Disordered Eating

Bulimia Nervosa & Binge Eating Disorder

Bulimia Nervosa--DefinitionO Bulimia is an illness in which a

person binges on food or has regular episodes of overeating and feels a loss of control.

O The person then uses different methods -- such as vomiting or abusing laxatives -- to prevent weight gain

O This is known as “binge and purge”

CausesO Exact cause of bulimia is unknown.O Genetic, psychological, trauma, family,

society, or cultural factors may play a role. O Bulimia is likely due to more than one

factor.O Begins with general dissatisfaction of

physical appearance.O Some evidence of chemical messenger

abnormalities (serotonin, feelings of satiety)

Risk FactorsO Risk factors for developing bulimia

O FemaleO Late teens—early adulthoodO Have parents/siblings with eating

disorderO Societal/peer pressureO Performance pressure in sports

PrevalenceO Affects 1%-4% of the U.S. population

O 3.1-12.4 millionO 19-30% college females O People with bulimia are often at a

normal weight, but they may see themselves as being overweight.

O Because the person's weight is often normal, other people may not notice this eating disorder.

Bulimia/Binge Eating DisorderSymptoms

O Binge Eating Disorder--Disorder where individuals frequently consume large amounts but DO NOT purge.O Eating unusually large amts of food even when

full/not hungryO Eating rapidly during binge episodesO Feeling that your eating behavior is out of controlO Feeling depressed, disgusted, ashamed, guilty or

upset about your eatingO Experiencing depression and anxietyO Frequently dieting, possibly without weight lossO Losing and gaining weight repeatedly, also called yo-

yo dieting

Signs & SymptomsO Binge Episodes

O In bulimia, eating binges may occur as often as several times a day for many months.

O People with bulimia often eat large amounts of high-calorie foods, usually in secret.

O People can feel a lack of control over their eating during these episodes.

O Binges lead to self-disgust, which causes purging to prevent weight gain. Purging may include:

Signs and SymptomsO Purging Episodes

O May occur several times a dayO Forcing yourself to vomitO Excessive exerciseO Using laxatives, enemas, or diuretics

(water pills)O Purging often brings a sense of relief.

Signs & SymptomsO Symptoms that other friends/family can

see:O Compulsive exerciseO Suddenly eating large amounts of food or

buying large amounts of food that disappear right away

O Regularly going to the bathroom right after meals

O Throwing away packages of laxatives, diet pills, emetics (drugs that cause vomiting), or diuretics

Health ProblemsO Cavities or gum infectionsO The enamel of the teeth worn away or

pitted. O Broken blood vessels in the eyesO Dry mouthO Rashes and pimplesO Small cuts and calluses across the tops

of the finger joints from forcing oneself to vomit

O Electrolyte imbalance

Health ComplicationsO Permanent damage to esophagusO Dehydration, which can lead to major

medical problems, such as kidney failureO Heart problems, such as an irregular

heartbeat and heart failureO Digestive problems, and possibly a

dependence on laxatives to have bowel movements

O Anxiety and depressionO Drug and alcohol abuse

TreatmentO Most often, a stepped approach is used for

patients with bulimia. O Support groups may be helpful for patients with

mild conditions who do not have any health problems.

O Cognitive-behavioral therapy (CBT) and nutritional therapy are the first treatments for bulimia that does not respond to support groups.

O Antidepressants are often used for bulimia. O A combination of CBT and antidepressants is

very effective if CBT does not work alone.

Bulimia Nervosa—Recovery

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Complete recoveryBulimic episodesChronic bulimia