There are a few different types of Bulimia Nervosa, but all share similar symptoms and outcomes. All revolve around the practice of binging -- compulsive eating in which many calories are consumed in a short period of time -- then purging the consumed food. Purging can be done through self induced vomiting, taking laxatives, diuretics, or ipecac, fasting between meals, restrictive dieting and excessive exercise. Bulimia can last for years and is difficult to overcome without therapy. It affects primarily women, but men can suffer from Bulimia too. It can occur in any age, income and social class.
The most common type of Bulimia is called Simple Bulimia Nervosa. Like other types, it usually starts after a stressful or unhappy period in a person’s life, such as divorce or a loss of a loved one. The person may first binge for comfort, and then begins to feel guilty about the overeating, resulting in purging. She becomes preoccupied with her personal appearance, body and image and dieting.
Anorexic Bulimia Nervosa often occurs after recovery from Anorexia Nervosa, usually without therapy or support. Unlike sufferers of Anorexia Nervosa, those who are bulimic can’t stop eating, so they begin a cycle of binging and purging. Eventually, victims may relapse to Anorexia Nervosa.
With Multi-impulsive Bulimia Nervosa, Bulimia occurs along with other impulsive and self-destructive behaviors. Victims may engage in substance abuse, cutting or self-mutilation, promiscuity and criminal activity.
The causes of Bulimia Nervosa are unknown. Some studies suggest a genetic connection or chemical imbalance in the brain. Family history, social values and personality also play a role. Those who suffer from Bulimia tend to place a high value on being thin, are obsessed with body image and are perfectionists. Stress and unhappiness can trigger Bulimia. It is often accompanied by other mental illnesses like depression and anxiety.
There are many long term risks of Bulimia Nervosa. Ten percent of sufferers die from complications related to the illness. Recurrent vomiting can lead to stomach ulcers or rupture and problems with the esophagus, as well as tooth decay, gum disease and mouth sores. Long term Bulimia can result in dry skin, thin hair, electrolyte imbalances and metabolism changes that can cause heart disease, low blood pressure, fainting, bowel problems, osteoporosis, and kidney damage resulting from dehydration. There is also a risk of suicide and long term depression and anxiety.
Bulimia can often go on for years or a lifetime without treatment. It can rarely be overcome without support, and since the symptoms are not that noticeable to outsiders, it can be easily overlooked. Unlike those with Anorexia, bulimics are usually within normal body weight ranges. The most noticeable symptom is a preoccupation with weight and food. Bulimics may be secretive about food, and sneak it or steal it.
The most effective treatment for Bulimia is psychotherapy. Treatment can occur in a residential facility for serious cases, or in a day program for others. Along with therapy, bulimics also may need medical care to treat the various complications. Hospitalization with IV fluids may be necessary in some cases. It’s helpful to have support from a dietitian to plan a realistic diet. Antidepressants can help to ease accompanying depression and anxiety.
For more information on treatment of Bulimia, see: