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Bulimia

Bulimia is an illness in which a person binges on food or has regular episodes of overeating and feels a loss of control. The person then uses different methods -- such as vomiting or abusing laxatives -- to prevent weight gain. Many (but not all) people with bulimia also have another eating disorder called anorexia nervosa.

Causes

Bulimia is much more common in women. The disorder is most common in adolescent girls and young women. The affected person is usually aware that her eating pattern is abnormal and may feel fear or guilt with the binge-purge episodes. The exact cause of bulimia is unknown. Genetic, psychological, trauma, family, society, or cultural factors may play a role. Bulimia is very likely due to more than one factor.

Symptoms

In bulimia, eating binges may occur as often as several times a day for many months. The typical pattern is a person who often eats large amounts of high-calorie foods, usually in secret. People can feel a lack of control over their eating during these episodes. Binges lead to self-disgust, which causes purging to prevent weight gain. Purging may include:

  • Forcing yourself to vomit
  • Excessive exercise
  • Using laxatives, enemas, or diuretics (water pills)
  • Purging often brings a sense of relief.

People with bulimia are often at a normal weight, but they may see themselves as being overweight. Because the person's weight is often normal, other people may not notice this eating disorder.

What may alert you to a dear one having bulimia
  • Compulsive exercise
  • Suddenly eating large amounts of food or buying large amounts of food that disappear right away
  • Regularly going to the bathroom right after meals
  • Throwing away packages of laxatives, diet pills, emetics (drugs that cause vomiting), or diuretics
Examination and Tests
  • A dental exam may show cavities or gum infections (such as gingivitis)
  • The enamel of the teeth may be worn away or pitted because of too much exposure to the acid in vomit
  • Broken blood vessels in the eyes (from the strain of vomiting)
  • Dry mouth
  • Pouch-like look to the cheeks
  • Rashes and pimples
  • Small cuts and calluses across the tops of the finger joints from forcing oneself to vomit
  • Blood tests may show an electrolyte imbalance (such as hypokalemia) or dehydration
Treatment

People with bulimia go to the hospital for the following problems:

  • Anorexia
  • Major depression
Most often, a step-wise approach is used for patients with bulimia. The treatment approach depends on how severe the bulimia is, and the person's response to treatments. Support groups may be helpful for patients with mild conditions who do not have any health problems. Cognitive-behavioral therapy (CBT) and nutritional therapy are the first treatments for bulimia that does not respond to support groups. Antidepressants known as selective serotonin-reuptake inhibitors (SSRIs) are often used for bulimia. A combination of CBT and SSRIs is very effective if CBT does not work alone. Patients may drop out of programs if they have unrealistic hopes of being "cured" by therapy alone.

Before a program begins, you should know that:

  • You will probably need to try many different therapies to overcome this difficult disorder
  • It is common for bulimia to return (relapse), and this is no cause for despair
  • The process is painful, and you and your family will need to work hard

Outlook (Prognosis)

Bulimia is a long-term illness. Many people will still have some symptoms, even with treatment.People with fewer medical complications of bulimia, and those who are willing and able to take part in therapy have a better chance of recovery.

Possible Complications

Bulimia can be dangerous. It may lead to serious medical complications over time. Possible complications include:

  • Constipation
  • Dehydration
  • Dental cavities
  • Electrolyte imbalances
  • Hemorrhoids
  • Pancreatitis
  • Swelling of the throat
  • Tears of the esophagus from too much vomiting


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