Bulimia Nervosa

Bulimia is an eating disorder characterized by episodes of binge eating or eating large amounts of food, then purging by vomiting or excessively using laxatives as a way to compensate for the large amount of food eaten.

According to the DSM-5, the diagnostic criteria for binge eating is having recurrent episodes of binge eating which includes eating large amounts of food in a discrete period of time. During a binge eating episode, one feels that they have no control over their eating and they cannot stop. After binge eating, a compensatory behaviour of self-induced vomiting, misuse of laxative, medications, fasting or excessive exercise is implemented.

Symptoms

  • Evidence of binge eating, including disappearance of large amounts of food in short periods of time/  
  • Evidence of purging behaviors, including frequent trips to the bathroom after meals.
  • Fear of eating in public
  • Maintains excessive exercise regimen.  
  • Has calluses on the back of the hands and knuckles from self-induced vomiting.  
  • Frequent diets.  
  • Shows extreme concern with body weight and shape  
  • Noticeable fluctuations in weight, both up and down.
  • Gastrointestinal complaints.
  • Fainting
  • Dental problems
  • Menstrual irregularities

Prevalence

According to research, bulimia affects girls and younger women more than older women. The prevalence of bulimia nervosa was 0.3%. It is five times higher among females than males.

Prognosis

Only about half the people with bulimia fully recover. Most full recovery takes place between four and nine years later. About one-third of bulimia sufferers have made a partial recovery and 10-20% continue to have chronic symptoms. The mortality rate of bulimia, at 1.7 (deaths per 1000 person-years) is less than that of anorexia, which is about 5. Both of these eating disorders often co-occur with depression, anxiety, and other mood disorders, as well as personality disorders like borderline personality disorder.

When to seek help

If you have any bulimia symptoms, seek medical help as soon as possible. If left untreated, bulimia can severely impact your health. Talk to your primary care provider or a mental health professional about your bulimia symptoms and feelings. If you're reluctant to seek treatment, confide in someone about what you're going through, whether it's a friend or loved one, a teacher, a faith leader, or someone else you trust. He or she can help you take the first steps to get successful bulimia treatment.

Treatment

  • There are several types of treatments available for bulimia nervosa, however the combination of psychotherapy with antidepressants may be the most effective for overcoming the disorder.

1. Psychotherapy:

  • Cognitive behavioural therapy (CBT): this helps your normalize your eating patterns and identify the negative and unhealthy beliefs and behaviours that you have regarding eating and replace them with healthy ones.
  • Family based treatment: a person suffering from bulimia needs the support of their family. This helps parents intervene to stop their teenager’s unhealthy behaviors and how to be there for their child.
  • Interpersonal psychotherapy: helps address difficulties in your relationships and helps you improve your communication skills.
  • Dialectical behavioural therapy (DBT)

2. Medications

3. Nutrition Education ‍

4. Hospitalization