Bulimia Nervosa

What is Bulimia Nervosa?

Bulimia nervosa is an eating disorder characterized by recurrent binge eating followed by compensatory behaviors such as self-induced vomiting, fasting, over exercising, and/or the use of laxatives, diuretics or enemas. There are two sub-types of bulimia nervosa, the purging type and the non-purging type. An individual suffering from the purging type regularly engages in self-induced vomiting or the misuse of laxatives, while a non-purging individual uses fasting or over exercising to control their weight.

Signs, Symptoms and Effects

The primary sign of bulimia nervosa is a constant concern about food and weight. Erosion of dental enamel and scarring on the backs of the hands are common indicators of self-induced vomiting. An individual may frequently complain of a sore throat or abdominal pain and a small percentage of people experience swelling of the glands near the cheeks. Depression is also commonly associated with bulimia, as well as a decrease in sexual interest and irregular menstrual periods.

Persons with bulimia nervosa can severely damage their bodies by frequent binging and purging. The long term health effects include chronic gastric reflux, dehydration and hypokalemia, electrolyte imbalance, inflammation of the esophagus, oral trauma, gastroparesis, peptic ulcers, calluses, and erosion of tooth enamel. Electrolyte imbalance can lead to cardiac arrhythmia, cardiac arrest and even death. In rare instances, binging can cause the stomach to rupture, and purging can result in heart failure due to the loss of vital minerals.

What causes bulimia and who is affected by it?

While the exact causes of bulimia nervosa are unknown, it is known that genetic and environmental factors play a significant role in the development of the disorder. People with bulimia are often impulsive and may also abuse drugs, alcohol, and engage in self-injurious behavior. Scientists have recently found serotonin and norepinephrine levels to be altered in some individuals suffering with bulimia, but it is not yet known whether the difference in these neurotransmitters exists before the development of the disorder or as a consequence of the illness.

The typical onset for bulimia is late adolescence or early adulthood, but it can occur at any time throughout the lifespan. Bulimia nervosa mainly affects females but ten to fifteen percent of individuals with the disorder are male. An estimated two to three percent of young women will develop bulimia and it affects persons from all ethnic, racial and social backgrounds.

Treatment and Prevention

Most people with bulimia can be treated through outpatient therapy, but if the binge purge cycle is out of control admission to an eating disorders treatment program may be more beneficial. Cognitive-behavioral therapy (CBT) in either an individual or group setting helps around 40 percent of the patients end their episodes of binge eating. CBT focuses on changing the distorted thinking patterns associated with bulimia, as well as closely monitoring an individuals eating and purging behaviors. In group therapy those suffering from bulimia can talk with peers who have similar experiences, and gain support and encouragement for recovery.

Scientists continue to study the risk factors associated with the development of bulimia nervosa and other eating disorders to increase prevention efforts. Advocacy groups work to remove damaging articles from the media in an effort to prevent further development of the disorder.