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Bulimia Nervosa - symptoms, causes, and recovery
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.
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About the Author:
Abigail H. Natenshon, MA LCSW has been a psychotherapist in
private practice specializing in the treatment of eating disordered
individuals and their families for the past 28 years. She
is co-founder and director of Eating Disorder Specialists
of Illinois; A Clinic without Walls, and the author of "When
Your Child Has an Eating Disorder: A Step-by-Step Workbook
for Parents and Other Caregivers" (Jossey Bass, San
Francisco, October, 1999). Visit her web sites at www.empoweredparents.com
/ www.empoweredkidZ.com
and www.treatingeatingdisorders.com
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