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DESCRIPTION
Bulimia nervosa is an psychological eating disorder characterized by abnormal perception of body image, constant craving for extremely large amounts of high-calorie foods, episodes of uncontrolled binge eating of these foods, followed by self-induced vomiting or laxative use to "purge" the body of the foods eaten during the binge. The binge eating and purging are carried out in secret. This is a serious medical and psychological problem with potentially dangerous complications that affects primarily adolescents or young adults, usually female and those with appearance stressed professions, such as models, actors and dancers.
Unlike people with anorexia , whose self-starvation eventually becomes obvious, those with bulimia can hide the disorder for long periods, even years, because their weight is usually in the normal range (some are even overweight) and the binging and purging are done in secret.
People with bulimia often feel extremely guilty about their behavior, which is why they may successfully hide the disorder for years, even from their spouses and children. Trips to the bathroom after meals, the sudden disappearance of large quantities of food, frequent dental visits, and mood changes may be hints that something is wrong.
FREQUENT SIGNS AND SYMPTOMS
Recurrent episodes of binge eating (rapid consumption of a large amount of food in a short time, usually less than 2 hours), plus at least 3 of the following:
- Preference for high-calorie, convenience foods during a binge.
- Secretive eating during a binge. Patients are aware that the eating pattern is abnormal, and they fear being unable to stop eating.
- Termination of an eating binge with purging measures, such as laxative use or self-induced vomiting.
- Depression and guilt following an eating binge.
- Repeated attempts to lose weight with severely restrictive diets, self-induced vomiting and use of laxatives or diuretics.
- Frequent weight fluctuations greater than 10 pounds from alternately fasting and gorging.
- People who regularly disappear into the bathroom after meals, experience mood swings, make frequent visits to the dentist and are present when large quantities of food suddenly disappear could be suffering from bulimia.
- No underlying physical disorder.
Physical signs of bulimia may include:
- Bad dreams.
- Hair loss.
- Yellow and/or dry skin.
- Premature wrinkles.
- Bad breath.
- Extreme premature weakness.
- Muscle fatigue.
- Dizziness.
The physical signs of bulimia contributed to induced vomiting may be:
- Broken blood vessels in the face and eyes.
- Swollen glands in the face and neck.
- Erosion of the enamel on the back of the teeth.
- Swollen salivary glands, resulting in a "chipmunk" appearance.
- Constant sore throat.
- Inflammation of esophagus.
- Hiatal hernia.
- Sometimes emboweled spoons or sticks used to induce vomiting have to be surgically removed.
If laxative abuse is a part of the picture:
- Damage to the bowel.
- Rectal bleeding.
- Perpetual diarrhea may result.
- Laxative use also washes potassium and sodium from the body, which can lead to electrolyte imbalances that may lead to dehydration, muscle spasms, and eventually cardiac arrest.
CAUSES
There is no known cause for bulimia, but experts think it is the result of a combination of psychological, biological and societal factors. The condition can also be hereditary.
The causes of bulimia are most often psychological in nature, and episodes of binging are often stress related. Binging may be a means by which an individual with bulimia attempts to manage emotions; they allow the person to focus attention away from unpleasant or uncomfortable emotional problems. People with bulimia may also be obsessed with exercise as a means of controlling weight.
This disorder affects many more women than men, especially those in professions that stress appearance, such as modeling, acting, or dance. Obsession with weight can also result from social factors. In today's society, we are constantly bombarded with the message that "thin is in" - and the thinner the better. As many as 1 in 8 girls between the ages of 13 and 19, including college students, may have this disorder.
Many individuals who suffer from this disorder come from families in which they were subjected to mental, physical or sexual abuse. In some families, substance abuse is also a factor. Many women started their first binge because of real or imagined male rejection. Others are perfectionists and overachievers with high standards but low self-esteem. particularly if a woman's basic emotional needs were not met in childhood, she may come to believe that her problems would be resolved if only she were attractive (that is thin) enough, and this obsession leads to bulimia.
