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Eating Disorders

Bulimia Nervosa

First coined in 1979 by an English psychiatrist, Gerald Russell, bulimia is an eating disorder highlighted by quickly eating large amounts of food (binge), followed by a getting rid of the eaten food via vomiting, laxatives, lots of exercise (purging). This abnormal pattern of food intake is caused by a fear of putting on additional body weight. Bulimia is also characterized by a poor body self-image, with the disorder affecting females nine times more than it affects males, and an onset usually during the teenage years. Those with bulimia also have a concomitant disorder, such as depression, anxiety, lack of impulse control, drug and alcohol abuse, as well as sexual promiscuity and spending lots of money. Such a disorder can lead to very poor health, and as mentioned, depression, which may lead to suicide.

Signs

There exist many signs and symptoms that a person suffering from bulimia may exhibit, with the severity and form varying from person to person. Some of the most common signs and symptoms are, for example, a preoccupation with how much calories are consumed, which of course can lead to a preoccupation of one’s weight. Thus, low self-esteem and depression can easily set in. Physical symptoms include the presence of an irregular menstrual cycle; constant gastric reflux after eating; an imbalance of electrolytes leading to irregular heart beat, heart attack and possibly death. An inflamed esophagus, constipation, infertility, peptic ulcers, and fluctuating body weight are all further possible symptoms. Furthermore, the vomiting during bulimia can create mixing of gastric acid with the teeth, causing: erosion of the teeth and gums, tooth enamel eroding, the swelling of salivary glands.

Causes

The possible causes of bulimia fall into two camps: biological and social. Regarding biology, some of the proposed causes are, for example, genetics, abnormal hormone levels (such as serotonin), and also sex hormones (such as the estrogen receptors) that are believed to cause the poor regulation of appetite in women, leading possibly to bulimia.

Regarding the social aspect, the concept of “thin is in” is showed through many studies to be a determining factor in a person’s onset of bulimia. Specifically, the mass media has been targeted for putting forth the perfect body image that people should strive for in themselves. However, a person must first buy-in to such an ideal before any symptoms of bulimia present, and it has been suggested that family and friends play a large role in pushing the ideal further, leading the person to slowly accept such a body image as desirable. Once fully accepted, the person then begins to dislike their body if it presently does not match up to the ideal standard, turning into a desire to look like the “ideal”, and possible symptoms of bulimia.

Management

There are two main ways to help lessen the effects bulimia may have on an individual. These main areas of treatment are Psychotherapy and drug therapy.

Regarding psychotherapy, Cognitive Behavioral Therapy (CBT) is mainly used. CBT works by rebuilding one’s beliefs, thoughts, attitudes about body image. During this therapy, the patient is required to keep track of how much food they consume as well as how often they vomit. This is done so that fluctuations in one’s emotions can be traced and hopefully lessened, avoiding the emotional patterns that precipitate bulimia. In terms of drugs, since there is a link between disorders of mood and bulimia, antidepressants and lithium are being used to treat bulimia. Also, since bulimia is considered by some to be an addiction, certain drugs which inhibit drug cravings are also used to treat this disorder.

Prognosis

The prognosis of bulimia tends to not be as hopeful as is with anorexia. Most sufferers of bulimia will eventually relapse, thus requiring more protracted care for their illness. The after effects from the disorder complicate any positive prognosis, effects such as inflammation of the esophagus, heart and lung problems, as well as stomach and pancreatic issues. Suicidal tendencies may linger with a person suffering from the disorder. Future complications in women wanting to become pregnant may suffer in terms of the emotional struggle they may have as a result of their changing bodies and the level of nutrition and health of the mother affecting the health of the newborn. Finally, there is the possibility that because of the stoppage in getting their period, women who suffer from bulimia may not be able to get pregnant.

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