Bulimia Nervosa

Bulimia nervosa is a serious eating disorder and it can become life-threatening if left untreated. People with bulimia often have a distorted view of their body and an intense fear of gaining weight. This can lead to a cycle of binge eating and compensatory behaviors, such as self-induced vomiting or excessive exercise, in an attempt to control their weight.

What Is Bulimia Nervosa?

Bulimia nervosa, or just bulimia, is a mental health condition characterized by a cycle of binging and purging. A person with bulimia consumes an unusually large amount of food in a short period, often in secret, and feels a loss of control during this episode. Following the binge, they feel extreme guilt and shame, which drives them to engage in compensatory behaviors to get rid of the calories. This can include self-induced vomiting, misusing laxatives or diuretics, fasting, or exercising excessively. Unlike those with anorexia nervosa, people with bulimia typically maintain a normal or even above-average weight, which can make the condition harder to spot.

Symptoms of Bulimia Nervosa

Bulimia symptoms can be both behavioral and physical. The most common signs include:

• Fear of Weight Gain: An intense preoccupation with body weight and shape.
• Binge Eating: Repeatedly eating large amounts of food in one sitting.
• Extreme Exercise or Fasting: Limiting calories or exercising excessively between binges.
• Misuse of Supplements: Taking dietary supplements or herbal products for weight loss.
• Lack of Control: Feeling unable to stop eating during a binge.
• Purging Behaviors: Using self-induced vomiting, laxatives, diuretics, or enemas to get rid of food.
• Distorted Body Image: Basing self-worth on body shape and weight.
• Physical Signs: Swelling in the cheeks and jaw, dental problems from stomach acid, and sores or calluses on the knuckles from inducing vomiting.

Causes of Bulimia

The exact cause of bulimia is not fully understood, but it is believed to be a mix of several factors, including:

• Genetics: Eating disorders can run in families, suggesting a possible genetic link.
• Dieting: A history of dieting can increase the risk of developing an eating disorder. Many people with bulimia severely restrict calories between binges, which can trigger more binging and purging.
• Emotional and Mental Health: Conditions like depression, anxiety, and low self-esteem are often linked to bulimia. Experiencing stressful life events or being bullied about weight can also be a factor.
• Societal Pressure: The emphasis on thinness in media and culture can influence a person’s perception of their body image and self-worth.

Bulimia Nervosa Diagnosis

Diagnosing bulimia nervosa involves a thorough evaluation by a healthcare professional. Because a person with bulimia often keeps their behaviors a secret, diagnosis can be challenging. A doctor will typically ask about eating patterns, feelings of control during binges, and any compensatory behaviors like purging. They may also ask about family history of eating disorders or other mental health conditions. To check for the physical effects of bulimia, the doctor might order tests like blood work, an EKG to check heart function, or a urinalysis. Early and honest communication with a doctor is key to getting a proper diagnosis and starting treatment.

Bulimia Nervosa Treatment 

Treating bulimia usually involves a team-based approach, combining different therapies and professional support.

• Psychotherapy

Psychotherapy like Cognitive behavioral therapy (CBT) is often a cornerstone of treatment. It helps people identify and change the thought patterns and behaviors that contribute to their bulimia.

• Nutritional Counseling

A registered dietitian can help a person with bulimia develop a healthy relationship with food and create a balanced meal plan to stop the cycle of binging and purging.

• Medication

Antidepressants, particularly a type called selective serotonin reuptake inhibitors (SSRIs), can be prescribed to help reduce bulimic symptoms and treat co-occurring depression or anxiety.

• Group Therapy

Sharing experiences and coping strategies with others who have bulimia can be a powerful part of recovery.

Risk factors

Several factors can increase a person’s risk of developing bulimia, including:

• Family History: A family history of eating disorders or weight-control issues can raise the risk.
• Gender: Bulimia is more common in females than in males.
• Age: The disorder often starts in the late teens or early adulthood.
• Dieting: Frequent dieting or severe calorie restriction.
• Mental Health Issues: Having a history of depression, anxiety, or substance abuse.

Complications

Bulimia can lead to serious and sometimes life-threatening complications, such as:

• Heart Problems: Irregular heartbeat or even heart failure due to an electrolyte imbalance.
• Kidney Failure: Caused by severe dehydration.
• Gastrointestinal Issues: Tears in the esophagus or stomach rupture.
• Dental Problems: Severe tooth decay and gum disease from stomach acid.
• Poor Nutrition: A lack of essential vitamins and minerals.
• Co-occurring Conditions: Depression, anxiety, or substance abuse often occur alongside bulimia.

Prevention

• Promote a Healthy Body Image: Encourage confidence and self-worth based on a person’s personality and skills, not just their appearance.
• Discourage Dieting: Avoid promoting unhealthy weight-control behaviors like fasting or using diet pills.
• Eat Together: Having regular family meals can help foster a healthier relationship with food.
• Seek Early Help: If you notice signs of an eating problem in yourself or a loved one, seek professional help right away.

Getting the Holistic Care at BMHH

If you or a loved one is struggling with bulimia symptoms, seeking comprehensive and compassionate care is a crucial step toward recovery. At the Bangkok Mental Health Hospital (BMHH), our team of specialists can provide holistic care that addresses both the physical and mental aspects of bulimia. We offer a range of treatments, from one-on-one therapy to nutritional counseling, all tailored to meet your specific needs. Getting the right support is essential for overcoming this challenging illness and starting a journey toward a healthier life.

Contact Bangkok Mental Health Hospital today.

• Phone: 02-589-1889
• Line: @bmhh
• Mail: [email protected]
• Location: Bangkok Mental Health Hospital

Article by

Nongnaphat Wanussakul,M.D.
Adult Psychiatry
Bangkok Mental Health Hospital (BMHH)