Bulimia

 Bulimia

Overview

Bulimia (boo-LEE-me-uh) nervosa, commonly called bulimia, is a serious, potentially life-threatening eating disorder. People with bulimia binge eat. This means people feel like they've lost control over their eating. They eat large amounts of food in one sitting. This often occurs in secret, and they often feel very guilty and shameful. Then they try to get rid of the food and extra calories in an unhealthy way, such as vomiting or misusing laxatives. This is called purging.

If you have bulimia, you probably focus on your weight and body shape even when you're trying to think about other things. You may judge yourself severely and harshly for what you see as flaws in your appearance and personality. Bulimia is related to how you see yourself — not just about food. It can be hard to overcome, and it can be dangerous.

It's important to remember that an eating disorder is not something you choose. Bulimia is a complex illness that affects how your brain works and how you make decisions. But effective treatment can help you feel better about yourself, eat healthier and reverse serious complications.

Symptoms

Bulimia symptoms may include:

Living in fear of gaining weight and trying to lose weight in unhealthy ways.

Repeatedly eating unusually large amounts of food in one sitting.

Feeling a loss of control during binge eating. You may feel like you can't stop eating or can't control what you eat.

Vomiting on purpose or exercising to extremes after binge eating so that you don't gain weight.

Using medicines that make you urinate, called water pills or diuretics, or laxatives or enemas to pass stool when they're not needed.

Fasting, limiting calories or not eating certain foods between binges.

Using dietary supplements or herbal products for weight loss. These products can be dangerous.

Being very unhappy with your body shape and weight.

Letting your body shape and weight guide how you feel about yourself and your worth.

Having extreme mood swings.

People with bulimia may use different methods to purge. The severity of bulimia depends on the number of times a week that you purge and the problems caused by doing so.

causes

The exact cause of bulimia nervosa isn’t known. But researchers think it may be a combination of genetics and learned behaviors. If you have a relative that has or had an eating disorder, you're at a higher risk of developing one yourself.

Popular culture and the media put pressure on people to have a certain body type. These outside influences can affect your body image and self-esteem. Also, feeling stressed, upset or out of control can all lead to bulimia.

Risk factors

Females are more likely to have bulimia than males. Bulimia often begins in the late teens or young adulthood.

Factors that raise your risk of bulimia include:

Family history and genes. Having a family history of eating problems and weight-control issues can increase the risk of an eating disorder. People with first-degree relatives — siblings, parents or children — who are diagnosed with an eating disorder may be more likely to have an eating disorder. This suggests a possible genetic link.

Mental health and emotional issues. Mental health and emotional problems, such as depression, anxiety or substance misuse, are linked closely with eating disorders. People with bulimia may feel badly about themselves, especially if they're bullied about weight or shape. In some cases, distressing events and factors that cause emotional distress may play a part, such as being mistreated as a child.

Dieting. People who diet are more likely to have eating disorders. Many people with bulimia severely limit calories between binge-eating sessions. This may cause them to binge eat again and then purge. Other causes for binge eating can include stress, strong emotions, having a distorted or negative body image and boredom.

Complications

Bulimia may cause many serious and even life-threatening complications, including:

Not seeing yourself as worthy and feeling hopeless or even suicidal.

Problems getting along with others or being socially isolated.

Poor nutrition.

Not drinking enough fluids, which can lead to major medical problems, such as kidney failure.

Heart problems, such as an irregular heartbeat or heart failure.

Severe tooth decay and gum disease.

Not having a period or not having a period on a regular schedule.

Gastrointestinal problems, including tears in the tube that carries food, or a hole in your stomach or small intestine. You also could have rectal prolapse, which is when part of the large intestine slips outside the anus.

Conditions that often occur along with bulimia include anxiety, depression, personality disorders or bipolar disorder, and misuse of alcohol or drugs. Self-harm, thoughts about suicide or suicide also can occur.

Diagnosis

To diagnose bulimia, your healthcare professional will:

Talk to you about your eating habits, ways to lose weight and physical symptoms.

Do a physical exam.

Request blood and urine tests.

Request an ECG or other tests to look for problems with your heart.

Do a mental health evaluation, including talking about how you feel about your body and weight.

Your healthcare professional also may request more tests to pinpoint a diagnosis, rule out medical causes for weight changes and check for any related complications.

A diagnosis of bulimia usually includes episodes of binging and purging at least once a week for three months. But any binge and purge behaviors, even when done less often, can be dangerous and need treatment. The more often the episodes occur, the more severe the bulimia is.

Treatment

When you have bulimia, you may need one or more types of treatment. Treatment includes proven therapies and medicines that may help you get better.

Treatment generally involves a team approach that includes you, your family, your primary healthcare professional, a mental health professional and sometimes a dietitian who knows how to treat eating problems.

Here's a look at bulimia treatment options.

Talk therapy

Talk therapy, also known as psychotherapy, involves talking to a mental health professional about your bulimia and related issues.

Studies show that these types of talk therapy can reduce symptoms of bulimia:

Enhanced cognitive behavioral therapy, also known as CBT-E, to help teenagers and adults with bulimia create healthy-eating patterns and replace unhealthy, negative beliefs and behaviors with healthy, positive beliefs and behaviors.

Family-based treatment, also known as FBT, to help the parents of children and teenagers with bulimia learn what to do about unhealthy-eating behaviors and help their child regain control over what is eaten.

Dialectical behavioral therapy, to help people better tolerate distress, become more emotionally balanced, be more mindful and get along better with others.

Ask your mental health professional which type of therapy will be used and how that therapy helps treat bulimia.

Medicines

Specific antidepressants may reduce the symptoms of bulimia. The only antidepressant that the U.S. Food and Drug Administration (FDA) has approved specifically to treat bulimia is fluoxetine (Prozac). This is a selective serotonin reuptake inhibitor, also known as an SSRI. It may help with symptoms of bulimia, even if you're not depressed. This medicine works better when it's used with talk therapy.

Nutrition education

Dietitians with special training in treating eating disorders can help. They can design an eating plan to help you eat healthier, manage feelings of being overly hungry or having too many cravings, and provide good nutrition. Eating regularly and not limiting the amounts or types of food you eat is important in overcoming bulimia.

Hospitalization

Usually, bulimia can be treated outside of the hospital. But if symptoms are severe and you have serious health complications, you may need to be treated in a hospital. Some programs for eating disorders may offer day treatment rather than a hospital stay.

Treatment challenges in bulimia

Although most people with bulimia get better, some find that symptoms don't go away entirely. Periods of binge eating and purging may come and go through the years. For example, some people may binge eat and purge when they're under a lot of stress.

If you find yourself back in the binge eating-purge cycle, get help. Follow-up sessions with your primary healthcare professional, dietitian or mental health professional may help you before your eating disorder gets out of control again. Learning positive ways to cope, finding healthy ways to get along with others and managing stress can help keep an eating problem from returning.

If you've had an eating disorder in the past and you notice your symptoms returning, seek help from your medical team right away.

Type of Doctor Department :Psychologist