There are indications of possible physiological elements in this disorder as well. For example, people with eating disorders tend to have a type of chemical imbalance similar to one found in persons with clinical depression. Both have high levels of adrenocorticotropic hormone (ACTH), a hormone produced by the pituitary gland that inhibits T cell function and thereby depresses immunity. People who suffer from bulimia may also have low levels of the neurotransmitter serotonin, which can lead to cravings for simple carbohydrates - common binge foods.
According to research, lack of a hormone that controls appetite may be the reason bulimics fail to feel full. In such persons, eating a meal apparently does not stimulate adequate production of the hormone cholecystokinin-pancreozymin (CCK), which is found in the small intestine and the brain. They have to keep eating and binging, in order to feel satisfied. However, more research is needed to determine whether this is the cause behind the majority of cases of binge eating.
A study conducted at the University of Iowa College of Medicine and the University of Wisconsin found that reducing weight as part of athletic training may lead to bulimia. A survey of 700 high school wrestlers found that 2 percent were involved with binge eating followed by vomiting, fasting, excessive exercise, or the use of laxatives to avoid weight gain.
RISK INCREASES WITH
Strict, compulsive, perfectionist family environment.
Anorexia nervosa.
Depression.
Stress, including lifestyle changes, such as moving or starting a new school or job.
Neurotic preoccupation with being physically attractive.
PREVENTIVE MEASURES
Raise children in a wholesome family environment with emphasis on caring and good communication rather than on external appearances.
Encourage rational attitude about weight.
Avoid stress.
EXPECTED OUTCOME
Outcome is variable; patients can learn to control the behavior with counseling, psychotherapy, biofeedback training and individual or group psychotherapy.
POSSIBLE COMPLICATIONS
Dental problems including erosion of the enamel of back teeth and cavities.
Ulcers.
Internal bleeding; stomach rupture (rare).
Inflammation of the throat.
Dehydration.
Pancreatitis.
Hypoglycemia.
Erratic heartbeat, low pulse rate and low blood pressure.
Cessation of menstrual cycles.
Fluid and electrolyte imbalance from vomiting.
Kidney damage.
Serious medical problems that without treatment the complications can be fatal. Bulimia is a very serious illness that can lead to anemia, fluid depletion, electrolyte imbalances, infertility, internal bleeding, malnutrition and many other disorders. If not treated, bulimia can lead to various cancers, kidney damage, liver damage and cardiac arrest.
Relapse.
TREATMENT
GENERAL MEASURES
Psychiatric consultation is frequently necessary to overcome bulimia, as the cause is most often psychological. Long-term treatment may be needed to improve self-esteem. Therapy will consist of assessing nutritional status, establishing target goals, identifying triggers, improving relationships, overall well-being, techniques to avoid stress, etc.
Treatment in an eating disorder facility may be recommended.
Hospitalization in severe cases.
Psychotherapy or counseling that may include hypnosis or biofeedback training.
Additional information available from: American Anorexia/Bulimia Association, Inc. (AABA)
C/O Regent Hospital
293 Central Park West, Suite 1R
New York, NY 10024
Phone: (212) 575-6200
Website: www.aabainc.org
American Anorexia/Bulimia Association (AABA): New Jersey Chapter
10 Station Place
Metuchen, NJ 09940
Phone: (732) 549-6886
Toll Free: (800) 522-2230 (NJ Only)
Fax: (609) 688-1588
Website: www.njaaba.org
National Eating Disorders Association (NEDA)
(Formerly National Eating Disorders Organization [NEDO])
(Formerly Eating Disorders & Prevention, Inc. [EDAP])
603 Stewart Street, Suite 803
Seattle, WA 98101
(206) 382-3587 Ext 10
(206) 829-8501 Fax
Information & Referral Helpline: 1-800-931-2237
Website: www.nationaleatingdisorders.org
Center for the Study of Anorexia and Bulimia (CSAB)
1841 Broadway, 4th Floor
New York, NY 10023
Phone: (212) 333-3444
Website: www.icpnyc.org
Anorexia Nervosa & Related Eating Disorders (ANRED)
P.O. Box 5102
Eugene, OR 97405
(503) 344-1144
Website: www.anred.com
National Association of Anorexia Nervosa and Associated Disorders (ANAD)
Box 7
Highland Park, IL 60035
Phone: (847) 432-8000 EXT 5728
Fax: (847) 433-4632
Website: www.anad.org
Massachusetts Eating Disorders Organization, Inc. (MEDA) 92 Pearl Street
Newton, MA 02158
Phone: (617) 558-1881
Fax: (617) 558-1771
Website: www.medainc.org
MEDICATION
Antidepressants may be prescribed. They are sometimes helpful for some patients.
ACTIVITY
No restrictions.
Possible lifestyle changes include eating a well-balanced diet filled with high-fiber foods and complex carbohydrates. Consume no sugar, junk foods, heavy starches or white flour products. Eat smaller, more frequent meals to avoid feeling hungry or overly full. Chew food well and stop eating before uncomfortably full. Keep a journal to track food choices and emotions associated with eating. Work against cravings by having healthy snacks on-hand, drinking plenty of water and focusing on activities that take the mind off of food, like going for a walk or working on a project. Use stress management techniques, like exercise, meditation and yoga, instead of food to soothe stressful situations.
DIET, SUPPLEMENTS & NUTRIENTS
If hospitalization is necessary, intravenous fluids may be prescribed. During recovery, vitamin and mineral supplements will be necessary until signs of deficiency disappear and normal eating patterns are established.
For outpatient therapy, supervision and regulation of eating habits, a food diary may be maintained, feared foods will be reintroduced.
While healthier eating behaviors are being established, try to eat a well-balanced, high- fiber diet.
Consume no sugar in any form. Avoid junk foods and white flour products. Be aware that you may experience withdrawal symptoms such as anxiety, depression, fatigue, headache, insomnia, and/or irritability for a time after you eliminate sugar from the diet.
Note: Nutritional supplements are available from HerbalRemedies.com and bulk herbs are available from Mountain Rose Herbs. Links to both of these websites are given below. They offer great natural-organic products with great prices.
NUTRIENTS Supplement Suggested Dosage Comments Very Important Multivitamin and mineral complex
With
Vitamin A
And
Natural beta-carotene
And
Potassium
And
SeleniumAs recommended by health care provider.
15,000 IU daily. If you are pregnant, do not exceed 10,000 IU daily.
25,000 IU daily.
100 mg daily.
200 mcg daily.The bulimic syndrome results in extreme vitamin and mineral deficiencies. Extremely high doses are needed because nutrients pass rapidly through the gastrointestinal system and are poorly assimilated. Do not use a sustained-release formula. Alive! Whole Food Energizer Multi-Vitamin with Minerals, Naturally Occurring Iron (No Iron Added), Nature's Way - 180 Tabs, Multi-Vitamin / Multi-Mineral Supplements Zinc 50 mg daily. do not exceed a total of 100 mg daily from all supplements. Necessary in protein metabolism; aids the sense of taste and increases the appetite. Deficiencies are common in people with this disorder. Zinc Ionic Mineral Supplement, Fully Absorbable, 100 +/- ppm, 16 fl. oz., Ionic Zinc, 50 mg, 2 fl. oz., Trace Minerals, Zinc (Chelated), 100% Natural, Nature's Way, 30 mg, 100 Caps Plus
Copper3 mg daily. Needed to balance with zinc. Copper Ionic Mineral Supplement, Fully Absorbable, 50 +/- ppm, 16 fl. oz. Important Acidophilus As directed on label. Take on empty stomach so it can pass quickly to the small intestine. Stabilizes intestinal bacterial. Protects the liver. Acidophilus Powder, Non-Dairy, 4 oz. Bulk, Lactobacillus Acidophilus, Kosher Liquid, All Natural, Vegetarian Medium, Lactose Free, Apple-Strawberry Flavor, 16 fl. oz., Dynamic Health, Acidophilus & Bifidus, NOW Foods, 8 Billion, 60 Caps Calcium 1,500 mg daily at bedtime. Has a calming effect and replaces lost calcium stores. Coral Calcium Complex Liquid, 100% Pure Okinawan, 32 fl. oz., Dynamic Health, Calcium Ionic Mineral Supplement, Fully Absorbable, 700 +/- ppm, 16 fl. oz., Just An Ounce Calcium & Magnesium Liquid, Almond Flavor, 16 fl. oz. Magnesium 750 mg daily. Works with calcium. Magnesium relaxes smooth muscle and has a bronchodilating effect. Just An Ounce Calcium & Magnesium