The 2 Types of Bulimia and Its Features

exist Two main types of bulimia : Purgative and non purgative. Many people consider bulimia nervosa to be the eating disorder in which people binge and then perform compensatory behaviors such as vomiting or laxative use.

Although this brief description contains some truthful information, with this article I intend to give you a more real and complete view of this Mental illness: characteristics, causes and types - purgative versus non-purgative.

Types of bulimia

Types of Bulimia Nervosa

1. Bulimia nervosa not purgative

This subtype is much less common, since it occurs only in 6-8% of cases. Therefore, it is not surprising that it is also the least known.

These are people who do not resort to vomiting or other compensatory methods of this type after binge-they do not use laxatives, edemas, etc.-.

In this type of bulimia nervosa, the main method used to lose weight is the performance of intense physical exercise, as well as resort to fasting and subsistence allowance.

These long periods of starvation are responsible for bingeing again, since the person experiences a voracious hunger that is not capable Of dominating.

Again, after this binge episode, the girl will feel remorse and guilt, depriving herself of food again or performing physical exercise in a way Excessive

These methods of weight control are very ineffective to eliminate the amount of calories ingested in a single binge.

Intense physical exercise and subsequent fasting also usually occur in the purgative subtype of bulimia nervosa, although secondary.

The consequences of this subtype of bulimia nervosa in the organism are much less pronounced than the purgative subtype, as we shall see more ahead.

2. Bulimia nervosa purgative

The vast majority of people with bulimia nervosa are classified in the purgative type, which is characterized by the presence of vomiting and use of Laxatives or enemas after binge eating.

The aim of these people is to eliminate as soon as possible the largest possible proportion of food ingested, to end the anxiety that produces them Think they are going to get fat. They also present irrational thoughts about the functioning of the organism.

For example, some girls first eat a food of a characteristic color, such as a red tomato, and insist on vomiting until The vomit is the same color (since it has been the first food ingested and means that there is nothing in the stomach).

This and other completely erroneous information is transmitted daily through social networks and pages about anorexia and bulimia.

Although these pages are persecuted and censored continuously, they reappear with another name and with the same intention: to transmit Information that they consider truthful, to make competitions to see who loses more weight in a short period of time, to support each other, etc.

On the other hand, although this type of Anorexia nervosa Presents similarities with a type of anorexia nervosa - purgative subtype - in this type of bulimia Nervous girls are not underweight.

In fact, in the Bulimia nervosa -In both types- the girls are in normopeso or have some type of overweight.

This subtype is the one that produces the greatest negative effects, both in relation to the ravages that the organism undergoes and the behaviors and thoughts that Show:

  • It is observed that these girls have a greater desire to be thin, which leads them to become obsessed with weight loss.

  • There is also a more serious body distortion or, what is the same, perceive a greater difference between their real silhouette and the one they have in front of the mirror.

  • In addition, it is found that feeding patterns are more abnormal than in the case of non-purgative bulimia nervosa.

  • Finally, it is found that it is more frequent to find associated mental disorders in this subtype, especially those related to the state of mind
    Such as depression - and those that include obsessive thoughts.

Common features

In 50% of cases it occurs Amenorrhea In women (loss of menstruation as a result of the disorder).

In addition, we found that the personality characteristics of girls suffering from bulimia nervosa are similar regardless of subtype:

  • Emotional instability .

  • Impulsiveness .

  • They often have other addictions-to tobacco, alcohol, drugs, etc.-

  • They are very sociable.

  • They usually behave very impulsively, uncontrolled and - in some cases - hostile.

In both subtypes of bulimia nervosa, two triggers for binge episodes are:

  • The realization of diets.

  • Experiencing a high negative affect.

There is evidence that dieting produces overeating - even when there is no prior eating disorder.

A good example is the"Minnesota Experiment", in which some experimenters invited 36 volunteers to participate.

In this experiment, two phases were established:

1. At first, they were allowed to eat as much as they wanted, for 12 weeks. The average daily calories amounted to 3,400.

2. Subsequently, the subjects were severely restricted. They only had two meals a day, which amounted to 1,500 calories total.

The results showed that after a few weeks, experiment volunteers began to develop food concerns, as did many They became interested in recipes and cooking in general.

It was also found that many behaviors were increased such as chewing gum, drinking coffee or smoking.

In addition, according to the subjects' testimony, they began to eat more than their body allowed when they had the opportunity, even when there was Finalized the experiment to which they were submitted.

Other side effects that they suffered were: difficulty concentrating, loss of interest in sexuality, bad mood, sleep problems, etc. Some of them even developed severe depression.

All these characteristics are present in the disorder of bulimia nervosa.

After a year, it was verified that most of the symptomatology had remitted and that the participants of this study recovered the habits Normal power supply.

As you can see, this interesting study shows the serious consequences of fasting and starvation - which are often present in Diseases such as anorexia or bulimia.

What is Bulimia Nervosa?

It is a mental disorder characterized by the conduct of maladaptive behaviors in relation to the food field.

Following the DSM-IV-TR Diagnostic Manual , This disorder has three essential characteristics:

  • Loss of control over food intake ("binge eating").

  • Numerous attempts to control body weight.

  • Excessive preoccupation with body image and weight.

It is a mental illness that mainly affects women, just as it happens in the Anorexia nervosa (95% of the patients belong to the Female gender).

