It is a common phenomenon that when people are under-stress or feel lonely, they tend to consume high calorie foods, thinking that the food will make them feel better. However, scared of the effects of overeating, these people tend to punish themselves by choosing some extreme behavior, such as fasting, purging, or other weight loss strategies. This phenomena of binge eating followed by purging is referred to as bulimia. 

What Is Bulimia?

Bulimia, also termed as Bulimia Nervosa, is classified as a psychological condition that may potentially be life-threatening in severe cases. In this condition people are over-occupied with their self-image and appearance. They tend to use every mean possible to get rid of extra pounds after binge eating. Bulimia is divided into two types:
1

Purging Bulimia

In this type of bulimia, people try unnatural methods of restricting their caloric intake to prevent weight gain, for example, using emetics diuretics or laxatives to induce vomiting, diuresis and forceful diarrhea respectively.

2

Non-Purging Bulimia

In this type of bulimia, people try other methods to shed weight. For example, excessive and strenuous physical exercises, severe calorie restriction dieting or even fasting. It is hard to delineate the two varieties which often overlap and thus the behavior is usually referred to as purging.

What Are the Signs and Symptoms of Bulimia?

Being in a state of Bulimia is pretty hard and somewhat frustrating for the individuals who are living with this condition. It is fairly embarrassing for them to control their urge to binge, so most of these individuals live a secret life to hide their "love for food" from others. These individuals tend to eat alone so that nobody notice their food intake, they shop at different stores at a time to minimize the risk of being "guessed" of their food disorder. In most cases, people who are in close contact with them can tell that something is not quite right. Here are a few classic sign and symptoms.

Binge Eating

The first symptom that a person acquires is binging, which refers to a high indulgence in the food consumption or eating excessive amount of food until it becomes physically impossible to ingest any more food. This is associated with a few behaviors such as:

  • Eating while hiding from other. it means going to eat secretly so that no one can know you are eating.

  • Food Storage. These people tend to store junk food in their closets. Their garbage bin is usually full of wrappers and covers.

It is imperative to mention that these vicious cycles of excessive food intake are not associated with any weight gain.

Purging

Once these people consume large quantities of food, they tend to feel guilty and scared of the weight gain. To counter that, they set extremely strict rules and regulations to get rid of the calorie content. This is termed as purging. Some frequently reported symptoms are:

  • Lot of exercise. Performing lot of exercise without check and balance. This leads to problems in the muscles such as frequent soring, muscle or joint injuries and muscle wasting.

  • Usage of pills. Using different types of diuretics and laxatives, specifically after consuming food. These people tend to disappear for significant amount of time after consuming meals.

  • Smell of vomit from bathroom. The bathrooms usually is stinking with the smell of vomit which these individuals try to hide with air-fresheners and perfumes.

Guilty Feeling

Because of low self-esteem and feeling of too fat, the patients often set very strict regulations on eating and exercise. Usually, these goals are hard and even impossible to achieve, which in turn makes them feel guilt. This vicious cycle repeats and makes the patients feel worse about them.

Other Notable Symptoms

  • Fluctuation in weight: fluctuation in weight occurs due to sudden weight gain and speedy weight loss.

  • Inflated cheeks: These individuals tend to have chipmunk facies (inflated cheeks) due to purging behavior.

  • Purging despite normal-weight: Individuals who purge despite being in the normal or near-normal weight range are at high risk of developing nutritional deficiencies and imbalance that may prove life-threatening.

  • Change in teeth color: Due to persistent and excessive exposure to stomach acid, teeth turn yellow and appears dull.  

  • Callus formation on knuckles: Due to frequent attempts at unnaturally inducing vomiting, these individuals often develop callosities or erosions on their knuckles (that are referred to as Russell's Sign, due to constant rubbing of teeth against ring and index finger.

More Notable Symptoms

  • Huge amount of time and money spent on food

  • Depression

  • Anxiety

  • Chronic throat inflammation

  • Broken vessels visible in eyes

  • Disturbances in the menstrual cycle 

What Causes Bulimia?

Bulimia is said to be an idiopathic disorder. That means the cause is unknown but there are certain factors that may increase the risk in certain individuals. These are:

Genetic Factors

A positive family history of bulimia or other eating disorders can increase the risk several folds.

Bullied Children

Individuals who have a history of being bullied at the school or other places tend to have this problem.

Exposed to Harsh Behavior

People who have been exposed to harsh behavior or have been sexually or physically abused are at much higher risk.

Puberty Related Changes

Changes in the hormones and social influences such as being friends with slim and fit girls or living in the surrounding of body-conscious individuals can also lead to bulimia.

Low Self-Esteem and Related Issues

Individuals with poor self-esteem or those who have other psychological conditions like post-traumatic stress disorder, attention-deficit hyperactivity disorder, depression and anxiety disorders are also at high risk.

Athletes in Competitive Sports

Athletes unknowingly adopt unhealthy strategies to maintain low body weight to stay fit and healthy that can also lead to this disorder.

How Can Bulimia Be Treated?

When a person is going through Bulimia, he needs to go through several treatments. But these treatments only work best when these are done with the support of family members and doctors.

Drugs

Use of anti-depressant can help to reduce the risk of bulimia. And the only drug that has been approved by FDA is fluoxetine. 

Nutritional Counseling

If a person is over-weight and facing binging problem, it is imperative to consult a good nutritionist to learn more about the healthy weight-loss options. And if you are below average weight and having a purge problem, consult a dietitians so that he can propose a good diet to maintain normal weight.

Psychotherapy

Psychotherapy is a kind of treatment in which the patient discusses about his disorder and this helps reduce the symptoms in the light of recommendations and solutions offered by the therapist. This includes

  • Intellectual behavioral therapy. This therapy aims at removing the unhealthy thoughts regarding self-image and replacing it with positive and healthy thoughts.

  • Social psychotherapy. This therapy solves patient’s problems regarding close relations and also helps in dealing with the communication problems.

  • Controversial behavior therapy. It eases patient’s relationship problems and also guides the patient's self-control and tolerance.

Hospitalization

if you have very serious problem with bulimia or othehr serious health complications, you may need treatment in a hospital. Some eating disorder programs also provide day treatment.

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