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Bulimia
Anorexia |
Bulimia |
Binge Eating Disorder
Eating Disorder Not Otherwise Specified
Bulimia Bulimia is
something of a combination of anorexia and binge eating disorder, with one
big difference: purging - most commonly by vomiting. In other words, an
individual suffering from bulimia might starve him or herself for as long as
possible, then binge in a loss of control. That binge would be accompanied
by deep feelings of guilt and regret and then be followed by a purge. Small or
large amounts of food might be eaten and then purged. The purge is often
accomplished by vomiting, but it could also be done with taking a large
amount of laxatives or partaking in excessive exercise soon after the binge.
Much of this disorder mirrors that of anorexia.
However, sufferers of bulimia are often much more aware that they have an
eating disorder, and might appear to be a "normal" dieter.
Risk Factors
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Other people in the family are obese, have
an eating disorder, or have a mood disorder such as depression or anxiety.
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Having a job or being in a sport that
stresses body size, such as ballet, modeling, or gymnastics.
-
Being the type of person who tries to be
perfect all the time, never feels good enough, or worries a lot.
-
Dealing with stressful life events, such as
divorce, moving to a new town or school, or losing a loved one.
-
Bulimia is most common in teens. Like other
eating disorders, bulimia usually starts in the teen years. But it can start
even earlier or in adulthood.
-
Bulimia is most common in women. About 10
out of 11 people with bulimia are female. But some boys and men have it too.
-
While bulimia often starts in the teen
years, it usually lasts into adulthood and is a long-term disorder.
Signs and Symptoms
These symptoms are the same as those for Anorexia, except
for those in the last section.
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Dramatic weight loss in a relatively short
period of time.
-
Wearing big or baggy clothes or dressing in
layers to hide body shape and/or weight loss.
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Obsession with weight and complaining of
weight problems (even if "average" weight or thin).
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Obsession with calories and fat content of
foods.
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Obsession with continuous exercise.
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Frequent trips to the bathroom immediately
following meals (sometimes accompanied with water running in the bathroom
for a long period of time to hide the sound of vomiting).
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Visible food restriction and
self-starvation.
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Visible bingeing and/or purging.
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Use or hiding use of diet pills, laxatives,
ipecac syrup, or enemas.
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Isolation. Fear of eating around and with
others.
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Unusual Food rituals such as shifting the
food around on the plate to look eaten; cutting food into tiny pieces;
making sure the fork avoids contact with the lips (using teeth to scrap food
off the fork or spoon); chewing food and spitting it out, but not
swallowing; dropping food into napkin on lap to later throw away.
-
Hiding food in strange places (closets,
cabinets, suitcases, under the bed) to avoid eating.
-
Flushing uneaten food down the toilet (can
cause sewage problems).
-
Vague or secretive eating patterns.
-
Keeping a "food diary" or lists that
consists of food and/or behaviors (ie., purging, restricting, calories
consumed, exercise, etc.)
-
Pre-occupied thoughts of food, weight and
cooking.
-
Visiting websites that promote unhealthy
ways to lose weight.
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Reading books about weight loss and eating
disorders.
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Self-defeating statements after food
consumption.
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Hair loss. Pale or "grey" appearance to the
skin.
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Dizziness and headaches.
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Frequent soar throats and/or swollen glands.
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Low self-esteem. Feeling worthless. Often
putting themselves down and complaining of being "too stupid" or "too fat"
and saying they don't matter. Need for acceptance and approval from others.
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Complaints of often feeling cold.
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Low blood pressure.
-
Loss of menstrual cycle.
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Constipation or incontinence.
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Perfectionistic personality.
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Loss of sexual desire or promiscuous
relations.
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Mood swings. Depression. Fatigue.
-
Insomnia. Poor sleeping habits.
- Evidence of binge-eating, including disappearance of large amounts of
food in short periods of time or the existence 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--despite weather, fatigue, illness,
or injury--the need to “burn off” calories taken in.
- Unusual swelling of the cheeks or jaw area.
- Calluses on the back of the hands and knuckles from self-induced
vomiting.
- Discoloration or staining of the teeth.
- Creation of complex lifestyle schedules or rituals to make time for
binge-and-purge sessions.
- Withdrawal from usual friends and activities.
- In general, behaviors and attitudes indicating that weight loss,
dieting, and control of food are becoming primary concerns.
Medical Definition
According to the
Diagnostic and Statistical Manual of Mental Disorders (DSM-IV TR) published
by the American Psychiatric Association, the criteria for diagnosing a
patient with bulimia are:
- Recurrent episodes of binge eating. An episode of
binge eating is characterized by both of the following:
- Eating, in a fixed period of time, an amount of
food that is definitely larger than most people would eat under similar
circumstances. Mainly eating binge foods.
- A lack of control over eating during the episode:
a feeling that one cannot stop eating or control what or how much one is
eating.
- Recurrent inappropriate compensatory behavior to
prevent weight gain, such as: self-induced vomiting; misuse of laxatives,
diuretics, or other medications; fasting; excessive exercise.
- Triggers include periods of stress, traumatic
events, and self-evaluation of body shape and weight.
- These symptoms may occur after every meal, on a
daily basis, or once every few months.
- The disturbance does not occur exclusively during
episodes of anorexia nervosa.
Health Risks
- Electrolyte imbalances that can lead to irregular heartbeats and
possibly heart failure and death. Electrolyte imbalance is caused by
dehydration and loss of potassium and sodium from the body as a result of
purging behaviors.
- Inflammation and possible rupture of the esophagus from frequent
vomiting.
- Tooth decay and staining from stomach acids released during frequent
vomiting.
- Chronic irregular bowel movements and constipation as a result of
laxative abuse.
- Gastric rupture is an uncommon but possible side effect of binge
eating.
Sources:
Something
Fishy, Wikipedia,
WebMD,
NEDA
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