Jump to content

Bulimia nervosa

From Wikipedia, the free encyclopedia

This is an old revision of this page, as edited by Master T (talk | contribs) at 00:05, 2 April 2008 (→Diagnosis). The present address (URL) is a permanent link to this revision, which may differ significantly from the current revision.

Bulimia nervosa
SpecialtyPsychiatry Edit this on Wikidata

Bulimia nervosa, mostly known as bulimia is an eating disorder in which the subject engages in recurrent binge eating followed by feelings of guilt, depression, and self-condemnation. The sufferer will then engage in compensatory behaviors to make up for the excessive eating, which are referred to as "purging". Purging can take the form of vomiting, fasting, the use of laxatives, enemas, diuretics or other medications, or overexercising.[1]

The word bulimia comes from the Latin (būlīmia) from the Greek βουλῑμια (boulīmia), ravenous hunger, compounded from βους (bous), ox + λῑμος (līmos), hunger.[2]

Diagnosis

The criteria for diagnosing a patient with bulimia are:[3]

  1. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
    1. Eating, in a fixed period of time (e.g., within any two-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances.
    2. A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating).
  2. Recurrent inappropriate compensatory behavior to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics or other medications; fasting, or excessive exercise.
  3. The binge eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for three months.
  4. Self-evaluation is unduly influenced by hotty shape and weight.
  5. The disturbance does not occur exclusively during episodes of anorexia nervosa.

See the Diagnostic and Statistical Manual of Mental Disorders. If any of these symptoms are noticed, a doctor or psychologist should be contacted. However, these symptoms are often difficult to spot. Unlike anorexia nervosa, the person must be of normal or higher weight and is less likely to drop a significant amount of weight on a continual basis. Because bulimia carries a great deal of shame, the bulimic desperately tries to hide the symptoms from family and friends. Bulimia is more likely to span over a lifetime unnoticed, causing a great deal of isolation and stress for the suffering individual. Despite the frequent lack of obvious physical symptoms, bulimia has proven to be fatal, as malnutrition takes a serious toll on every bodily organ.[4]

Cyclic patterns

Bulimics go through cycles of over-eating and purging that can be very destructive to the body. These cycles often involve rapid and out-of-control eating, which may stop when the bulimic is interrupted by another person or when his/her stomach hurts from over-extension, followed by self-induced vomiting or other forms of purging. This cycle may be repeated several times a week or, in serious cases, several times a day.[5]

Some bulimics eat secretly; others eat socially but are bulimic in private. They also differ in "how much" they purge. Some can vomit without gagging themselves after eating. Often when the urge hits, they go to great lengths to purge, as if an uncontrollable urge is making them do so. Medical evidence shows that the chemicals released when purging may make a person feel "high".[citation needed] This can also lead to extreme dehydration and electrolyte imbalances.

Some bulimics do not regard their cycles as a problem, while others despise and fear the vicious and uncontrollable cycle.[6] Bulimics may appear underweight, normal weight or overweight. Bulimia can also take the form, more commonly, when the suffereer eats an average amount and again self-induces vomiting.

Types

There are two sub-types of bulimia nervosa: purging and non-purging.

Purging type is the more common type of bulimia, and involves any of self-induced vomiting, laxatives, diuretics, enemas, or Ipecac, to rapidly extricate the contents from their body.[7]

Non-purging type occurs in only approximately 6%-8% of bulimia cases, as it is a less effective means of ridding the body of such a large number of calories. It involves doing excessive exercise or fasting after a binge, to counteract the large amount of calories previously ingested. This often occurs in purging-type bulimics, but is a secondary form of weight control.[8]

Causes

Bulimia is related to deep psychological issues and feelings of lack of control. Sufferers often use the destructive eating pattern to feel in control over their lives.[9] They may hide or hoard food and overeat when stressed or upset. They may feel a loss of control during a binge, and consume great quantities of food (over 20,000 calories.)[10] After a length of time, the sufferer of bulimia will find that they no longer have control over their binging and purging. The binging becomes an addiction that seems impossible to break. Recovery is very hard and often in the early stages of recovery the patient will gain weight as they are still binging but no longer purging, causing anxiety which will in turn cause the patient to revert back to bulimia.

There are higher rates of eating disorders in groups involved in activities that emphasize thinness and body type, such as gymnastics, dance, cheerleading, acting and figure skating.[11] Bulimia is more prevalent among Caucasians. In one study, diagnosis of bulimia was correlated with high testosterone and low estrogen levels, and normalizing these levels with combined oral contraceptive pills reduced cravings for fat and sugar.[12]

Consequences

Bulimia can cause following health problems:

Many bulimics also have anxiety or mood disorders. One study found anxiety in 75% of bulimic have been previously misdiagnosed with mood disorders. After appropriate treatment for an eating disorder, symptoms once thought be the result of bi-polar disorder, depression or anxiety disorder for examples eventually subside along with the eating disorder itself. Prominent mood disorders include depression and substance abuse. Some experts are finding in some individuals that their depression was caused by the eating disorder itself.[13] To make patient history, treatment and prognosis even more baffling, many professionals intentionally exaggerate the severity of symptoms, even adding on a mood disorder diagnosis when none is warranted, in order to increase the likelihood of insurance coverage. Most insurance companies will cover inpatient treatment for severe mood disorders but not for eating disorders alone.

Bulimics are also more likely to attempt suicide and engage in impulsive behaviors. Bulimic females typically have a less favorable opinion of themselves than control groups. They are more pessimistic, more ambivalent towards others, strive for less recognition in areas that are socially significant or require leadership. Many bulimics, like anorexics, binge eaters and others with eating disorders, at one time were considered over-acheivers, highly intelligent and true rising stars among their peers. Yet, bulimics eventually become so consumed by food and/or weight that they, like anorexics, binge eaters and other individuals with eating disorders, have little time for the normal ambitions they once had.

See also

References

  1. ^ bulimia - Definitions from Dictionary.com
  2. ^ Bulimia nervosa - Definition, Description, Causes and symptoms, Demographics, Diagnosis, Treatments, Prognosis, Prevention
  3. ^ Abnormal Psychology An Integrative Approach - First Canadian edition. By D.H. Barlow, V.M.Durand, and S.H. Stewart
  4. ^ Assessment and Treatment of Bulimia Nervosa - June 1998 - American Academy of Family Physicians
  5. ^ http://www.psych.org/public_info/eatingdisorders52201.cfm
  6. ^ http://www.edauk.com/sub_what_is_bulimia.htm
  7. ^ Durand, Mark, Barlow, David. "Essentials of Abnormal Psychology - Fourth Ed." Thomson Wadsworth, CA 2006, ISBN 0-534-60575-3
  8. ^ Durand, Mark, Barlow, David. "Essentials of Abnormal Psychology - Fourth Ed." Thomson Wadsworth, CA 2006, ISBN 0-534-60575-3
  9. ^ BBC - Health - Conditions - Eating disorders
  10. ^ Bulimia
  11. ^ Bulimia Nervosa
  12. ^ Bulimia May Result from Hormonal Imbalance - Startpage - ki.se
  13. ^ Durand, Mark (2006). Essentials of Abnormal Psychology (Fourth Edition ed.). Wadsworth, CA: Thomson. ISBN 0534605753. OCLC 61458584. {{cite book}}: |edition= has extra text (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
Retrieved from "https://en.wikipedia.org/enwiki/w/index.php?title=Bulimia_nervosa&oldid=202679200"