If compulsive eating gives you brief pleasure followed by guilt, and if the fear of gaining weight is your number one enemy, these are the main signs that you may be suffering from an eating disorder called bulimia.

Eating disorders are a real problem, which can affect anyone regardless of social class, but especially girls and women in adulthood.

What is Bulimia?

Bulimia or bulimia nervosa is a serious psychological eating disorder that is life-threatening. It is usually characterized by the consumption of an abnormally large amount of food in a short period of time, followed by an attempt to avoid gaining weight by expelling what was consumed.

Common expulsion methods include self-induced vomiting, excessive use of laxatives or diuretics, extreme or prolonged periods of exercise, fasting, or extreme dieting.

Often, during these internal binge episodes, a person suffering from bulimia will experience a loss of control and engage in frantic efforts to undo these feelings.

People with bulimia often have a distorted body image. They are obsessed with their weight and are intensely self-critical. Many of them are at a normal weight or even overweight, which makes bulimia hard to spot and diagnose.

Research shows that about 1.5% of women and 0.5% of men will experience bulimia at some point in their lives. As mentioned before, it is more common in women, especially during adolescence and the early years of adulthood.

It is estimated that 20% of women in college have symptoms of bulimia. Artists are also at higher risk for eating disorders, as are athletes whose bodies and weights are closely monitored. Dancers, models, and actors may also be at higher risk.

Symptoms of Bulimia

The most common physical symptoms of bulimia include:

  • Constant fluctuation in weight
  • Broken blood vessels in the eyes
  • Enlarged glands in the neck and under the jawline
  • Oral trauma, such as lacerations inside the mouth or throat from repeated vomiting
  • Stained teeth (from stomach acid)
  • Calluses on the backs of the hands
  • Esophageal inflammation
  • Frequent vomiting
  • Chronic gastric reflux
  • Infertility

Signs and symptoms of binge eating:

  • Disappearance of large amounts of food
  • Eating in secret
  • Lack of control when eating
  • Alternating between overeating and fasting
  • Intense fear of gaining weight
  • Comments about being fat
  • Preoccupation with weight and body
  • Very negative self-image
  • Excessive use of laxatives or diuretics
  • Use of supplements or herbs for weight loss
  • Excessive exercise
  • Going to the bathroom immediately after meals
  • Not participating in normal social activities
  • Smell of vomit

If left untreated, bulimia can cause serious complications for the human body, including kidney failure, gingivitis, dental cavities, digestive problems or constipation, chronic dehydration, nutritional deficiencies, anemia, and electrolyte imbalances, which can result in cardiac arrhythmia, cardiac arrest, or even death.

Women may experience the absence of menstrual periods. In addition, anxiety, depression, and substance or alcohol abuse can be common in people with bulimia.

Causes of Bulimia

The exact cause of bulimia is currently unknown; although it is thought that multiple factors contribute to the development of this disorder.

People with mental health conditions or a distorted view of reality are at higher risk. The same is true for those who have a strong need to meet expectations and social norms.

Those who are highly influenced by the media may also be at risk. Some of the main causes of bulimia include:

  • Stressful transitions or life changes
  • A history of abuse or trauma
  • Negative body image
  • Low self-esteem
  • Professions or activities focused on appearance / performance
  • Anger
  • Depression
  • Perfectionism
  • Impulsiveness

Some research suggests that bulimia is hereditary, or may be caused by a deficiency of serotonin in the brain.

How is Bulimia Diagnosed?

Various tests are performed to diagnose bulimia. First, the doctor will do a physical exam and may also order blood and urine tests. A psychological evaluation will help determine the person’s relationship with food and their body image.

The doctor may use criteria for diagnosing mental disorders. The criteria used to diagnose bulimia include:

  • Binge eating
  • Regular expulsion through vomiting
  • Persistent behaviors to expel consumed food, such as excessive exercise, misuse of laxatives, and fasting
  • Self-esteem that is overly influenced by weight and shape

The severity of bulimia can be determined by how often, on average, the patient exhibits binge eating and purging behaviors.

Bulimia is classified from mild to extreme:

  • Mild: 1 to 3 episodes per week
  • Moderate: 4 to 7 episodes per week
  • Severe: 8 to 13 episodes per week
  • Extreme: 14 or more episodes per week

When a patient has been diagnosed with bulimia for a long time, they will likely need additional tests. These tests may check for complications that can include problems with the heart, kidneys, or other organs.

Treatment for Bulimia

Since bulimia is not only an eating disorder but also a psychological disorder, treatment does not focus only on nutritional and dietary education, but also on mental health care.

Because negative body image and low self-esteem are often underlying factors at the root of bulimia, it is important that therapy is included in the recovery process. Treatment for bulimia generally includes:

  • Ending the cycle of compulsive purging – the initial phase of bulimia treatment involves breaking this harmful cycle and restoring normal eating behaviors.
  • Food education and nutritional support, which means learning about healthy eating habits, creating a nutritious meal plan, and possibly a controlled weight loss program.
  • Improving negative thoughts – this bulimia treatment phase focuses on recognizing and changing irrational beliefs about weight, body shape, and dieting.
  • Resolving emotional issues – this phase of bulimia treatment focuses on healing emotional problems that may have caused the eating disorder. Treatment may address interpersonal relationships and can include cognitive behavioral therapy, psychotherapy (also known as talk therapy), and family therapy.
  • Antidepressants and anti-anxiety medications to treat anxiety and depression caused by excessive food consumption.
  • Treatment for complications, which may include hospitalization in severe cases of bulimia

Successful treatment generally includes not just antidepressants and psychotherapy, but also a collaborative approach among the doctor, mental health care professional, family members, and friends.

See Also: Anorexia: Main Causes, Symptoms, and Treatments
Photos: Daniela Brown