BULIMIA

WHAT IS BULIMIA? Bulimia nervosa is an eating disorder

characterized by binge eating and purging, or consuming a large amount of food in a short amount of time followed by an attempt to rid oneself of the food consumed (purging), typically by vomiting, taking a laxative, diuretic, or stimulant, and/or excessive exercise, because of an extensive concern for body weight.

SYMPTOMS These cycles often involve rapid and out-of-control eating, which may stop when

the bulimic is interrupted by another person or the stomach hurts from over-extension, followed by self-induced vomiting or other forms of purging. This cycle may be repeated several times a week or, in more serious cases, several times a day and may directly cause:

Chronic gastric reflux after eating; Dehydration and  hypokalemia caused by frequent vomiting; Electrolyte imbalance, which can lead to cardiac arrhythmia, cardiac arrest , and

even death; Esophagitis,or  inflammation of the esophagus ; Boerhaave syndrome, a rupture in the esophageal wall due to vomiting; Oral trauma , in which repetitive insertion of fingers or other objects

causes laceratios to the lining; of the mouth or throat; Gastroparesis or delayed emptying; Constipation; Mallory-Weiss tears; Infertility; Enlarged glands in the neck, under the jaw line; Peptic ulcers; Calluses or scarson back of hands due to repeated trauma from incisors; Constant weight fluctuations are common.

CAUSESA) Biological Like with anorexia nervosa, there is evidence of genetic predispositions

contributing to the onset of this eating disorder.Abnormal levels of many hormones, notably serotonin, have been shown to be responsible for some disordered eating behaviours. Brain-derived neurotrophic factor (BDNF) is under investigation as a possible mechanism.

There is evidence that sex hormones may influence appetite and eating in women, and the onset of bulimia nervosa. Studies have shown that women with hyperandrogenism andpolycystic ovary syndrome have a dysregulation of appetite, along with carbohydrates and fats. This dysregulation of appetite is also seen in women with bulimia nervosa. In addition, gene knockout studies in mice have shown that mice that have the gene encoding estrogen receptors have decreased fertility due to ovarian dysfunction and dysregulation of androgen receptors. In humans, there is evidence that there is an association between polymorphisms in the ERβ (estrogen receptorβ) and bulimia, suggesting there is a correlation between sex hormones and bulimia nervosa.

Dieting, a common behaviour in bulimics, is associated with lower plasma tryptophan levels. Decreased tryptophan levels in the brain, and thus the synthesis of serotonin, increases bulimic urges in currently and formerly bulimic individuals within hours.

B) SOCIALo Media portrayals of an 'ideal' body shape are widely

considered to be a contributing factor to bulimia. In a 1991 study by Weltzin, Hsu, Pollicle, and Kaye, it was stated that 19% of bulimics undereat, 37% of bulimics eat an amount of food that is normal for an average human being, and 44% of bulimics overeat.  A survey of 15- to 18-year-old high school girls in Nadroga, Fiji, found the self-reported incidence of purging rose from 0% in 1995 (a few weeks after the introduction of television in the province) to 11.3% in 1998.

o Through the cognitive and socio-cultural perspectives, indications towards the origin of bulimia nervosa can be established. Fairburn et al.’s cognitive behavioral model of bulimia nervosa provides a chief indication of the cause of bulimia through a cognitive perspective, while the “thin ideal” is particularly responsible for the etiology of bulimia nervosa through a socio-cultural context.

Tension and

cravings

Binge eating

Purging to avoid Weight

gain

Shame and

disgust

Strict dieting

TREATMENT The treatment of choice for bulimia is cognitive-behavioral

therapy. Cognitive-behavioral therapy targets the unhealthy eating behaviors of bulimia and the unrealistic, negative thoughts that fuel them. Here’s what to expect in bulimia therapy:

Breaking the binge-and-purge cycle – The first phase of bulimia treatment focuses on stopping the vicious cycle of bingeing and purging and restoring normal eating patterns. You learn to monitor your eating habits, avoid situations that trigger binges, cope with stress in ways that don’t involve food, eat regularly to reduce food cravings, and fight the urge to purge.

Changing unhealthy thoughts and patterns – The second phase of bulimia treatment focuses on identifying and changing dysfunctional beliefs about weight, dieting, and body shape. You explore attitudes about eating, and rethink the idea that self-worth is based on weight.

Solving emotional issues – The final phase of bulimia treatment involves targeting emotional issues that caused the eating disorder in the first place. Therapy may focus on relationship issues, underlying anxiety and depression, low self-esteem, and feelings of isolation and loneliness.

HELPING A PERSON WITH BULIMIA

If you suspect that your friend or family member has bulimia, talk to the person about your concerns. Your loved one may deny bingeing and purging, but there’s a chance that he or she will welcome the opportunity to open up about the struggle. Either way, bulimia should never be ignored. The person’s physical and emotional health is at stake.

It’s painful to know your child or someone you love may be binging and purging. You can’t force a person with an eating disorder to change and you can’t do the work of recovery for your loved one. But you can help by offering your compassion, encouragement, and support throughout the treatment process.

WHAT HAVE THEY TRIEDDieting

Talking therapy(counselling etc.)

Self-help

Medication

I am looking for a different approach

Other option

I prefer not to say

http://en.wikipedia.org/wiki/Bulimia_nervosa

http://www.helpguide.org/mental/bulimia_signs_symptoms_causes_treatment.htm