Bulimia Nervosa
Bulimia nervosa is a serious eating disorder which can be fatal. It is characterised by bingeing on food, followed by self induced vomitting so that the sufferer does not gain weight. Typically after a binge the sufferer will feel depressed at their loss of control. Bulimia nervosa is also known as binge-purge syndrome.
The disease is characterised mainly by the following three behaviours:
- Regular binge eating, where the sufferer loses control and eats a huge amount of food.
- The sufferer tries to compensate fo this behaviour by self induced vomitting, abuse of laxatives, fasting, obsessive exercise or slimming pill abuse.
- Extremely conscious of their body image. Unlike anorexia, with bulimia nervosa sufferers are more likely to be at a more normal weight for their height.
How common is bulimia nervosa?
It is surprisingly common, affecting between 1 and 2% of teenage and young adult women. It is predominantly a disease suffered by women, as only 20% of bulimia sufferers are male.
It is thought that there is a genetic factor involved with bulimia nervosa as it appears to run in families. Some doctors believe that the brain pathways controlling appetite are involved in the disorder. However, the run in families could also be explained via environmental factors.
I am concerned that my daughter may be suffering from bulimia. What are the signs and symptoms?
The main signs and symptoms may include:
- Binge eating. You may see a large amount of food disappear from the fridge or freezer, you may see evidence of chocolate wrappers in the waste bin. The sufferer may buy food to replace the food she has eaten in the hope of remaining undetected.
- Visiting the toilet after eating in order to vomit. Wretching sounds coming from the toilet. The smell of vomit. Laxative packets and wrappers in the waste bin. Evidence of laxative suppositories and enemas.
- Problems with dental health, including discolouration and erosing of tooth enamel (caused by the regurgitation of strong stomach acids.)
- A general obsession with her figure and appearance, more than would be considered normal for a teenage girl.
- Changing her lifestyle in order to be able to binge and vomit in secret.
- Facial swelling caused by repeating vomitting.
What are the health consequences of bulimia nervosa?
Typical health problems suffered by bulimics include:
- Dehydration and loss of electrolytes in the blood, caused by vomitting and / or abuse of laxatives.
- Anaemia.
- Heart problems, including an irregular heart beat, weakened heart muscle, low blood pressure, low pulse rate, dizziness, ultimately heart failure.
- Constipation, diarrhea, cramps, bloating, wind.
- Ulcers in the stomach.
- Sore, ulcerated throat.
- Dental health problems, including periodontitis (gum disease), loss of tooth enamel and cavities. Mouth ulcers.
- Swelling of cheeks and jaw.
- Abrasion of knuckles (from putting them in the mouth to induce vomitting).
- Depression, low self esteem, anxiety.
- Inability to concentrate.
- Dry skin.
- Loss of monthly periods, with correspondingly reduced fertitily.
Bulimia can be a very serious disease and complications arising from it can prove fatal. These complications can include heart failure, internal bleeding, malnutrition, kidney and liver damage, and cancers including cancer of the oesophagus.
How is it treated?
Treatment takes a multipronged approach and can include the following:
- Advice on how to eat a healthy diet
- Psychological counselling from a doctor or psychiatrist trained in eating disorders.
- Psychotherapy to try and create a healthy body image. Cognitive Behaviour Therapy (CBT) has been well studied and is thought to be helpful in these cases. Therapy may also involve other family members.
- Self help groups
- Antidepressants.
Even with treatment, there is always the danger of a relapse. The disease may last only a short time or can go on for years. About 25% of patients recover without any treatment; with treatment, about 50% of patients recover or improve.