6. [6] Sysko, R., Sha, N., Wang, Y., Duan, N., & Walsh, B. T. (2010). Early response to antidepressant treatment in bulimia nervosa.Psychological medicine,40(6), 999–1005.

Read more about: bulimia eating disorder
Story first published: Monday, July 1, 2019, 18:30 [IST]
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