Bulimia Nervosa is an eating disorder that
affects girls in late adolescence and early adulthood. A person who suffers
from the disorder will consume large quantities of food (bingeing) then rids
their bodies of the food either by self-induced vomiting or using laxatives
(purging) or by excessive exercising, non-purging. The food, usually
carbohydrates, is consumed in large amounts over a short period of time,
until the person is full. The drive to binge is so strong the sufferer will
eat leftovers from the trash bin and steal in order to feed the compulsion.
The disorder may become so overbearing that the person’s life becomes out of
control, trying to keep the bingeing a secret. Bulimia affects 1.1%-4.2% of
girls or women in their lifetime.
There are three different types of Bulimia
Nervosa. While they are considered 3 separate illnesses, they share common
features. The first and least severe of the types is Simple Bulimia Nervosa.
It commonly occurs in girls around eighteen years of age. The girls are
fairly popular and make friends easily. The bingeing is usually caused by a
period of unhappiness in their life. A destructive relationship with a boy is
a primary cause for young girls to binge. The relationships cause the girl to
focus on her body image due to the boy belittling or ridiculing the girl
about her weight or how she looks. Many different diets are tried to lose
weight, but due to the lack of rigid control needed to succeed on the diet,
they often fail. The cycle then begins; vomiting is introduced as an
increased effort to lose weight. They lose control as the body’s normal
mechanisms of appetite control are overridden and confused. Their weight may
stay close to normal but their eating habits will gradually worsen in time.
There is likely to be many girls who
have mild symptoms of Simple Bulimia Nervosa who never get help and run the
risk of condition worsening. Sufferers tend to seek help when they are
planning to start a family to ensure that the baby will not be harmed.
The second type is Anorexic Bulimia Nervosa.
Suffers of this type have a similar background to girls who suffer with
Anorexia Nervosa. Girls who suffer with bulimia are slightly less obsessive
and are slightly more mature emotionally. It is usually preceded by a brief
period of anorexia. The sufferer usually begins to recover without any
treatment. Weight may stabilize for a short while during this time and
menstruation may restart. Control over anorexia is not sustained and the
bingeing cycle begins in small ways. Bulimia gradually starts to worsen once
the person begins vomiting. After eating what would be considered an ordinary
meal by a person who doesn’t suffer from bulimia, they often begin vomiting.
This then leads them to lose control over appetite control and "true"
bingeing starts. The illness is usually dominated by bingeing and vomiting.
Weight will remain low for a period of time but gradually rise to above
normal weight. The sufferer will experience a period of weight loss in
anorexic phase that includes restrictive eating.
The third and most severe of the types is
Multi-Impulsive Bulimia Nervosa. This type is similar to simple bulimia
nervosa as it has similar characteristics and age group. The sufferer has a
severe range of abnormal behaviors that include problems with impulse and
emotional control. They also have problems with other behaviors in their life
which makes it more difficult for the bulimic. They may have problems with
drug abuse and promiscuity. Deliberate self harm, also called cutting, is a
big issue with the
sufferer of the disorder. They may steal to feed the other problems as well
as the bulimia. Problems within the family may also cause or be a direct
result of the bulimia and other problems in their life. They tend to have
poor impulse control that starts at an early age. Attendance at school is low
and they do poorly in their studies resulting in poor grades. Building and
maintaining lasting relationships is hard for a person who suffers with
multi-impulsive bulimia nervosa, the control that the disorder and other
problems have over the person makes them keep their life secret and separate
from other lest they find out.
There are many physical signs, symptoms and
risks involved that give clues to others about a potential problem. Leaving
the table immediately after a meal is a very important sign that a person is
suffering from bulimia. Calluses on the back of the person’s hand are another
sign that there may be a potential problem. "Vomiting is most frequently
induced by forcing two finger of the right hand down the throat. This often
causes a chronic blister just below the knuckle where it rubs on the upper teeth"
(Introducing Bulimia Nervosa, 2003). If you notice that large amounts of food
is missing in a short period of time then the person may be taking the food
to their room and bingeing, so they can hide the evidence. The person’s
weight may fluctuate with the bingeing episodes. Look at their mouths,
repetitive vomiting causes and erosion of dental enamel as well as ulcers
inside the mouth. If the person has bulimia you may find evidence of bingeing
and purging. This may include signs that look or smell like they may have
just vomited. There will be physical evidence as well. Laxative and/or
diuretic wrappers, plates hid under the bed and containers of vomit that may
under the bed or in closets. A person who suffers from bulimia may have an
excessive and rigid exercise regimen that they will follow regardless of
weather, health, or other injuries. If they had friends and were in
activities in school and they suddenly withdraw from them then there may be a
problem that needs to be addressed. They may be unwilling to tell you that
they have a problem and will lie about it to ensure that no one finds out.
After being confronted about a potential problem with bulimia nervosa they
may become more aggressive and more secretive.
