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Bulimia — what is it?

Bulimia, or bulimia nervosa, is a serious and potentially life-threatening psychiatric illness.

It is an eating disorder in which a person binge eats and then tries to compensate by over-exercising and purging, either through vomiting or the use of laxatives.

The two major symptoms of bulimia nervosa are recurrent bingeing on food, followed by purging, to compensate for the overeating.

Bingeing involves eating large amounts of high-calorie foods in a short time, usually defined as a 2-hour period. The individual may consume up to 3,000 calories or more.

When bingeing starts, it is hard to stop. The person may consume the food so fast that they hardly taste it. They cannot control their behavior. After bingeing, the person feels bloated, unattractive, guilty, ashamed, and regretful. There is a powerful and overwhelming fear of gaining weight.

To compensate, they try to reduce the risk of gaining weight through actions such as self-induced vomiting, over-exercising, fasting or dieting, and overusing diuretics, enemas, or laxatives. They may take amphetamines or other illegal substances.

Purging can lead to serious complications. Moreover, it does not reduce weight and may even contribute to weight gain in the long term.

A vicious cycle of guilt results, due to low self-esteem and feeling overweight, even if the person’s weight is normal. The individual may then set themselves strict and unrealistic rules about eating, exercise, or both. When they are unable to maintain these goals, another binge occurs.

A person with bulimia nervosa is most likely of normal weight or slightly overweight. It can be difficult to notice the signs and symptoms because the person will try hard to hide them. A few of these indications are: eating alone, hiding or hoarding food, compulsive exercising, constantly complaining about being overweight, going through phases of fasting or saying they are not hungry, and then eating too much.

Treatment is long term. Ideally, it combines psychotherapy, family therapy, nutrition counseling, and medication.

[telling doctor about bulimia]

Many people who seek treatment recover from bulimia.

It is essential for the patient to accept their need for treatment, and agree to co-operate and participate. Some patients resist treatment, while others may fluctuate in their adherence.

Stressful life events may trigger relapses.

Behavioral and cognitive therapy can help patients:

  • understand why they have the disorder, and which feelings, behaviors, and thoughts are contributing to it
  • change their perception of appearance, body weight, food, and eating

Support from family and friends is key to effective and long-term positive outcomes.

The patient’s family needs to understand what bulimia nervosa is and to identify its signs and symptoms rapidly. Family therapy can help in the healing process.

Interpersonal therapy focuses on social roles and relationships. Patients learn new ways to manage conflicts with friends or family and to improve these relationships.

Medications can help with depression. Fluoxetine, also known as Prozac, is an approved drug that could be consumed.

Nutritional counseling can help break the cycle of bingeing and compensation. Patients learn to structure and pace their meals, and to set calorie goals that match their needs.

Hospitalization is rarely needed unless there is a risk of suicide or self-harm.

If you’re not confident with your own body, talk to someone, reach out. There needs to be an outlet or you’ll wind up being irrational and losing yourself forever. Don’t resort to being a bulimic.

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