Bulimia nervosa, or simply “bulimia,” is an eating disorder characterized by repetitive binge eating and subsequent weight control measures. Those affected often resort to drugs that can be life-threatening. FITBOOK has summarized everything you should know about the disease.
The pressure to be slim is often omnipresent, especially in adolescents. During diet attempts, many young women and men fall victim to disordered eating habits. In the worst case, an eating disorder such as bulimia (bulimia nervosa) develops. Those affected try to get rid of the food they have eaten by vomiting, fasting, excessive physical activity or laxatives. The disease is accompanied by an enormously high level of suffering and the weight-control measures often determine the lives of those affected. In order to recognize the early warning signs of bulimia in yourself and your loved ones, you should know which symptoms to look out for.
What are the symptoms of bulimia?
In bulimia, a distinction is made between the “purging type” and the “non-purging type”. In the “purging type”, sufferers of bulimia nervosa eat very large amounts of food at once, from which they then “clean” or empty themselves by vomiting or abusing laxatives. This process is repeated several times a day, depending on the severity of the disease. Those affected by the “non-purging type” fast and do a lot of sport. Bulimia manifests itself in typical symptoms such as:
- panic fear of gaining weight
- obsessive preoccupation with weight and one’s own body
- a very bad self-image
- binge eating
- self-induced vomiting
- abuse of laxatives
- excessive and exaggerated exercise
- broken, yellow teeth due to stomach acid
- a swollen face, “hamster cheeks”
- heartburn
- gas
- social isolation
If bulimia remains untreated for a long time and the severity of the disease continues to increase over the course of the disease, it is also accompanied by a severe loss of control. In other words, those affected become downright addicted to the cycle of binge eating and the subsequent weight-regulating behavior.1,2
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What are the causes and risk factors for bulimia?
In principle, anyone, regardless of age, can develop bulimia. Although a higher percentage of young girls and women are affected by the disease, the number of men suffering from bulimia has also increased sharply in recent decades. Factors that contribute to the development of the disease can include:
- a pre-existing eating disorder such as B. Anorexia
- social factors
- traumatic experiences
- biological requirements
- genetic predisposition
- psychological factors, such as depression or low self-esteem
The sense of control is an important part of the disorder. Especially when a feeling of loss of control prevails during puberty or during times of social, emotional or psychological turmoil, people with bulimia see self-determined food intake and weight regulation above all as something they can control and use this to deal with their emotions. Mental illnesses such as B. Depression or a Borderline Personality Disorder accompanied by bulimia, since the behavior here also serves as a very unhealthy form of emotion regulation.
What are the consequences and risks?
Primarily through the act of vomiting and abuse of laxatives, bulimia can have serious, irreversible and life-threatening consequences. Self-induced vomiting disrupts the mineral balance in the body and puts a strain on the stomach, esophagus and heart. Even the brain can be affected by self-injurious behavior. Possible consequences of bulimia can be:
- malnutrition
- Heart muscle weakness caused by low levels of potassium in the blood
- Kidney damage from a lack of electrolytes
- Stomach rupture from overeating very large amounts of food, causing the stomach to bloat so much that it ruptures
- Constipation or intestinal discomfort due to slowed food transport and/or laxative abuse
- osteoporosis due to calcium deficiency
- irreversible tooth damage caused by damage from stomach acid
- Inflammation of the esophagus due to the constant vomiting and the irritating stomach acid
- gastric mucosal inflammation
- inflammation of the pancreas
- hormonal changes, such as missed periods
- dry skin, brittle hair and nails
- morphological changes in the brain, in which the composition of the brain matter changes and/or shrinks, which can lead to difficulty concentrating and headaches
- Cerebral edema from sodium loss
In the worst case, the damage caused by the disease can even lead to death or serious illness. Among other things, frequent or persistent inflammation of the esophagus or pancreas and inflammation of the gastric mucosa promote the development of cancer.3,4
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How is the disease diagnosed?
Anyone who suffers from symptoms of bulimia or knows for sure that they have an eating disorder should first talk to their family doctor. People with statutory health insurance often find it difficult to get a place in therapy. Your family doctor may be able to help you find a psychiatrist, therapist, or other specialist, in addition to a physical exam and blood draw. This diagnoses the disease using the criteria of bulimia, which are recorded in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V-5):
- Repetitive binge eating, in which you eat uncontrollably and excessively over a short period of time (about two hours).
- Weight-control behaviors that follow binge eating, such as vomiting, abuse of laxatives, exercise, or fasting
- the cycle of binge eating and regulation occurs at least once a week for three months
- self-esteem is strongly dependent on body image and weight
- the symptoms do not only appear during anorexic episodes
A distinction is also made between degrees of severity of the disease. Measurement begins with “mild” bulimia, in which the “binging and purging” cycle occurs one to three times a week, and extends to “extreme” bulimia, in which those affected have binge eating 14 or more times and then take unhealthy actions.5
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What about the treatment options?
The longer the illness persists, the more difficult it is to stop the behavior altogether. It is all the more important that sufferers seek professional help as early as possible so that bulimia does not become chronic. Although it is possible to heal from the disease, it usually takes several attempts and therapy lasting several years for patients to fully recover. Treatment options include approaches such as:
- psychotherapy
- behavior therapy
- group therapy
- hospital stay
- relaxation therapy
- nutritional advice
- Drug treatment, e.g. B. with antidepressants
The possible approaches are often combined. Therapy with only antidepressants is not promising in the long term, since behavioral therapy measures also have to be used to learn how to deal with food and one’s own self-image differently or in a healthier way. If the bulimia is severe and there are other mental or physical illnesses, a hospital stay may be the only thing that can help.
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self-help and contact points
Bulimia nervosa or bulimia is a serious illness whose symptoms significantly determine the lives of those affected and cause an enormous amount of suffering. Anyone who suffers from bulimia should always seek professional help in the form of psychotherapy, group therapy, their family doctor and/or nutritional advice. Since therapy places are unfortunately limited, self-help books and self-help groups can be a first step towards recovery as support or orientation.
Of the Federal Association for Eating Disordersdie Federal Center for Health Education and also that Federal Ministry of Health provide information on their websites about bulimia and other eating disorders and offer those affected and their families literature, information on contact and advice centers as well as information on therapy places. There are also organizations such as ANADwhose sole purpose is to provide those affected and their families with information about all the options that can contribute to recovery.6,7