Bulimia Nervosa

Bulimia Nervosa

The word bulimia comes from the Latin (bulimia) from the Greek (boulimia), ravenous hunger. Bulimia nervosa, also called bulimia, is a psychological eating disorder. Sometimes a person with anorexia or bulimia starts out just trying to lose some weight or hoping to get in shape. But the urge to eat less or to purge spirals out of control. Bulimia is characterized by episodes of binge-eating followed by inappropriate methods of weight control known as "purging". Purging can take the form of vomiting, fasting, the use of laxatives, enemas, diuretics or other medications, or compulsive exercising.

* Purging Type: during the current episode of Bulimia Nervosa, the person has regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas

* Nonpurging Type: during the current episode of Bulimia Nervosa, the person has used other inappropriate compensatory behaviors, such as fasting or excessive exercise, but has not regularly engaged in self-induced vomiting or the misuse of laxatives etc.

Eating disorders are more than just going on a diet to lose weight or trying to keep exercising every day. They are extremes in eating behavior -- the diet that never ends and gradually gets more restrictive, for example. Or the person considers working off what she or he has eaten more important than going out and meeting friends.

Risk factors for bulimia are similar to those of other eating disorders, such as anorexia:

* being from a western culture

* obesity

* exposure to a restrictive dieting environment

* low self esteem, social anxiety, depression, feelings of lack of control

The following groups are considered to be at the highest risk:

* those of age 10 through to 25 (though typically bulimia tends to start in late teens or early 20s)

* athletes

* those with a history of anorexia

* students who are under heavy workloads

* those who have suffered traumatic events in their lifetime such as child abuse and sexual abuse

* people raised in dysfunctional families

* those positioned higher on the socioeconomic scale

* the highly intelligent and/or high-achievers

* perfectionists

However, the disorder can occur in people of all ages and both sexes. Eating disorders occur most often in adolescents and young adults. New research finds that they are increasingly prevalent among young children.The disorders are more difficult to identify in young children because they are rarely suspected.

There is a new rise of cases in men. In older patients, symptoms may have continued untreated for several years or decades, making the behaviors increasingly ingrained and difficult to confront. A popular assumption is that eating disorders are female diseases, but 10% of patients are male (men are more apt to conceal them, so the incidence among males may be underreported). Unfortunately, many men do not get the help they need for fear being thought of having a "women's disease".

Most studies of individuals with eating disorders have been conducted using Caucasian middle-class women. Studies now indicate, however, that minority populations are significantly affected. There is some indication that African-American girls and young women may be at particular risk for eating disorders because of poor body images caused by cultural attitudes that denigrate the physical characteristics of minorities.

Causes

No one is really sure what causes eating disorders, although there are many theories about why people develop them. In the studies of bulimia nervosa there is a continuing debate concerning the underlying cause of the disease - whether it is physiological or psychological. Studies have found convincing results for both theories.

Eating disorders are complex conditions caused by a combination of emotional, family, interpersonal, biological, socio-cultural, and precipitating factors. Bulimia is felt to be based on a person's dissatisfaction with their own body image and is related to deep psychological issues and feelings of lack of control Many people develop the disorder being a teenager, when we are exposed to emotional and physical changes, problems at school and in relation with family, peer pressure. It is a difficult period when we feel a great need for independence but we experience the frustrating feeling of lacking control over our personal freedom, behavior and body, simultaneously. Girls gain some additional body fat during puberty, some respond to this natural and necessary change by becoming very fearful of their new weight. They might mistakenly feel obliged to get rid of it any way they can. Many people stress the role of pop culture in this area as a reason for this corrupted self image and need to act against the nature. Teenagers, not even being fully aware of it, are surrounded with pictures of extremely thin celebrities and want to follow this example and usually develop negative self-image (the individual may actually be underweight) as well. Modern culture heavily emphasizes healthy lifestyle that is respresented by fit and skinny people and such requirements seem to be the ultimate ones to gain acceptance when fulfilled.

Studies have shown eating disorders occur more frequently in relatives of people with bulimia than in others. It may be interpreted as a proof that genetics can make us more likely to become bulimic. On the other hand it indicates how important family is, the support we receive from our enviromnent - or lack of it, the role models and set of principles we are shown.

Organic causes for bulimia are being investigated. There is evidence that bulimia and other eating disorders may be related to abnormalities in levels of chemical messengers within the brain, specifically the neurotransmitter serotonin. Other studies of people with bulimia have found alterations in metabolic rate, decreased perceptions of satiety, and abnormal neuroendocrine regulation.

Diagnosis and symptoms