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The word bulimia derives from the Latin (būlīmia), which originally comes from the
Greek βουλιμία (boulīmia; ravenous hunger), a compound of βους (bous), ox + λιμός
(līmos), hunger. Bulimia nervosa was named and first described by the British
psychiatrist Gerald Russell in 1979.
The frequent contact between teeth and gastric acid, in particular, may cause:
Bulimics are much more likely than non-bulimics to have an affective disorder, such as
depression or general anxiety disorder: A 1985 Columbia University study on female
bulimics at New York State Psychiatric Institute found 70% had suffered depression
some time in their lives (as opposed to 25.8% for adult females in a control sample from
the general population), rising to 88% for all affective disorders combined. Another study
by the Royal Children's Hospital in Melbourne on a cohort of 2000 adolescents similarly
found that those meeting at least two of the DSM-IV criteria for bulimia nervosa or
anorexia nervosa had a sixfold increase in risk of anxiety and a doubling of risk for
substance dependency Bulimia also has negative effects on the sufferer's dental health
due to the acid passed through the mouth from frequent vomiting causing acid erosion,
mainly on the posterior dental surface.
Diagnosis
The onset of bulimia nervosa is often during adolescence, between 13 and 20 years of
age, and many cases have previously suffered obesity, with many sufferers relapsing in
adulthood into episodic binging and purging even after initially successful treatment and
remission.
• Purging type bulimics self-induce vomiting (usually by triggering the gag reflex
or ingesting emetics such as syrup of ipecac) to rapidly remove food from the
body before it can be digested, or use laxatives, diuretics, or enemas.
• Non-purging type bulimics (approximately 6%–8% of cases) exercise or fast
excessively after a binge to offset the caloric intake after eating. Purging-type
bulimics may also exercise or fast, but as a secondary form of weight control.
Management
Pharmacological
Some researchers have hypothesized a relationship to mood disorders and clinical trials
have been conducted with tricyclic antidepressants, MAO inhibitors, mianserin,
fluoxetine, lithium carbonate, nomifensine, trazodone, and bupropion. Research groups
who have seen a relationship to seizure disorders have attempted treatment with
phenytoin, carbamazepine, and valproic acid. Opiate antagonists naloxone and
naltrexone, which block cravings for gambling, have also been used.[19]
There has also been some research characterizing bulimia nervosa as an addiction
disorder, and limited clinical use of topiramate, which blocks cravings for opiates,
cocaine, alcohol and food. Researchers have also reported positive outcomes when
bulimics are treated in an addiction-disorders inpatient unit.
Psychotherapy
Other
There are higher rates of eating disorders in groups involved in activities which idealize a
slim physique, such as dance, gymnastics, modeling, cheerleading, running, acting,
rowing and figure skating. Bulimia is more prevalent among Caucasians. Exposure to
mass media also appears to have an effect: a survey of 15–18 year-old high schoolgirls 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.
http://en.wikipedia.org/wiki/Bulimia_nervosa