Bulimia Nervosa: Symptoms, Causes, Treatment

The Bulimia nervosa Is a disorder of eating behavior whose main characteristic is the ingestion of large quantities of food.

In this article I will explain what it consists of, its characteristics, causes, symptoms, treatment, diagnosis and much more.

Bulimia Nervosa: Symptoms, Causes, Treatment

It is one of the most common psychological disorders among young people and their main diagnostic criterion is that they experience a lack of control to control food intake.

There are two other main features:

  • The person tries to compensate for the binge and the possibility of gaining weight through some purging behavior.
  • The person has an exaggerated belief that their personal assessment depends on their silhouette and body weight.

Examples of purging techniques are self-imposed vomiting, excessive exercise, the use of laxatives, and the use of diuretics.

However, there are bulimic people who do not use purges and spend large periods of time fasting between meals.

Because of this, the DSM-IV distinguishes between purgative and non-purgative bulimia nervosa. It is estimated that two out of three bulimic people use purging techniques.

The disorder is usually more severe in people who practice purging, because they are more frequent the binge and are given More major depressions Y Panic disorders co-occurring.

Symptoms of bulimia

Bulimia Nervosa: Symptoms, Causes, Treatment 1

Signs and symptoms of binge eating

  • Lack of control over intake, inability to stop eating until feeling uncomfortable or discomfort.
  • Eat secretly at night or away from home, or want to eat alone.
  • Eat large amounts of food without weight change.
  • Alternate between overeating and fasting. Normally there are no normal foods, or fasting or eating too much.
  • Disappearance of food.

Signs and symptoms of purging

  • Use laxatives, diuretics or enemas after eating.
  • Take pills to take away the appetite.
  • Go to the bathroom after meals to vomit.
  • Odor of vomit: The bath or person can smell vomit.
  • Excessive exercise, especially after eating.

Physical signs and symptoms

  • Calluses or scars on fingers as a cause of vomiting.
  • Cheeks swollen by frequent vomiting.
  • Dental enamel worn due to exposure of teeth to stomach acid.
  • Normal weight: Men and women with bulimia often have normal weight or some overweight. Being below normal weight at the time of purging can indicate anorexia nervosa.
  • Frequent weight changes due to alternate episodes of purging and binge eating.

How to know if you have bulimia nervosa

Bulimia nervosa

Ask yourself the following questions. The more"ifs"you have, the more likely you are to have BN or other eating disorder:

  • Do you dominate food or diet your life?
  • Are you obsessed with your body or your weight?
  • Do you usually eat until you feel bad or overly full?
  • Are you afraid to start eating and not be able to stop?
  • Do you feel embarrassed, guilty or depressed after eating?
  • Do you vomit, take laxatives, or do excessive exercise to control your weight?

Causes of Bulimia

Concerns about weight and body image play an important role, as well as That low self-esteem .

On the other hand, bulimic people may have Problems controlling your emotions . Eating can be a way to release anxiety or emotional problems; In fact, they often binge or purge in depressed, anxious, or stressful states.

The main causes are:

  • Genetic factors : the same as Anorexia nervosa , There is evidence that genetic predisposition contributes to the onset of BN. Abnormal levels of hormones and neurotransmitter serotonin have been found in eating disorders. People with bulimia are also more likely to have parents with psychological or substance abuse disorders.
  • Poor body image : There may be a lack of satisfaction with the body due to the current culture's emphasis on beauty and thinness.
  • Low self-esteem : Women and men who are considered low value, useless or unattractive are more likely to develop BN. Abuse in childhood, depression, or Perfectionism Can contribute to the low self-esteem .
  • History of abuse or trauma : It seems that women with bulimia have a higher incidence of sexual abuse.
  • Vital changes : Bulimia can develop by vital changes or transitions, such as physical changes of puberty, starting college or breaking a relationship. Purges and binges can be Ways to cope with stress .
  • Professional activities : People who work in professions in which the image is important have more pressure and are more vulnerable to developing bulimia.
  • Genetic factors : There may be a genetic factor related to the development of bulimia. Research suggests that people who have a close relative who has or has had bulimia are four times more likely to develop it than those who do not have a relative with the condition.

Diagnosis

Diagnostic criteria according to DSM-IV

1) Presence of recurrent binge eating. A feast is characterized by:

  1. Ingestion of food in a short time in a quantity greater than that which most people would ingest in a similar period and in the same circumstances.
  2. Sensation of loss of control over food intake.

B) Inappropriate compensatory behaviors in order not to gain weight as a provocation of vomiting, excessive use of laxatives, diuretics, enemas or other drugs, fasting and excessive exercise.

C) Binge eating and inappropriate compensatory behaviors occur, on average, at least twice a week for a period of 3 months.

D) Self-assessment is over-influenced by body weight and silhouette.

E) The alteration does not appear exclusively during the course of anorexia nervosa.

Specify Type:

  • Purgative: The individual regularly causes vomiting or uses laxatives, diuretics or excessive enemas.
  • Non Purgative: The individual engages in other inappropriate compensatory behaviors, such as fasting or intense exercise, without regular use of vomiting, laxatives, diuretics, or enemas.

Comorbidity

The most common psychological disorders associated with bulimia are disorders of mood and anxiety disorders.