The age of onset of the disorder oscillates between the 18-25 years, reason why it appears later than the anorexia nervosa.

In addition, unlike anorexia, in bulimia nervosa the girls never present an underweight or weight below that recommended according to their constitution Body and age.

On the other hand, with regard to the characteristics of binge-making, which are the most significant factor of this disease, the following:

  • The person does not feel pleasure during the mass ingestion episode.

  • High calorie foods are ingested, which prohibit themselves in their restrictive diets (with a caloric content of 3 to 27 times Higher than recommended in one day).

  • They occur in a short period of time.

  • These episodes are usually carried out in secret.

  • It causes abdominal pain and, frequently, feelings of repentance or guilt also occur.

  • They do not occur during mealtimes - in which they usually carry a restrictive diet - but between hours.

  • It can also be produced away from home, by buying or stealing food.

The bulimic patient strives to hide her illness by carrying out these binges and compensatory behaviors without their relatives noticing.

These behaviors aimed at concealing the problem are characteristic of people with bulimia nervosa and sometimes complicated by lies.

In addition, as there is no significant loss of body weight, this eating disorder is often overlooked by family members and friends.

The behaviors performed by people with bulimia nervosa, especially vomiting, often cause deterioration in the body.

Some of the most common symptoms and signs are:

  • Feeling of fatigue and physical weakness.

  • Headache.

  • Feeling of fullness or satiation (in relation to food).

  • Sickness.

  • Gastric discomfort.

  • Intestinal bleeding, which is usually mild or moderate.

  • Signs on the back of the hand (calluses, scars, etc.).

  • Increased size of salivary glands.

  • Erosion in dental pieces.

  • Swollen hands and feet.

These vomiting constitute the most frequent compensatory mechanism in the disease - sometimes also accompanied by the use of laxatives -, and are produced by The feeling of guilt and regret that the girls suffer.

This behavior, like intense exercise, the use of other methods to expel ingested food or subsequent fasting is the only way in which These people manage to reduce the anxiety suffered after a binge.

With respect to the consequences That this disease has in its day to day, we find that usually deterioration or abandonment of the studies, Since the addiction to the food happens to require all his time.

Causes

This mental disorder has a multi-causal origin, in which the pursuit of thinness to be more attractive is not the only reason why People develop the disease.

Genetic and family causes

It seems that there are genetic relationships that predispose a person to the disease, since it is more likely to develop it when A family member also has a eating disorder.

Of course, here it is difficult to delineate cases in which influence is merely genetic or when, on the contrary, what is acquired are the Bad habits that family members learn from each other in relation to food.

Psychological causes

Among the most relevant psychological causes to develop this type of disorder is having a low self-esteem , Which can make the Person is more vulnerable and gives more importance to his figure.

It has also been found that girls who have experienced some particularly traumatic experience - such as being a victim of sexual abuse or violence Physical - are more likely to have this disorder.

Socio-cultural causes

Of course, it is no coincidence that there is an increase in this type of disorder in societies where it is granted a special Importance to the slender figure.

The media, the messages we receive from people around us - criticism of being overweight or praise for losing weight - Empower us to seek this ideal of beauty in ourselves.

In addition, there are professions in which the image takes on special relevance: models, television presenters, etc.

Associated Psychopathology

According to some authors, in 63% of cases of bulimia nervosa there is a personality disorder.

As you can imagine, the presence of a personality disorder Complicates the course and recovery of the disease.

In the case of women with bulimia nervosa, the most frequent is the Borderline personality disorder .

It is a disorder characterized by unstable social relationships, risky sexual behaviors, substance abuse (alcohol or drugs), A loose or unstable emotionality and frequent feelings of emptiness.

Authors such as Dolan (1994) have pointed out that this borderline personality disorder presents between 24% and 44% of cases of bulimia nervosa.

Another type of associated psychopathology that is frequently found in patients with bulimia nervosa is depression, impulsivity, anxiety, low Self-esteem and greater egocentrism.

All this influences that people with bulimia nervosa present high-risk behaviors, such as robberies and suicidal attempts.

References

  1. Echeburúa, E., & Marañón, I. (2001). Comorbidity of alterations in eating behavior with personality disorders. Psychology Behavioral, 9 (3), 513-525.
  2. Del Cioppo, G. F. (2006). The cyclical present of the bulimic crises. Research Yearbook, 13, 15-18.
  3. Lobera, I. J. (2011). Bulimia nervosa and isoretinoin treatment. Eating Disorders, (13), 1481-1489.
  4. Mora Giral, M., & Raich, R. M. (1994). Food restriction and bulimia nervosa: A causal link?
  5. Salorio del Moral, P., Campillo Cascales, M., Espinosa Gil, R., Pagán Acosta, G., Oñate Gómez, C., & López, I. (2011). Disorders of personality and Anorexia nervosa and bulimia. A study with the MCMI-III. Psychology. With, 15.
  6. Sánchez-Carracedo, D., Mora, M., Raich, R. M., & Torras, J. (1999). Bulimia nervosa Beyond the DSM-IV? Psychology Yearbook / The UB Journal of Psychology, 30 (2), 97-116.
  7. Sierra Puentes, M. (2005). Nervous Bulimia and its subtypes. Diversitas: Perspectives in Psychology, 1 (1), 46-62.
  8. Image source.


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