There are many symptoms that a person with
bulimia may suffer from that no one but they know about. They may have an
irregular menstrual cycle or it may stop altogether. They may also have
esophageal burning caused from stomach acids burning the lining of the
throat. Abdominal swelling and pain is common with a person who frequently
forcing themselves to vomit. The person may be lethargic and suffer from
fatigue because of the binge/purge cycle. Swelling of the hand and feet is a
common occurrence in bulimia suffers from retaining water. Headaches may
occur because of the fasting and from vomiting. A person may become
constipated or have diarrhea from eating too much food and the body not being
able to digest and rid of it properly. Use of laxatives also breaks down the
linings and juices of stomach and intestines that they use to digest of the
food. Depression can occur because of being secretive about having a
disorder, withdrawing from friends and family in order to binge and from
feeling of self-loathing due to the disorder itself.
There are serious risks involved with the
bulimia disorder. Frequent vomiting causes the acid that is in the stomach to
digest food to enter the mouth. The acid then
dissolves the enamel on teeth causing lasting damage to them. The four central
upper teeth hold the greatest risk of breakdown and rotting from the
vomiting. As with the symptoms of bulimia, the menstrual cycle may become
irregular even stopping altogether. Dangers from irregular or no menstrual
cycle may be cysts in the uterus. The uterus needs to shed the lining every
month, failure may also cause endometriosis. Risks involving the stomach are
a big risk, because the person is causing a disruption from putting pressure
on the stomach and its linings from vomiting. "Major disturbance of the blood
chemistry, particularly loss of potassium, and rupture of the stomach are
occasional causes of sudden death but fortunately this is rare unless
behavior is extreme" (Introducing Bulimia Nervosa 23). Suicide and self-harm
because of feelings of depression and hopelessness from hiding the disorder
are the greatest risks of bulimia.
Bulimia suffers may display certain
characteristics that may alert others to a potential problem. They may
express excessive concern about their weight, saying that they are overweight
even when they not. Overeating is another sign that they have an eating
disorder, especially if followed by leaving the table immediately after
eating. They may start a strict diet that will then lead to bingeing.
Expressing guilt or shame about eating or saying that they have already
eaten, they may suffer from bulimia and are planning opportunities to binge.
When life begins to revolve around food, being secretive about it, high
calorie bingeing, and feeling out of control with their eating, bulimia
nervosa may be a direct result. This all may lead to feeling of depression
because they feel that they cannot stop and that they are all alone in world.
Bulimia Nervosa can have psychological
consequences for a person who suffers from it. Depression is one of the
biggest psychological consequences for bulimia suffers. They have difficulty
talking about there feelings and do not want to talk about what they are
going through. They do not want to admit that they have a problem. They may
become withdrawn and avoid social situations, especially where there is food
present. Since this is usually a private disorder, they do not want to be
where people and food in the same place. They plan their binges and do not to
have to be tempted in a place where they can do nothing to feed their
Other consequences are more visible and
noticeable. A person will have many problems with there teeth. Vomiting on a
regular basis will cause erosion of teeth enamel. They will also have an
increase in dental cavities as well as sensitivity to hot and cold items. The
salivary glands, in the cheek area, will become swollen and sore from
vomiting. Lining of the throat and esophagus will become irritated and tear
from repeat vomiting. They will develop stomach ulcers as well from frequent
vomiting. The acid in the stomach will deteriorate the linings. Misusing
laxatives and diuretics, the body can lose needed sodium and potassium, which
can cause and increase irregular heartbeats, damage the heart muscle, cause
heart failure and death in an individual. Laxatives and diuretics may also
cause constipation and irregular bowel movements. The abuse that is put on
the body from bulimia nervosa will eventually cause it to deteriorate and
eventually, if left untreated, fail altogether. Bingeing and purging takes
essential vitamins and resources from the body causing it to take what the
body needs to maintain health. The person will become rundown and may even
lose days at a time from the toll the body takes. "I was sleeping 1 or 2 and
sometimes 3 days at a time. I would wake up, take a shower, and still feel
exhausted. On my way to leaving the house to get a few things done, I would
still feel so exhausted that I would say to myself ‘I need a nap for 30 minutes’,
only to wake up the next day" (Joshua Children’s Foundation 2000-2002).
There are many different type of treatments for
bulimia. Individual psychotherapy will give one on one therapy and help as to
how to treat the disorder. Behavioral therapy and cognitive therapy are other
options in treating bulimia nervosa. Medication can be used to help treat the
disorder. Antidepressant medication works to help with a chemical imbalance.
They will help lift the person’s mood and help them get back in touch with
real life. Anticonvulsant drugs are another option in treating the illness.
Bulimia nervosa is an eating disorder that is
on the rise. While unknown as to what causes this disorder, there are studies
that have shown links to heredity. "It is reported that among persons
suffering from eating disorders, that as many as 85% have been victims of sex
abuse" (Joshua Children’s Foundation).