What is Bulimia Nervosa?
Bulimia Nervosa is an eating disorder marked by out of
control eating followed by some form of purging. It
typically accompanies a pathological fear of weight gain
leading to food restriction, followed by the need to gorge
in response to extreme hunger. The excessive caloric intake
leads to the perceived need to purge. With bulimia, eating
becomes disregulated and feels out of control.
What is a bulimic binge?
Bulimic eating episodes are called binges; binges are
defined as the consumption of large amounts of food during
a short period of time. In some instances, victims of
bulimia cannot stop eating until they have consumed so much
food that their body and skin aches. In other instances,
victims of bulimia report having "binged" on as few as 5
grapes, or on three teaspoons of cottage cheese. It is my
opinion that a bulimic binge has less to do with the amount
of food consumed, and more to do with the sense of being
out of control and virtually compelled to consume the food.
The manner in which the food is consumed (generally
frenzied and mindless, where the food is hardly tasted) is
also important in determining a binge. Many bulimics
describe a "trance-like" state that comes over them when
they are binge eating.
As an example of a binge episode, one young woman with
bulimia found herself, at a time of great stress, compelled
to drive into a 7-11 convenience store where she purchasing
three cupcakes; she then proceeded to stuff them down her
throat whole in an emotional frenzy in the dark and
deserted alley behind the store. As far as she was
concerned, her binge had begun at the moment when she drove
her car up to the front door and did not finish until she
had purged the cupcakes. She felt that she was in an
altered state throughout the five-minute interval, and
experienced a profound sense of relief from her anxiety
following the binge/purge cycle. The bulimic cycle releases
endorphins, brain chemicals that infuse a person with a
sense of numbness or euphoria. Ironically, the relief
passes in short order, only to be replaced by anxiety and
guilt for the bulimic behaviors.
What causes bulimia?
Bulimia results from the coming together of diverse
factors, both chemical and environmental. People are born
with an inherited predisposition towards developing
bulimia, particularly where addiction is in the genes. Bulimic
individuals who experience the hardest struggle in making a
full recovery are those who suffer from addictions to
substances. A significant correlation between the
development of clinical bulimia nervosa and sexual abuse
has also been proven.
In addition to genetics, environmental factors can
contribute to triggering the onset of bulimia. These
include peer pressures, family attitudes, the influence of
the media creating a need for thinness, poor self-esteem
and a lack of acceptance of self and body shape. In
addition, poor eating habits can be the start of a problem
that can eventually escalate to bulimia; dieting and
excessive hunger lead to gorging and gorging leads to the
propensity to purge. The bottom line, however, is that
bulimia and anorexia are the misuse of food to resolve
emotional problems. When a person is incapable of facing
feelings, defining problems, and resolving them
effectively, that person is more apt to become susceptible
to the onset of bulimia. Bulimia and anorexia are the most
lethal of all the mental health disorders, killing or
maiming for six to thirteen percent of its victims, 87
percent of whom are individuals under twenty years of age.
What are the symptoms of bulimia?
Other symptoms of bulimia may include the abuse of
laxatives, diuretics, and/or diet pills, all of which are a
form of purging. Another very common form of bulimia is
compulsive and excessive exercising, which is also commonly
known as an activity disorder.
How easy is it to recognize bulimia?
How easy is it to recognize bulimia in a loved one? Not
easy at all. Bulimic individuals appear to be of normal
weight most often. Being a secretive disease, there is
typically no way to recognize bulimia simply
by observing visible behaviors. Observers need to learn to
read the hidden signs of a hidden disease. Most often,
bulimia is a disease that the victim covets and holds close
as a result of the fear of loosening a grip on a crutch
that has gotten them through life and hard times. By
purging one's dinner, (i.e. taking control of one's own
body) the victim feels in control of his or her life. With
bulimia, purging becomes a metaphor for refusing to face
and deal with all of life's difficulties. Bulimia rarely
shows up in the doctor's office or in lab tests for blood
and urine.
Who suffers from bulimia?
Children are reported to suffer from bulimia at ever
younger ages. The average age of onset has recently dropped
from 13 - 17 to ages 9 - 12. As girls reach puberty at ever
younger ages, they find themselves growing larger at
precisely the time when they are most aware of society's
prescription for them to be thin. Dieting, rather than
healthy eating, becomes a way of life for children in
search of thinness. Dieting damages healthful
metabolic processes and establishes unhealthy eating habits
that bring young people into their adult years with a
propensity for disordered eating and obesity.
The unresolved issues and dysfunctional habits connected
with bulimia is frequently brought into a person's adult
years. Many bulimic individuals in their 20's, 30's and
40's have harbored these secret diseases alone and isolated
for decades at a time. A member of my therapy group for
adults with bulimia and anorexia stated that during the 20
years of her bulimia, she had never told a single person of
her struggles. She believes that her husband and four
children still do not know. Another gal spoke of seeing a
psychiatrist for seven years twice a week without
confessing to him that she was bulimic. When asked why, she
stated that she felt he would be “grossed out” and would
not want to work with her anymore.
Do people recover from bulimia?
It has been said that “Once bulimic, always
bulimic.”
Not so. Research has shown that where detected early and
treated effectively, 80% of victims of bulimia recover.
There is every reason to believe that outcomes can and will
be good to cure the disease, as well as improve the quality
of life for the sufferers of bulimia. My book,
When Your Child
Has an Eating Disorder is a reader-friendly and effective
guide for patients, parents and professionals in bringing
about healing.
