What is bulimia?

Bulimia nervosa, or simply bulimia, is an eating disorder. People with bulimia consume large amounts of food in a short time (usually less than 2 hours). These food-binges often occur in secret and involve high calorie, high carbohydrate foods that can be eaten quickly, like ice cream, doughnuts, candy, popcorn, and cookies.

After these binge episodes, most bulimics (80-90 per cent) ‘purge’ their bodies of the excess calories by vomiting, abuse of laxatives or diuretics.

A smaller number of bulimia sufferers resort to other methods of eliminating these excess calories, like extreme exercise or fasting. A few bulimics use a combination of purging and non-purging methods. Those who resort to extreme fasting-bingeing-vomiting may be suffering from both anorexia as well as bulimia. This is a particularly hazardous combination of eating disorders.

The use of vomiting by bulimics can easily become addictive. Although in the first instance they may have done it to get rid of excess food calories, it soon becomes a form of security. They are afraid to stop because they fear their eating habits are out of control and without the use of vomiting they fear they will become grossly overweight.

Usually, such self-induced vomiting does not lead to the expected weight loss. The body simply adapts. This can lead the bulimic to resort to even more extreme purging measures.

Who suffers from bulimia nervosa?

Bulimia typically begins between the ages of 12 and 21 years. It occurs in both sexes, but most often in women. Many bulimics maintain fairly normal or high normal body weight, but some experience significant weight fluctuations. The typical bulimic is a white, single, female, high school or college student.

A separate category of bulimia sufferers are athletes who are involved in sports/activities with stringent weight-conditions, like gymnastics, ballet, boxing etc.

The medical consequences of bulimia

Bulimia is extremely harmful to the body. The exact medical consequences will depend on the type of purging behavior used and the length of time (and severity) involved.

Repeated vomiting causes loss of water (causing dehydration), and loss of minerals like sodium and potassium (causing electrolyte imbalance), as well as trauma.

In addition, vomiting can lead to tears in the lining of the throat, esophagus and stomach (ulcers). Also it erodes tooth enamel due to the stomach acid vomited with the food (causing cavities).

Over-use/ abuse of laxatives and diuretics causes loss of sodium and potassium (causing increased risk of heart damage) as well as seriously irregular bowel movements and constipation.

Like individuals with anorexia, many people with bulimia suffer from clinical depression, anxiety, obsessive compulsive disorder (OCD), and other psychiatric conditions. These problems, combined with their impulsive tendencies, place them at higher risk of suicide.

What is the treatment for bulimia

Like anorexia and binge eating, bulimia is a psychological condition with dietary consequences. Therefore, the treatment of bulimia involves sorting out both psychological and dietary needs of the person, in order to restore normal behavior patterns and a healthy approach to diet and weight control.

Similar to the treatment for anorexia and binge eating, the treatment of bulimics is usually conducted by a team of medical, nutritional, and mental health professionals, who evaluate the underlying symptoms and provide care.

In a nutshell, a bulimic needs to learn other, healthier ways to eat and to control their weight. They must learn that good food and a healthy diet will not make them fat. They also need to understand and manage the triggers/ situations that cause them to binge in the first place.

Warning signs of bulimia

If you think that your loved one might be in danger from bulimia, here are some warning signs to watch out for.

• Disappearance of large amounts of food in short periods of time or evidence of wrappers and containers indicating the consumption of large amounts of food.
• Evidence of purging behaviors, including frequent trips to the bathroom after meals, signs and/or smells of vomiting, presence of wrappers or packages of laxatives or diuretics.
• Excessive, rigid exercise regimen-the feeling to “burn off” calories taken in despite weather, fatigue, illness, or injury.
• Unusual behavior and/or attitudes indicating that weight loss, dieting, and control of food are becoming overriding concerns.
• Unusual swelling of the cheeks or jaw area. Discoloration or staining of the teeth.
• Always remember that most bingeing and purging occurs in secret, or in the company of a very close friend.

How family and friends can help

Having spoken with many individuals suffering from bulimia, I advise the following:

1. Bulimia is a serious illness. Do not wait for it to ‘go away’ or try to treat it yourself. Instead, seek professional medical assistance at the earliest possible opportunity.

2. If you have a loved one whom you suspect of having a binge eating disorder, tell them you are worried about their health and offer to accompany them on a visit to their doctor. Look for eating disorder clinics in your local phone book. In addition, many college or university campuses have support groups for people with eating disorders.

3. Be supportive and non-judgmental. Remember, like binge-eating, bulimia has nothing to do with personal weakness or greed – it is a psychological issue. It could just as easily happen to you.