According to a 1992 study (Schwalburg, Barlow, Alger and Howard), 75% of people with bulimia also have an anxiety disorder, such as social phobia or generalized anxiety.

On the other hand, depression usually appears after bulimia and substance abuse also often appears next to it.

Treatment of bulimia

The two main treatments used in people with bulimia nervosa are psychotherapy and medication.

Psychotherapy

The most commonly used therapy is Cognitive-behavioral (CBT), in which the way of thinking and irrational and negative behaviors are changed by a positive way of thinking and behaving.

In CBT the patient notes how much he eats and periods of vomiting in order to identify and avoid emotional imbalances.

For this therapy to be successful it is important that both the practitioner and the patient participate.

People who receive CTT and show early behavioral changes are more likely to achieve long-term results.

Other goals to achieve with CBT are to break the binge-purge cycle and solve emotional problems.

Interpersonal psychotherapy and dialectical behavioral therapy have also shown some positive results.

CBT has been shown to be effective in adults, although there is little research in adolescents.

For adolescents, family therapy can help, because they may need more family support and guidance.

Adolescents do not perceive Negative consequences of bulimia And have less motivation to change.

With family therapy, the family is involved in the behaviors and eating habits of the adolescent, takes more control of the situation at the beginning and little by little gives autonomy to observe the advances in eating habits.

Medication

Antidepressants Known as selective serotonin reuptake inhibitors (SSRIs) may have modest benefit. Among them are fluoxetine, sertraline, paroxetine and fluvoxamine.

Some positive results of the treatment may be: lowering of obsessive thoughts about losing weight, decrease or absence of binge eating, less psychiatric symptoms, improvement in social functioning, desire to solve the consequences of bulimia.

Complementary Therapies and Habits

  • The use of relaxation techniques Or meditation can help you become more body conscious and develop a positive image.
  • Avoid caffeine, tobacco or alcohol.
  • Drink 6-8 glasses of water a day.
  • Avoid refined sugars such as sweets or soft drinks.

If you do not consume the necessary nutrients (consult your doctor before consuming):

  • Consume a multivitamin with vitamins A, C, E, vitamins B, magnesium, calcium, zinc, phosphorus, copper and selenium.
  • Consume omega-3 fatty acids in natural foods like salmon or capsules.
  • Coenzyme Q10 as a muscle support, antioxidant and to improve the immune system.
  • Probiotics to improve the health of the digestive system and the immune system.

Medical Consequences

Bulimia can have several consequences on the body:

  • Enlargement of the salivary gland, due to continuous vomiting, which gives a"chubby"appearance to the face.
  • Wear of dental enamel due to vomiting.
  • Electrolyte imbalance: chemical alteration of body fluids, which can lead to renal failure and cardiac arrhythmia.
  • Intestinal problems with the use of laxatives.
  • Callosities in fingers or hands by stimulation of vomiting from the mouth.

Risk factor's

Factors that may increase the risk of developing BN are:

  • To be a woman : Women are more likely to have bulimia than men.
  • Age : It is more likely to begin in adolescence or early adulthood.
  • biology : Having a family member with an eating disorder increases the odds of developing bulimia.
  • Psychological and emotional problems : Having anxiety disorders or low self-esteem can contribute to eating disorders.
  • Society : In the western society the thinness and the physical attractiveness is valued, and they are equated with the success and the popularity.
  • Profession : Actors, athletes, models or professionals who act in front of the public are at greater risk of developing eating disorders.

Complications

BN can lead to serious complications:

  • Heart problems, such as irregular heart rate or heart failure.
  • Dehydration, which can lead to medical problems such as liver failure.
  • Anxiety and depression.
  • Dependence of laxatives.
  • Alcohol or drug abuse.
  • Wear of dental enamel.
  • Suicide.

Tips for helping family members with bulimia

If you suspect that a family member or friend has bulimia, talk to him / her about your concerns.

It may deny binging or purging, although it may be favorable to overcoming the problem.

It is an eating disorder that should not be ignored and treated as soon as possible.

To help, you can follow these tips:

  • It offers support and understanding: the person may be on the defensive, but if he is willing to be helped, shows understanding and do not judge.
  • Avoid stress or blame: negativity makes things worse, since bulimia is often caused by stress or low self-esteem.
  • Be a good example: show positive habits about food, physical exercise and body image.
  • Accept your limits: although you can help, it is the affected person who must make the decision to be treated and overcome the problem.
  • Take it easy: dealing with a psychological disorder is stressful and can cause you discomfort.

Tips for people with bulimia

If you have bulimia you know the problem of being out of control and the negative consequences it has.

However, it is possible to overcome it and you can break the habits of purging or binging, changing them by healthier habits.

  • Admit that you have a problem: The first step is to admit that your relationship with food is distorted and out of control.
  • Consult someone: If you have kept your problem a secret, it can be difficult to talk to someone. However, it is important that you do not be alone and find someone to listen to you.
  • Stay away from situations that increase the likelihood of binge eating or purging: avoid spending time with people who are constantly talking about diet, do not look at fashion or eating magazines, and stay away from websites that promote weight loss or thinness.
  • Seek professional help: If you can not overcome the problem yourself, seek the help of a professional.

References

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