What is Bulimia Nervosa?

Bulimia Nervosa affects 1-3% of the American female population and approximately 0.1-0.3% of the male population, according to the American Psychiatric Association. Given that Bulimia Nervosa is a dangerous eating disorder, it is important to be able to recognize the signs and symptoms in yourself or in someone you love.

Bulimia is constituted by recurrent episodes of binge eating and purging behavior. Binge eating consists of eating significantly more than most others would within a given amount of time (such as a two-hour time span). Individuals who binge eat also feel they do not possess control over their eating, how much they eat, or what they eat.

In addition to binge eating, individuals with bulimia engage in inappropriate compensatory behaviors in order to try to avoid gaining weight from binge eating episodes. Inappropriate compensatory behaviors may include: misusing enemas, laxatives, diuretics, or other medications, excessively exercising, self-induced vomiting, and/or fasting.

In order to receive a diagnosis of bulimia, binge eating and purging behaviors must occur on average twice a week for at least three months or longer. Furthermore, individuals who suffer with this eating disorder evaluate themselves based upon their body shape and/or weight.

Two types of bulimia exist - purging type and non-purging type. In purging type bulimia, the individual's inappropriate compensatory behaviors include engaging in the misuse of laxatives, enemas, and/or diuretics and/or engaging in self-induced vomiting. On the other hand, an individual suffering from non-purging type bulimia does not regularly engage in the misuse of laxatives, enemas, or diuretics or self-induced vomiting. Rather she or he typically engages in excessive exercise or fasting as inappropriate compensatory behaviors.

If you have a loved one with this eating disorder, he or she may display warning signs. Individuals who have bulimia may exhibit one or more warning signs, including: binge eating, responding to stress or uncomfortable emotions by eating, depression, weight fluctuations, using the restroom after meals often, feeling out of control, menstrual irregularities, experiencing shame or guilt and may try to hide her or his behavior, tries to diet and fails, having swollen glands, and obsessing about weight. Individuals with bulimia may also eat in secret. If you are a parent and have a child with this eating disorder, you may notice food missing from the cupboards, pantry, or refrigerator or you may find a lot of empty food containers or wrappers in the garbage or hidden around your child's bedroom.

You may also notice the smell of vomit on someone who suffers with bulimia or the smell of vomit in the bathroom after they've used it. Your loved one may try to cover up the smell with air fresheners, perfume, mints, gum, or mouthwash. You may also notice nicks or scars on your loved one's hands or knuckles from repeated, frequent self-induced vomiting. Repeated and frequent vomiting may also lead to "chipmunk" or puffy cheeks and discolored - yellow or clear - teeth.

If you suspect someone you love is suffering from bulimia, please encourage them to seek professional help. Be gentle about it. Perhaps you could say something like, "I've noticed lately that you are really concerned about what your weigh. I've also noticed that you spend a lot of time in the gym working out to lose weight. I'm really worried about you. Are you okay?" This may open up a dialogue about what is going on with your loved one. If he or she doesn't want to talk about the issue, though, don't push it. Simply reiterate that you care about your loved one and suggest that he or she may want to think about seeing a therapist to talk about what's going on.

Bulimia nervosa is a serious eating disorder that can cause dangerous medical consequences to an individual who suffers with it. Recognizing the warning signs and symptoms of the eating disorder may alert you that your loved one needs help. Encouraging your loved one to seek help from a mental health professional may be the first step in her or his journey toward recovery.

Sources:

The Renfrew Center: Bulimia Nervosa:
http://www.renfrewcenter.com/eating-disorders-anorexia-bulimia/bulimia-nervosa.asp

Help Guide: Bulimia Nervosa: Signs, Symptoms, Treatment, and Help:
http://helpguide.org/mental/bulimia_signs_symptoms_causes_treatment.htm

Medicine Criteria: DSM-IV Diagnostic Criteria for Bulimia Nervosa:
http://www.medicalcriteria.com/criteria/bulimia.htm