Bulimia: What is it and When to Get Help

bulimia

Food and eating can be a source of comfort for many people, but for others it can be a source of anxiety, stress, and shame. Thanks to the massive influence of media and entertainment in modern society, many people have developed unrealistic ideas about body size and shape, and this has contributed to the development of mental health disorders related to eating for many men and women around the world.

There are several different eating disorders, and each one of them involve different struggles related to restricting or controlling the way a person eats and what they eat as well. No matter the type, eating disorders usually arise due to a person experiencing severe lack of confidence in their personal appearance that causes them to engage in unhealthy behavior that can be life threatening if it is not treated.

This article will discuss bulimia; we will discuss what bulimia is and when a person should seek support and treatment to overcome it.

Bulimia, or Bulimia Nervosa, is described by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)  as involving the following symptom criteria:

  • Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
    • Eating, in a discrete period of time (e.g. within a two-hour period), an amount of food that is definitely larger than what most people would eat during a similar period of time and under similar circumstances.
    • Lack of control overeating during the episode (e.g. a feeling that you cannot stop eating, or control what or how much you are eating).
  • Recurrent inappropriate compensatory behavior to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics, or other medications, fasting, or excessive exercise.
  • The binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for three months.
  • Self-evaluation is unduly influenced by body shape and weight.
  • Binging or purging does not occur exclusively during episodes of behavior that would be common in those with anorexia nervosa.

Researchers believe that about 30 million people have been diagnosed with some form of an eating disorder. Eating disorders are much more frequently diagnosed in women than in men, and studies have shown that 1.5% of American women have been diagnosed with bulimia.

People who struggle with bulimia engage in what is called “binge eating”; this involves eating to excess in large quantities, then engaging in problematic behaviors to get rid of the food to avoid gaining weight.

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This could mean vomiting, using laxatives or other diuretics, excessive exercise, or any other strategy to compensate for the number of calories that have been eaten. Continued binging and purging of food can lead to life-long health consequences if not remedied. For example, repeated incidents of binging and purging can cause a person to become dehydrated, losing key electrolytes needed to keep the body running appropriately. Recurrent vomiting can also cause internal damage, including tears or ruptures in the digestive tract, heart problems, nutritional deficiencies, tooth decay and many more problems that could even lead to death.

The following is a list of signs and symptoms that you, or someone you love may be experiencing bulimia nervosa and may be in need of help and support:

  • Eating a large amount of food in a set period of time (often within 2 hours).
  • Binge eating in secrecy.
  • Exercising much more than normal to compensate for the food consumed.
  • Feeling as though one’s eating is out of control.
  • Feelings of guilt or shame accompanying binges.
  • Increased risk of cavities and loss of dental enamel due to repeated vomiting.
  • Scarring on the back of the hand from stimulating the gag reflex.
  • Swollen salivary glands due to self-induced vomiting.
  • Vomiting, fasting, or using laxatives or diuretics to compensate for the food consumed.

While bulimia can obviously lead to severe physical health complications and is considered a medical problem, it is primarily a mental health condition that is frequently accompanied by other mental health issues, such as depression or anxiety.

Studies have found that almost half of those surveyed that are struggling with bulimia also have a diagnosis of bipolar disorder or depression and more than half have an anxiety disorder diagnosis.

The combination of these mental health concerns can cause increased feelings of guilt or shame in people experiencing bulimia and could cause them to withdraw and not seek out treatment or help when they really need it. That is why it is important for all of us to know the signs and red flags to look out for regarding bulimia so that we can identify when a loved one (or ourselves) is struggling and get the help that is needed.

If you or someone you know is experiencing any of these symptoms and they seem to cause a disruption in the person’s overall functioning in life, it is important to get assistance from a mental health professional. 

When someone is able to identify that they are struggling from symptoms of bulimia, that can be the first step in helping them to get the help that they need. Symptoms of bulimia often require psychological treatment to help a person recognize where their struggles with their body image are coming from and how to use healthier coping skills to improve their overall health and functioning.

For those experiencing minor signs or symptoms of bulimia, they may be able to work with a mental health professional in an outpatient setting where they can meet weekly and work on helping the person develop insight into their struggles and to find new ways to manage their self-image distortions. If a person is experiencing severe signs of bulimia where they cannot function on their own without engaging in binging and purging behavior, they may need to participate in a treatment recovery program that is in a residential setting. These kinds of environments can help a person begin to understand how their bulimia symptoms developed and how they can relearn to manage food and nutrition in a healthy way.

Overall, seeking a consultation with a mental health professional who is an expert on eating disorders is the first step to learning what may be the best option for you.

Here are some resources that can get you the help that you need:

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Dr. Shannon McHugh is a Licensed Clinical and Forensic Psychologist in Los Angeles, California. She specializes in assessment and treatment of children, adolescents, and adults who have developmental and social delays, behavioral difficulties, and those who have experienced traumatic events
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