Bulimia Nervosa: What is It?

In today's appearance centered society we often hear of eating disorders, and not just on celebrity gossip television programs either. Eating disorders are a serious problem in the Western world where, on top of other factors, society places emphasis on thin, toned bodies. This thin-subculture can lead to eating disorders such as anorexia nervosa, and the lesser mentioned bulimia nervosa, the later is that which will be discussed in this paper in order to provide a better understanding of this very serious condition.

Bulimia nervosa is also known as binge-purge syndrome for its two part make up. Individuals with bulimia go through periods of binging in which they take in excessive amounts of food, often nearly 3,000 calories at a time. Following these binges are compensatory behaviors meant to compensate for the excessive calories consumed during the binge.

Binges often take place in secret, meaning when no one else is around, so that the disorder is kept a secret. Individuals with bulimia nervosa are often constantly afraid of someone finding out about the problem, and will do most anything to hide their disorder. During the binge, high calorie, sweet foods are consumed; this constitutes anything from cookies, cookie doe, ice cream, sandwiches, pizza, bread, butter, and the like. In general, soft foods are chosen as they are rarely properly chewed, and more rarely even tasted. Despite this lack of actually tasting and enjoying the food, binging brings on a feeling pleasure that releases the individual from the feels that started the binge; feelings of tension, irritability, and a powerlessness against resisting the urge to eat. Since the binge phase brings a release to the aforementioned tension, it is experienced as highly pleasurable, which results in the continued habit.

Unfortunately, the aftermath of binge eating leaves the individual feeling guilty and depressed. Bulimic individuals are extremely worried about their weight and appearance, and the high caloric intake threatens to add weight which can, in addition to ruining a figure, lead to discovery of the disorder. It is for this reason that compensatory behavior is engaged in. This behavior is usually vomiting (purging), or using excessive laxatives, both of which can and often do cause serious health problems. What isn't known is that both also fail largely to prevent the absorption of nearly half the calories. Excessive purging also leads to an inability to feel full, and thus a greater appetite. Additionally, tooth enamel is worn away by the acids present in the vomit. Esophageal problems are also common as the acid from the vomit also bathes the esophagus.

The use of laxatives isn't any better. In fact, laxative use fails to stop an even greater amount of calorie absorption than does purging. Additionally, it causes potassium deficiencies which lead to weakness in the body, intestinal disorder, heart damage, and kidney disease. Weight also fluctuates in binge-purge eaters, another unhealthy aspect for one's body.

Behaviors

Those with bulimia nervosa have been pinpointed as having specific behaviors, although they are not present in full in every bulimic patient, they are trademarks of bulimic individuals which usually exhibit two or three of the following personality traits and behaviors: poor impulse control, have a need to please those around them, become bored easily, are trusting, overly dramatic, exhibit strong emotions which rule decisions, and have mood swings. Despite the need to please others, bulimic patients exhibit signs of antisocial behavior (perhaps in order to better hide the problem), are more likely than other eating disorder patients to be sexually experienced and/or active, and may couple the disorder with drug or alcohol use or abuse.

The DSM-IV checklist for a diagnosis of bulimia nervosa lists four separate criteria.
Recurrent episodes of binge eating.
Recurrent or inappropriate compensatory behavior in order to prevent weight gain.
Symptoms continuing, on average, at least twice a week for three months.
Undue influence of weight or shape on self-evaluation.*

American Psychological Association. (2002) DSM-IV.

Comer, R. J. (2005). Fundamentals of Abnormal Psychology, 4^th Edition. New York, New York. Worth Publishers.