Bulimia Nervosa

What is bulimia?

Bulimia nervosa is an eating disorder. If you have this disorder, you eat larger amounts of food than most people would eat in a short time, then you may purge by making yourself vomit or using laxatives. Purging is meant to make up for binging. You may also cut back on eating or exercise too much to make up for binging.

Most bulimics have a normal weight but feel they cannot control their eating. Some people swing back and forth between anorexia and bulimia. Anorexia is an eating problem that occurs when people are so afraid of becoming overweight that they eat as little as possible. They may starve to death.

Although the disorder can affect men, most people with bulimia are young women. If you are pregnant, eating disorders can affect your health and your baby's development.

How does it occur?

The exact cause of this disorder is not known. It may be related to problems with the chemicals in the brain that regulate mood and appetite.

If you have bulimia nervosa you may:

• have a family history of bulimia or other eating disorders
• have a family or personal history of mood disorders, such as depression, anxiety, or bipolar disorder.

What are the symptoms?

Signs and symptoms of bulimia include:

• eating large amounts of food in short periods of time without being able to stop
• making frequent trips to the bathroom after eating
• vomiting, or using laxatives, diuretics, or enemas to purge food
• dieting or fasting
• exercising a lot after eating
• repeatedly losing or gaining more than 10 pounds
• feeling weak, depressed, or guilty after binge eating
• having heartburn or reflux from stomach acid injuring the esophagus or damaged teeth from stomach acid contained in vomit
• having swollen cheeks from repeated vomiting
• having scratches or scars on the back of fingers or hands from self-induced vomiting
• constantly thinking about being thin and feeling that weight is tied to self-esteem
• having menstrual problems.

Bulimia is especially dangerous when vomiting or laxatives are used to remove food from the body. Either habit can cause an electrolyte imbalance that can lead to irregular heartbeats and possibly heart failure and death.

How is it diagnosed?

Your healthcare provider takes a medical history, orders lab tests, and does a physical exam. He or she will ask about your eating patterns, looking for such behavior as:

• repeated episodes of binge eating followed by purging
• binging and fasting
• secret eating and binging
• exercising too much to prevent weight gain.

How is it treated?

If you have bulimia, you must recognize that you are suffering from a dangerous disorder. Treatment involves getting your eating habits back to normal. Your healthcare provider may suggest that you meet with a dietician to create a healthy eating plan. You may also benefit from psychotherapy or family counseling. Psychotherapy, either individual or group therapy, is very important. You may also need medicine used for mood disorders, such as antidepressants, antianxiety medicines, or mood stabilizers.

How long will the effects last?

You may stay preoccupied with eating for many years. You may need to continue taking medicine or having therapy for many months. Being under a lot of stress can cause a relapse. The earlier you seek treatment, the more successful it is likely to be.

How can I take care of myself?

• Eat healthy meals.
• Schedule regular meals. Avoid irregular eating habits and avoid fasting.
• Take vitamin and mineral supplements, if recommended by your healthcare provider.
• Avoid drinking too much caffeine.
• Do not drink alcohol.
• Do not use laxatives and diuretics. These can have serious side effects.
• Do not use diet pills.
• Seek professional help if you need to lose weight. It is best to lose weight slowly and in a healthy way.
• Limit your exercise program as advised by your treatment team.