Bulimia nervosa is a potentially life threatening disorder which is characterized by periods of bingeing and purging, preoccupation with body shape, body type and body weight, and a poor self-image. 

Binge eating involves eating large amounts of food (typically in private, or secretly) with no sense of control over how much or what is being consumed. Bingeing periods are followed by purging, which can take shape in many vicious forms such as the abuse of diuretics, laxatives and enemas to induce vomiting, over consumption of unhealthy weight-loss supplements, strict dieting and fasting, extreme workouts, and self-starvation in order to keep the calories at an excessively minimal level. 

The bulimia nervosa symptoms are not just restricted to food, over occupation with weight loss, and other behavioural symptoms. Instead, these behavioural symptoms point at a direction which is much more important. Bulimia nervosa is more about the lack of self-esteem and distorted image of the self. Hence, it can be difficult to recover from without a proper bulimia treatment plan. 

Signs and Symptoms of Bulimia

Bulimia symptoms can be categorized into the categories of emotional, behavioural and physical. Some of the major signs and symptoms of bulimia nervosa are as follows: 

Physical Symptoms: 

  • Significant fluctuations in weight, inches (both increases and decreases) 
  • Body weight within normal weight range, may be overweight
  • Gastrointestinal issues
  • Stomach cramps
  • Anemia, thyroid and hormonal problems, low blood cell counts, low potassium, slowed down heart rate
  • Difficulty concentrating, dizziness, fainting
  • Feeling cold all the time
  • Sleep problems
  • Cuts and calluses 
  • Dental problems such as enamel erosion, cavities and tooth sensitivity 
  • Dry, yellow and scaly skin, fine hair all over the body (lanugo)
  • Menstrual irregularities

Behavioural and Emotional Symptoms:

  • Behaviours that indicate dieting, weight loss, control of food
  • Evidence of binge eating (disappearance of food, fridge emptying often, wrappers lying around, empty cartons in the dustbin, etc.)
  • Evidence of purging (signs and smells of vomiting, frequent bathroom trips, packaging of laxatives, diuretics, etc.)
  • Eating privately
  • Food rituals (eating only a particular kind of food at one particular place, chewing too much, etc.) 
  • Hoarding of food in places
  • Hiding body with baggy clothes
  • Showing extreme concerns with body weight, shape, etc. 
  • Extreme moodiness 
  • Self injury like cutting, etc. without the presence of suicidal ideation (in some cases)
  • Impulsivity
  • Substance abuse

Bulimia Causes

The exact causes of bulimia are currently not known to the researchers, however, some risk factors have been identified that could lead to the development of bulimia nervosa.

It is a known fact that girls and women are more likely to have this disorder than boys or men are and begins in late adolescence or the onset of adulthood. The factors that may increase your likelihood of developing bulimia include having first-degree relatives with an eating disorder, being obese or overweight during childhood, psychological problems such as depression and anxiety issues, having witnessed or experienced traumatic events in the past, dieting frequently, etc. 

Diagnosis for Bulimia

If your doctor suspects that you have bulimia nervosa, then they may assess you in the following ways:

  • At first, they will ask you about your weight-loss or weight-gain, eating habits, and the way you have been losing weight, etc. 
  • Then they may conduct a physical examination to check for any underlying medical conditions and to assess the severity of the physical symptoms. 
  • Then they will request for blood and urine tests, along with electrocardiogram (ECG)V test reports. 
  • They will then conduct a psychological evaluation and use the criteria listed in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) for diagnosing bulimia nervosa. 

Treatments for Bulimia

Bulimia treatment involves psychotherapy, nutrition counselling, medication, and the aid of dieticians. The first goal of the treatment could be helping the client gain in fitness and health and making them realize that the way they perceive their body and food is not only a problem; it is terribly unhealthy and can critically damage their overall health.

A proper action plan is made for the treatment of bulimia nervosa which also addresses the client’s distorted thinking patterns, and assists them in making behavioural changes in order to live a better, healthier life. Psychotherapy for bulimia often involves cognitive behavioural therapy to help target the distorted thinking patterns and the unhealthy behaviours. During the course of the bulimia treatment, the patients learn the value of a balanced diet. Medications like prozac, SSRIs can be prescribed to help reduce the emotional symptoms. Nutrition education is also integrated into the treatment plan. Dieticians help design a proper eating plan through which healthy eating habits are inculcated into the client’s routine. Eating regularly without unhealthy restrictions is given prime importance in this plan. 

The treatment of bulimia is generally long term, as relapse can be possible at any given moment. Social support from close friends and family plays an important role in the recovery process. 

Frequently Asked Questions

Q. Do alternative medicines like herbal products and weight loss supplements help prevent or cure bulimia?

No. In fact, such supplements may be abused by people with bulimia nervosa to the extent that it may critically harm them. Such alternatives, more often than not, have serious side effects and for someone with a psychological disorder like bulimia nervosa, they may do much more harm than any good. Often, such products are not even approved by the governmental authorities and might not be safe for consumption.

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