Liquid, Almond Flavor, 16 fl. oz., Calcium & Magnesium Mineral Complex, 100% Natural, Nature's Way, 500 mg / 250 mg, 250 Caps Free-form amino acid complex As directed on label. To counteract protein deficiency, a serious problem in bulimia. Free-form amino acids are more readily available for use by the body than other protein forms. Amino 1000 Complete, 20 Essential & Non-Essential Amino Acids, Now Foods, 120 Caps Vitamin B complex 100 mg 3 times daily. Essential for all cellular functions. Ultimate B Complex Formula, Nature's Secret, 60 Tabs, Vitamin B Complex, W/Coenzyme B-2, Nature's Way, 631 mg, 100 Caps Vitamin B-12 injections 1 cc 3 times weekly or as prescribed by health care provider. Needed for the digestion of foods and the assimilation of all nutrients, including iron. Injections (under a health care provider's supervision) are best. If injections are not available, use a lozenge or sublingual form. Vitamin B-12, 2000 mcg, 100 Sublingual Lozenges Plus
Liver extract injections2 cc 3 times weekly or as prescribed by health care provider. A good source of B vitamins and other valuable nutrients. Vitamin C 5,000 mg daily, in divided doses. Necessary for all cellular and glandular functions. Vitamin C Liquid, with Rose Hips & Bioflavonoids, Kosher, Natural Citrus Flavor, 1000 mg, 16 fl. oz., Dynamic Health, Vitamin C 1000 with Bioflavonoids, Nature's Way, 100% Natural, 1000 mg, 250 Vcaps, Vitamin C Supplements & Products / Ascorbic Acid / Ester C Helpful Bio-Strath from Bioforce As directed on label, 3 times daily. For increased strength and energy. Aids in tissue repair and increases the appetite. Contains the B vitamins and other necessary nutrients. Or
Brewer's yeastStart with 1 tsp daily and work up to the amount recommended on label. A good source of B vitamins. Brewers yeast, Debittered, NOW Foods, 1 lb., Brewers Yeast, NOW Foods, 650 mg, 200 Tabs Iron ( Ferrous fumarate from Freeda Vitamins) As directed by physician. Take with 100 mg vitamin C for better absorption. To correct deficiencies and increase appetite. Caution: Do not take iron unless anemia is diagnosed. Iron Ionic Mineral Supplement, Fully Absorbable, 20 +/- ppm, 16 fl. oz., Iron Gluconate, Nature's Way, 18 mg, 100 Caps, Iron Complex with Vitamins and Herbs, Vegetarian, NOW Foods, 250 Tabs Or
Floradix Iron + Herbs from Salus HausAs directed on label, 3 times daily. A natural iron supplement than is easily assimilated. Iron Ionic Mineral Supplement, Fully Absorbable, 20 +/- ppm, 16 fl. oz., Iron Gluconate, Nature's Way, 18 mg, 100 Caps, Iron Complex with Vitamins and Herbs, Vegetarian, NOW Foods, 250 Tabs Kelp 2,000-3,000 mg daily. Supplies essential minerals especially iodine. Kelp Supplement, Nature's Way, Certified 650 mg, 100 Caps, Kelp Seaweed, Norwegian, NOW Foods, 100% Natural Acophyllum nodosum, 550 mg, 250 Caps Proteolytic enzymes As directed on label. Take with meals and between meals. Important for proper digestion and absorption of nutrients. Enzymes, All Complete, 250 mg, 90 Caps, Enzymes / Digestive Enzymes / Enzyme Supplements Or
Infla-Zyme Forte from American BiologicsAs directed on label. Take with meals and between meals. Important for proper digestion and absorption of nutrients. Vitamin D 600 IU daily. Needed to aid in calcium uptake and prevent bone loss, which can lead to tooth loss. Vitamin D, 400 IU, Nature's Way, 100% Natural, 100 Caps, Vitamin D, 1000 IU, NOW Foods, 180 Softgels, Vitamin D, NOW Foods, 2000 IU, 120 Softgels Vitamin E 600 IU daily. Necessary for tissue repair and a powerful antioxidant. Vitamin E-1000, Now Foods, 1000 IU, 100 Gels, Vitamin E, d-alpha tocopherol, 400 IU, 100 Softgels, Vitamin E Supplements & Products / Alpha-tocopherol ACES + Zinc from Carlson Labs As directed on label. To supply a combination of antioxidants.
