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Overview
Criteria
Warning Signs
Physical Complications

Bulimia Nervosa Overview

Bulimia Nervosa, often referred to as bulimia, is one type of eating disorder. People with bulimia binge uncontrollably on large amounts of food – sometimes thousands of calories at a time – and then purge the calories out of their bodies through vomiting, starving, excessive exercise, laxatives, or other methods.Bulimia Nervosa is a psychological disorder that produces many medical and physical problems. Bulimia Nervosa is often accompanied by feelings of guilt, depression, and self-condemnation.

Types of Bulimia Nervosa

  • Purging Type: During the episode, the person has regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas.
  • Non-purging Type: During the episode the person has used other inappropriate compensatory behaviors, such as fasting, excessive exercise w/o purging behaviors.

Criteria

Binge Eating on a regular basis. Binge eating is characterized by “Eating, in a discrete period of time, an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances.”

  • A sense of lack of control over eating during the episode (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:
    • Self-induced vomiting
    • Misuse of laxatives, diuretics, enemas, or other medications
    • Fasting
    • Excessive exercise
  • Frequency: the binge eating and purging both occur, on average, or at least twice a week for three months.
  • Body image issues: Self-evaluation is unduly influenced by body shape and weight (i.e. making your weight the only thing you judge yourself on)

Warning Signs

  • Excessive concern about weight
  • Strict dieting followed by eating binges (diet – binge – purge cycles)
  • Frequent overeating, especially when distressed
  • Bingng on high calorie, sweet foods
  • Use of laxatives, diuretics, strict dieting, vigorous exercise, and/or vomiting to control weight
  • Leaving for bathroom after meals- excessive requirements for privacy in bedroom or bathroom
  • Being secretive about food/binges/vomiting
  • Planning binges or opportunities to binge
  • Feeling out of control
  • Impulse control problems in other areas (may shoplift, be promiscuous, and/or abuse alcohol, drugs, credit cards and/or other risk taking behavior)
  • Competent front to hide depression, shame, and emptiness inside
  • Difficulty talking about feelings
  • Believes self-worth requires being thin
  • Bloodshot eyes
  • Swollen neck glands or frequent sore throat
  • Unusual or frequent dental problems
  • Bleeding or irritated gums
  • Buys large amounts of food that disappear with no explanation
  • Sudden changes in food likes or dislikes
  • Drinks excessive amounts of water or soda
  • Repeated excuses for not eating at regular meals with family and friends

Physical Complications

The Most Common Complications Leading to Death in Bulimia are:

  • Electrolyte imbalance
  • Irregular heart rhythms
  • Suicide

Other physical symptoms seen with Bulimia:

  • Bleeding or irritated gums
  • Worn tooth enamel, and increase in tooth sensitivity and decay
  • Chronically inflamed sore throat
  • Swollen glands in the neck and below the jaw
  • Intestinal problems
  • Bloodshot eyes
  • Callused and/or discolored skin on the finger joints
  • Abnormal blood test results
  • Kidney problems due to diuretic abuse
  • Severe dehydration from purging behaviors
  • Acid reflux

See the diagram below on how bulimia affects the entire body: