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Perfect Illusions: Eating Disorders and the Family
Eating Disorders
Bulimia Nervosa
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Bulimia is an emotional "weight control" disorder characterized by episodes of binge eating followed by some form of purging or restriction. Binges are the secretive periods of rapid consumption of high-caloric foods over a discrete period of time. Most bulimics follow bingeing with self-induced vomiting; however the purging may take the form of use of a laxative, emetic emetic (an agent that induces vomiting) or abuse of a diuretic (an agent which increases the volume of urine excreted), excessive exercise or fasting. The binge-purge cycle is normally accompanied by self-deprecating thoughts, depression and an awareness that the eating disorder is abnormal and out of control. Because most bulimics are within a normal weight range, the illness may go undetected by others for years. The majority of suffers are female, but there are also cases of Bulimia Nervosa in men.

Common Purging Behaviors:

  • Self-induced vomiting
  • Emetic abuse
  • Laxative abuse
  • Diuretic abuse
  • Fasting
  • Excessive exercise

Warning Signs:

  • 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.
  • An 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 and scars 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, or mood swings.
  • In general, behaviors and attitudes indicating that weight loss, dieting and control of food are becoming primary concerns.

Health Consequences:

  • 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.
  • Potential for gastric rupture during periods of bingeing, and 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.
  • Peptic ulcers and pancreatitis.

Important Facts:

  • There are two types of bulimia nervosa: purging and non-purging.
  • It occurs in 0.5 percent to 2.0 percent of adolescents and young adult women.
  • Bulimia nervosa affects 1-3% of middle- and high-school girls and 1-4% of college-age women.
  • Approximately 80% of bulimia patients are female (Gidwani, 1997).
  • It appears to be relatively uncommon in men.
  • It typically develops in early-to-mid-adolescence.
  • It is usually preceded by dieting behavior.
  • Bulimics are usually of average or above-average weight.
  • Self-evaluation is unduly influenced by size and weight.
  • There are ongoing feelings of isolation, self-deprecating thoughts, depression and low self-esteem.
  • There is full recognition of the behavior as abnormal.
woman sitting
Bulimia nervosa can be extremely harmful to the body. The recurrent binge-and-purge cycles can impact the entire digestive system and can lead to electrolyte and chemical imbalances in the body that affect the heart and other major organ functions.
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