BULIMIA SUPPLEMENTAL PRODUCTS
Supplements and information for help with bulimia, an eating disorder characterized by episodes of binge eating and purging.
Zinc Ionic Mineral Supplement, Fully Absorbable, 100 +/- ppm - 16 fl. oz.
WaterOz Ionic Zinc is a pure liquid Zinc supplement. Zinc moves through all the fluids in the body, it creates a defense against infection-causing bacteria and viruses trying to enter the body and stops bacterial and viral replication.Alive! Whole Food Energizer Multi Vitamin with Mineral, Nature's Way 18mg of Iron added - 90 Tabs
Alive Whole Food Energizer Multi Vitamin with Mineral with Iron by Nature's Way is absorbed into your blood stream 5 times faster than other leading brands.Once Daily Multi Vitamin & Mineral, All Natural, Lactose Free, w/ Iron - 100 Tabs
Nature's Way Daily Multi Vitamin & Mineral provides many of the essential nutrients that modern diets may lack. They are useful for protection, growth and maintenance of body systems as they age.Acidophilus Powder, Non Dairy - 4 oz. Bulk
Acidophilus Powder taken as a dietary supplement may help to detoxify and to rebuild a balanced intestinal flora.CoQ10, Vegetarian Coenzyme, NOW Foods 30mg - 60 Vcaps
A coenzyme for several key steps in the production of energy within each cell, and an antioxidant important in its clinical effects. It is these two properties make CoQ10 one of the best supplements available today.B-Stress Vitamin Complex w/ Siberian Eleuthero (Formerly Siberian Ginseng Root), Nature's Way - 100 Caps
If you're looking for herbal stress relief, you've come to the right place. B vitamins are essential precursors of coenzymes involved in the conversion of cellular energy, manufacture of hormones and proteins, and repair and maintenance of nerve structures.Red Clover Blossom & Herb, 500mg - 100 Caps
In Europe Red Clover is widely cultivated and used as a tonic and a salad herb. Herbalists have long prized Red Clover for it's traditional use as a blood purifier and it's isoflavones that offer great medicinal potential.St. Johns Wort Standardized Extract, 300mg - 90 Caps
St. John's Wort promotes a positive mood and extracts have been proven in many clinical studies in Europe, to have antidepressant effects, and is widely used for this reason.Mood Aid Formula with St. Johns Wort & 5-HTP Nature's Way - 60 Caps
Mood Aid uses St. John's Wort, to promote a positive mood. 5-HTP, the precursor of seratonin - a mood regulating neurotransmitter.5-HTP The Natural Serotonin Solution By Richard Passwater, Ph.D. & J. South, M.A
Explains how 5-HTP (Hydroxytryptophan) helps raise serotonin levels to alleviate depression, insomnia, anxiety and eating disorders.
NOTIFY YOUR MIDWIFE OR HEALTH CARE PROVIDER IF...
You have symptoms of bulimia or you suspect your child has bulimia.
The following occur during treatment:
- Rapid, irregular heartbeat or chest pain.
- Loss of consciousness.
- Cessation of menstrual periods.
- Repeated vomiting or diarrhea.
- Continued weight loss, despite treatment.
MoonDragon's Obgyn Information: Anorexia Nervosa
More information about a closely related, often seen eating disorder associated with bulimia. Has more dietary information to assist in recovery.
Mountain Rose Bulk Herbs
Mountain Rose Aromatherapy Oils
Click Here To Visit Herbal Remedies Product Page
MoonDragon's Health Index Page
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