BULIMIA NERVOSA

Stay Active, Stay Healthy, Stay Beautiful

WHAT IS BULIMIA NERVOSA?

The National Eating Disorder Association defines Bulimia Nervosa as, “a serious, potentially life-threatening eating disorder characterized by a cycle of bingeing and compensatory behaviors such as self-induced vomiting designed to undo or compensate for the effects of binge-

eating.”1

SYMPTOMS AND WARNING SIGNS

Symptoms Frequent episodes of

consuming very large amounts of food followed by behaviors to prevent weight gain, such as self-induced vomiting

A feeling of being out of control during the binge-eating episodes

Self-esteem overly

related to body image1

Warning Signs

Evidence of purging behaviors such as frequent trips to the bathroom, signs and/or smells of vomiting, presence of wrappers or packages, of laxatives or diuretics

Excessive, rigorous exercise regimen- despite weather, fatigue, illness or injury, the compulsive need to “burn off” calories

Withdrawal from usual

friends or activities 1

THESE ATHLETES ARE REALLY SKINNY…

• Many athletes actually suffer from Bulimia, without vomiting episodes.

• Some people are actually known as “obligatory

exercisers.”2

• What is an obligatory exerciser?

• A person who will not interrupt their exercise schedule, even when they are injured or when they know exercise could harm

their lives.2

IS THAT REALLY CONSIDERED A PART OF AN EATING

DISORDER?• Other names for

“obligatory exercisers”

• Activity disorder

• Compulsive athleticism

• Exercise addiction

• Exercise dependence

• Excessive exercise2

• Symptoms:

• Focuses on reducing body weight and changing body shape

• Maintains a rigid diet

• Structure social activities around the exercise routine

• Keeps extensive logs and

records2

TREATMENT FOR OBLIGATORY EXERCISE

• Periodization- cycles of training with set recovery periods

• Cognitive-behaviorial therapy

• Group therapy

• Family therapy

• Medicine2

• Do these symptoms and treatments sound familiar?

WHY WOULD I HAVE THIS?

Biological Factors Behavioral Factorrs Social Factors Psychological

Factors Genetics Eating Disorders

A combination of many different parts of your life can come together to affect your chance of an eating disorder. 9

DOES IT REALLY AFFECT ME?

Bulimia affects 1-2% of adolescent and young adult women.1

Q: I have lots of friends and I don't know anyone with bulimia. How come I don't know anyone

with bulimia if it's so prevalent?

A: People struggling with bulimia usually appear to be normal body weight.1

BUT AT LEAST I'LL BE SKINNY...

Does weight really matter when your

health is involved??

Health Risks of Bulimia

Electrolyte imbalances that can lead to irregular heartbeats or heart failure, even death

Tooth decay or staining of teeth from frequent vomiting.

Unfortunately, once tooth enamel is eroded, it will not regenerate, and restorative dental procedures may be necessary

Chronic or irregular bowel movements from the use of

laxatives8

I PLAY SPORTS, MY FRIENDS STAY HEALTHY...

• Athletes are just as at-risk of bulimia.

• According to a study, one-fourth of both male and female athletes had episodes of overeating on a daily basis (bingeing).

• The study also showed that more athletes admitted to Bulimia, rather than Anorexia, another common

eating disorder.3

• Female athletes also reported lower self-esteem than male athletes.

• Their goal was to achieve a body fat content that was very unhealthy and would

result in amenorrhea.3

WHY WOULD I CARE ABOUT AMENORRHEA?

• Ammenorrhea is when your menstrual cycle (your period) comes infrequently. (Ex.- once every 6 months)

• Most women have to maintain approximately 17% body fat to menstruate.

• Osteoporosis may occur within 1 year.

• Often increases food occupation and increases the likelihood

that overeating will occur.3

WHY DO ATHLETES CARE ABOUT GETTING SKINNY AND NOT JUST

ABOUT THE SPORT?

• Some athletes actually work for types of thinness.

• Performance Thinness- belief that a lower weight and body fat percentage will enhance their performance

• Common types- endurance sports (running, cycling)

• Appearance Thinness- belief that thinner athletes will be rewarded

• Common types- figure skaters, gymnastics3

TREATMENT OPTIONS

• Nutritional Counseling- learn to structure & pace meals, adjust calories to maintain weight

• Cognitive Behavioral Therapy (CBT)- identify & change disordered thoughts that bring on the compulsive behavior, find better ways to cope with life’s stresses

• Interpersonal Therapy- tries to improve relationships that

may be framing the problem4

TREATMENT OPTIONS (CONT.)

• These treatment options are usually more effective when implemented with other strategies

• Self-help- internet-based modes & support groups

• Medicine- SSRIs (selective serotonin reuptake inhibitors)4

WILL THIS LITTLE PILL HELP ME FEEL BETTER?

• One of the treatment options for Bulimia is medication. The most common medications fall in the category SSRis.

• SSRis (Selective Serotonin Reuptake Inhibitors)- changes the balance of serotonin in the brain, which helps the brain cells send and receive messages, which boosts moods

• Some ones I might hear- Celexa, Lexapro, Prozac, Zoloft,

Paxil5

TAKE SOME TIME TO YOURSELF!

• Some studies have been done to see if mindful meditation can work to stop the urge to binge, which is caused by your anxiety.

• These meditation interventions have been used for other addictive characteristics.

• One study found that the meditation can have marked

immediate impact on decreasing the episode. 6

HOW DO I MEDITATE MINDFULLY?

• This is something you can do even without money!

• Sometimes called “present-focused awareness”

• What do I do?

• Sit comfortably.

• Focus on your breathing.

• Bring your mind’s attention to the present without drifting

to concerns for the past or future.6

WHAT CAN MY PARENTS DO TO HELP ME?

• Coaches, athletic directors, teammates and parents should be aware of a pursuit of low percentage body fat.

3

• Greater percentage of full remission with parents

involved in the treatment process, ex. Family therapy.7

WHERE CAN I GO IN OHIO?

• Professionals

• Cincinnati- Anne Kearney-Cooke 513-588-9431

• West Chester- Teri Role-Warren

513-779-920910

• Centers

• Cleveland Center for Eating Disorders 216-765-0500

• Lindner Center of Hope 513-536-4673

• The Center for Balanced Living 614-293-9550

WORKS CITED

• 1 National Eating Disorder Association (2014). Bulimia Nervosa.

• 2 Physician Sports Med (2005). The Obligatory Exerciser Assessing an Overcommitment to Exercise.

• 3 International Journal of Eating Disorders (1999). Athletes and Eating Disorders: The National Collegiate Athletic Association Study.

• 4 The Harvard Medical School Family Health Guide (2006). Treating Bulimia Nervosa.

• 5 Mayo Clinic (2014). Selective Serotonin Reuptake Inhibitors.

• 6 The Harvard Health Publications (2014). Mindful Meditation May Ease Anxiety, Mental Stress.

• 7 National Institute of Mental Health (2012). Spotlight on Eating Disorders.

• 8 Journal of Women’s Health (2004). Bulimia: Medical Complications

• 9 National Institute of Mental Health (2014). What are Eating Disorders?

• 10 National Association of Anoxeria Nervosa and Associated Disorders (2014). Eating Disorder Professionals: Ohio.