What is Bulimia Nervosa?
Bulimia Nervosa, often known as bulimia, is a type of eating disorder (1). It is characterised by a pattern of bingeing and purging as a result of a distorted body image and a fear of gaining weight.
Compensatory behaviours follow uncontrollable eating binges. Purging, or severe fasting, tight diets, and intense exercise are examples of these. Purging is the process of expelling food intake in order to impact body weight or “make up for” calorie consumption.
Individuals with bulimia tend to be of or above normal weight, as opposed to Anorexia Nervosa, which results in significant weight loss. Bulimia, in the end, is more than just a food problem. Because of the underlying self-image problems, it is psychological in nature. Bulimia may also coexist with depression, panic and anxiety disorders, substance misuse, and behaviour disorder.
Symptoms of Bulimia Nervosa
A trigger sets off the bingeing cycle (e.g. stress, negative emotions). To cope with this trigger, people eat pleasurable high-calorie foods, frequently in secret (2).
As a result, after losing control and bingeing, one experiences feelings of shame, disgust, guilt, and self-blame. This leads to compensatory behaviours such as:
- Sense of lack of control over eating
- Over-preoccupation with body weight and shape
- Consumption of laxatives, weight-loss supplements, diuretics (water pills, to shed weight)
Due to this cycle of bingeing and purging, individuals with bulimia nervosa frequently suffer from:
- Menstrual irregularities
- Miminished potassium and electrolytes
- Cardiac irregularities (due to laxative use)
- Loss of dental enamel (due to frequent vomiting)
Diagnosis
The diagnostic criteria for bulimia include (3):
- Recurrent episodes of binge eating. An episode of binge eating is characterised by BOTH of the following:
- Eating an amount of food that is definitely larger than what most individuals would eat within a similar period of time under similar circumstances.
- A sense of lack of control over eating during the episode
- Recurrent inappropriate compensatory behaviours in order to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics, or other medications, fasting, and excessive exercise.
- Both binge eating and inappropriate compensatory behaviours occur, on average, at least once a week for 3 months.
- Self-evaluation is influenced by body shape and weight.
- The disturbance does not occur exclusively during episodes of anorexia nervosa.
Causes of Bulimia Nervosa
Currently, the cause of Bulimia Nervosa remains unknown. Some risk factors include:
- Being overweight during childhood
- Having a history of family members with eating disorders
- Engaging in strict diets
- Pre-existing psychological disorders like depression or anxiety.
FAQ
Q: What’s the difference between Anorexia Nervosa and Bulimia Nervosa?
A: Anorexia Nervosa is also an eating disorder with a focus on losing weight and having a distorted body image. However, unlike individuals with bulimia who often go through a cycle of bingeing and purging, individuals with anorexia severely restrict their food intake (4).
Another key distinction between the two conditions is that those suffering from Anorexia Nervosa have abnormally low weight for their height and age, while those with Bulimia Nervosa remain at healthy weight (4).
Q: What are the differences between Bulimia Nervosa and Binge Eating Disorder?
A: The primary distinction between Bulimia Nervosa and Binge Eating Disorder is that Bulimia is characterised by purging after a binge, whereas Binge Eating Disorder does not.
While each person’s experience is unique, it is common for persons who struggle with Bulimia to be motivated by a distorted body image and fear of gaining weight. Although people with Binge Eating Disorders could feel uneasy in their skin, they might not be as preoccupied with their appearance and weight as people with Bulimia are (5).
Q: How can I help someone who I think has Bulimia?
A: Getting someone to talk about it could be difficult, and they might even deny that they have a problem, but sometimes all it takes to get someone to open up is simply someone to support them and listen.
Work on listening without passing judgement. Your primary objective is to communicate your concern for their well-being and your desire to help (6).
Be understanding and patient. It may take some time for someone to be open and honest about their bulimia. You can reassure them that you’ll be there for them whenever and however they need when they’re ready to chat.
