Bulimia nervosa is an eating disorder and mental health condition. People who have bulimia try to control their weight by severely restricting the amount of food they eat, then binge eating and purging the food from their body by making themselves vomit or using laxatives.
Causes of Bulimia
There is no simple answer to the question of what causes bulimia. Although the condition is linked to a fear of getting fat, more complex emotions usually contribute. The act of binging and purging is often a coping mechanism.
1.Common emotional causes
Common problems that may lead to bulimia include:
Bulimia can also occur in people who have experienced physical illness, sexually abuse and difficult childhood, with family problems, arguments and criticism.
Bulimia is often linked to other psychological problems. Research shows that bulimia is more common in people who have:
obsessive compulsive disorder (OCD)
post-traumatic stress disorder (PTSD)
2.Cultural and social pressure
Some people believe that the media and fashion industries create pressure for people to aspire to low body weights.
Many young people become affected by eating disorders around the time of puberty, when hormonal changes can make them more aware of their body.If teenagers feel they have no say in their lives, bulimia can seem like the only way to take control.
There may be a genetic factor related to developing bulimia. Research suggests that people who have a close relative who have or had bulimia are four times more likely to develop it than those who do not.
4.Men and bulimia
The causes of bulimia in men can be slightly different. In many cases, bulimia develops because of bodybuilding or specific occupations like athletics, dancing or horse racing. However, like many women, younger men are increasingly becoming more vulnerable.
Eating disorders are often associated with an abnormal attitude towards food or body image.
People suffering from eating disorders tend to use their eating habits and behaviours to cope with emotional distress, and often have an abnormal or unrealistic fear of food, calories and being fat.
Because of this fear, people with bulimia nervosa tend to restrict their food intake. This results in binge eating followed by purging by vomiting or using laxatives. Less common methods of purging include taking diet pills, over-exercising, extreme dieting, periods of starvation or taking illegal drugs, such as amphetamines. They purge themselves because they fear that the binging will cause them to gain weight, and usually feel guilty and ashamed of their behaviour. This is why these behaviours are usually done in secret. Such binge-purge cycles can be triggered by hunger or stress, or are a way to cope with emotional anxiety.
Cycle of Guilt
Bulimia is often a vicious circle. If you have the condition, it is likely that you have very low self-esteem. You may also think you are overweight, even though you may be at or near a normal weight for your height and build.
This may encourage you to set yourself strict rules about dieting, eating or exercising, which are very hard to maintain. If you fail to keep to these strict rules, you binge on the things that you have denied yourself. After feeling guilty about binging, you purge to get rid of the calories.
Symptoms of Bulimia
The main signs of bulimia are binge eating and purging. There may also be psychological symptoms, such as:
an obsessive attitude towards food and eating
unrealistic opinions about body weight and shape
depression and anxiety
isolation – losing interest in other people
Without treatment, bulimia can lead to a number of physical complications.
Complications of Bulimia
There are a number of physical complications associated with bulimia.
These can include any of the following:
Dental problems – tooth decay. Excessive vomiting can also cause bad breath and a sore throat.
Difficulty in conceiving in the future.
Poor skin and hair
Swollen salivary glands from frequent vomiting which makes the face appear rounder.
Excessive vomiting and laxative use can cause chemical imbalances in your body. This can result in tiredness, weakness, abnormal heart rhythms, kidney damage, convulsions (fits) and muscle spasms.
Bowel problems – excessive use of laxatives can damage your bowel muscles, resulting in permanent constipation.
Heart problems – long-term complications of bulimia can include an increased risk of heart problems.
If you have an eating disorder such as bulimia, the first step is to recognise that you have a problem and visit a doctor. You may think it is not serious, but bulimia can damage your long-term health.
Accepting that you need help and support is the first step to recovery, but this may be a very difficult step for you to take. Most people who have bulimia hide their situation for months or years before seeking help. It can often take a change of situation, such as the start of a new relationship or living with new people, to make a person with bulimia want to seek help.
You can make a full recovery from bulimia. The earlier you start treatment, the quicker the recovery process will be.
People with bulimia need to explore and understand the underlying issues and feelings that are contributing to their eating disorder, and change their attitudes to food and weight. Your doctor may suggest medication, usually in addition to psychological treatment.
There is strong evidence that self-help books can be effective for many people with bulimia nervosa, especially if they ask a friend or family member to work through it with them.
If this is not suitable or is unsuccessful, a structured programme of cognitive behavioural therapy (CBT) under the guidance of a doctor is necessary. Some people may also benefit from antidepressant medication, as this can reduce the urges to binge and vomit.
CBT is the most common type of psychological treatment for bulimia. It involves talking to a therapist and looking at your emotions in detail to work out new ways of thinking about situations, feelings and food. It may also involve keeping a food diary, which will help determine what triggers your binge eating.
Bulimia is not usually treated in hospital. However, if you have serious health complications and your life is at risk, you may be admitted to hospital. Hospital treatment is also considered if you are at risk ofsuicide or self-harm.
The Recovery Process
Once diagnosed, people with bulimia can recover, but it may take a long time. It can be very difficult, both for the person affected and their family and friends.
To recover, someone with bulimia needs to:
change their eating habits
change the way they think about food
gain weight safely, if necessary
The longer someone has had bulimia, the harder it is to re-learn healthy eating habits and gain weight. It is important to start treatment as early as possible, so the person has the best chance of recovery.