BULIMIA NERVOSA

EATING DISORDERS
An eating disorder is to eat, or avoid eating, which negatively affects both one's physical and mental health. It is present when a person experiences severe disturbances in eating behavior, such as extreme reduction of food intake or extreme overeating, or feelings of extreme distress or concern about body weight or shape.

 The two main types of eating disorders are anorexia nervosa and bulimia nervosa. A third category is "eating disorders not otherwise specified (EDNOS) ," which includes several variations of eating disorders. Binge-eating disorder - This is a chronic condition that occurs when an individual consumes huge amounts of food during a brief period of time and feels totally out of control and unable to stop their eating morbid obesity, diabetes, hypertension, and cardiovascular disease.

BULIMIA NERVOSA
DEFINITION - episodes of secretive excessive eating (bingeing) followed by inappropriate methods of weight control, such as self-induced vomiting (purging) , abuse of laxatives and diuretics, or excessive exercise. Often, the individual will feel an impairment or loss of control during the binge eating and the purging becomes a way of regaining control.

THE BINGE & PURGING CYCLE

They obsess over what, when, and how much to eat, what they shouldnt eat, and how to avoid eating. At the same time, their calorie restriction triggers physical cravings the bodys way of asking for the nutrition it needs.

DIAGNOSIS DSM IV
1. Recurrent episodes of binge eating. An episode of binge eating is characterized by the of the following : Eating, in discrete period of time (e.g., within any 2hour period), an amount of food that is definitely larger than most people would eat during a similar period and under similar circumstances. A sense of lack of control over eating the period (e.g., a feeling that one cannot stop eating or control what or how much one is eating). Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics, enemas, or other medications, fasting, or excessive exercise. Both the binge eating and the compensatory behaviors must occur at least two times per week for three months. There is dissatisfaction with body shape and/or weight. The disturbance does not occur exclusively during episodes of Anorexia Nervosa.

2.

3. 4. 5.

SUBTYPES OF BULIMIA NERVOSA

Purging type bulimics Non-purging type bulimics

self-induce vomiting (usually by triggering the gag reflex or ingesting emetics such as syrup of ipecac) to rapidly remove food from the body before it can be digested, such as laxatives, diuretics, and enemas

exercise or fast excessively after a binge to offset the caloric intake after eating. Purging-type bulimics may also exercise or fast, but as a secondary form of weight control

CAUSES & RISK FACTOR

1. Poor body image (distorted image) - body dissatisfaction 2. Low self-esteem - depression, perfectionism, childhood abuse, and a critical home environment 3. Dieting 4. Appearance-oriented professions or activities 5. Major life changes - stressful changes or transitions 6. Biological factors - Eating disorders run in families 7. Low levels of serotonin play a role in bulimia

SIGNS & SYMPTOMS

BINGE EATING
Lack of control over eating Secrecy surrounding eating Eating unusually large amounts of food Disappearance of food Alternating between overeating and fasting

PURGING
Going to the bathroom after meals Using laxatives, diuretics, or enemas Smell of vomit Excessive exercising

PHYSICAL
Calluses or scars on the knuckles or hands Puffy chipmunk cheeks Discolored teeth Frequent fluctuations in weight Swollen glands in neck and face Constipation Irregular period Weakness

AFFECTS BULIMIA TO YOUR BODY

COMPLICATIONS
Weight gain
Abdominal pain, bloating Swelling of the hands and feet Chronic sore throat, hoarseness Swollen cheeks and salivary glands Weakness and dizziness Acid reflux or ulcers Ruptured stomach or esophagus

TREATMENT FOR BULIMIA

Pharmacological
Tricyclic antidepressants (TCA) trazodone, mianserin

Cognitive-behavioral therapy (CBT)

Breaking the binge-and-purge cycle

SSRI fluoxetine (Prozac)

Changing unhealthy thoughts and patterns

Interpersonal psychotherapy Mood stabilizer lithium carbonate

Group therapy Anti-anxiety buspirone (Buspar)

 The long-term prognosis for bulimics is slightly better than for anorexics

The recovery rate is felt to be higher

However, many bulimics continue to retain slightly abnormal eating and dieting behaviors even after the recovery period

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