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BULIMIA NERVOSA

Farida ulfa
15-057
Definition
• Bulimia nervosa is a disorder which disrupts the ability to maintain a `normal’ eating
pattern
• becomes increasingly unable to relate normally to food and develops a dependency
on a chaotic cycle of bingeing and purging. Typically they alternate between the
frantic activity of binge-eating and the subsequent state of panic and the need to get
rid of what has just been eaten.
• People with bulimia nervosa either make themselves vomit or use laxatives or diuretics -
or all of these - to purge themselves of the food they have consumed. Some people
have a period of excessive fasting or exercise to compensate for their over-eating.
• Bulimia nervosa is a serious, potentially life-threatening eating disorder characterized by
a cycle of bingeing and compensatory behaviors such as self-induced vomiting
designed to or compensate for the effects of binge eating.
Epidemiology
• Bulimia nervosa affects 1-2% of adolescent and young adult women.
• Approximately 80% of bulimia nervosa patients are female (Gidwani, 1997).
• People struggling with bulimia nervosa usually appear to be of average body weight.
• Many people struggling with bulimia nervosa recognize that their behaviors are unusual
and perhaps dangerous to their health.
• Bulimia nervosa is frequently associated with symptoms of depression and changes in
social adjustment.
Etiology
• develop from a strict diet, the reasons for a diet turning into an eating disorder go far
beyond the desire to be slim.
Sign and symptoms
• Regular intake of large amounts of food accompanied by a sense of loss of control
over eating behavior.
• Regular use of inappropriate compensatory behaviors such as self-induced vomiting,
laxative or diuretic abuse, fasting, and/or obsessive or compulsive exercise.
• Extreme concern with body weight and shape
Warning signs
• Evidence of binge eating, including disappearance of large amounts of food in short periods of time or
the existence of wrappers and containers indicating the consumption of large amounts of food.
• Evidence of purging behaviors, including frequent trips to the bathroom after meals, signs and/or smells
of vomiting, presence of wrappers or packages of laxatives or diuretics.
• Excessive, rigid exercise regimen--despite weather, fatigue, illness, or injury, the need to “burn off”
calories taken in.
• Unusual swelling of the cheeks or jaw area.
• Calluses on the back of the hands and knuckles from self-induced vomiting.
• Discoloration or staining of the teeth.
• Creation of lifestyle schedules or rituals to make time for binge-and-purge sessions.
• Withdrawal from usual friends and activities.
• In general, behaviors and attitudes indicating that weight loss, dieting, and control
• of food are becoming primary concerns.
Physical signs:
• Frequent changes in weight (loss or gains)
• Signs of damage due to vomiting including swelling around the cheeks or jaw, calluses
on knuckles, damage to teeth and bad breath
• Feeling bloated, constipated or developing intolerances to food
• Loss of or disturbance of menstrual periods in girls and women
• Fainting or dizziness
• Feeling tired and not sleeping well
Psychological Signs:
• Preoccupation with eating, food, body shape and weight
• Sensitivity to comments relating to food, weight, body shape or exercise
• Low self esteem and feelings of shame, self loathing or guilt, particularly after eating
• Having a distorted body image (e.g. seeing themselves as fat even if they are in a
healthy weight range for their age and height)
• Obsession with food and need for control
• Depression, anxiety or irritability
• Extreme body dissatisfaction
Behavioural Signs:
• Evidence of binge eating (e.g. disappearance of food)
• Vomiting or using laxatives, enemas, appetite suppressants or diuretics
• Eating in private and avoiding meals with other people
• Anti social behaviour, spending more and more time alone
• Repetitive or obsessive behaviours relating to body shape and weight (e.g. weighing
themselves repeatedly, looking in the mirror obsessively and pinching waist or wrists)
• Secretive behaviour around food (e.g. saying they have eaten when they haven’t, hiding
uneaten food in their rooms)
• Compulsive or excessive exercising (e.g. including exercising in bad weather, in spite of
sickness, injury or social events and experiencing distress if exercise is not possible)
• Dieting behaviour (e.g. fasting, counting calories/kilojoules, avoiding food groups such as
fats and carbohydrates)
• Frequent trips to the bathroom during or shortly after meals which could be evidence of
vomiting or laxative use
• Erratic behaviour (e.g. spending large amounts of money on food)
• Self harm, substance abuse or suicide attempts
Types
• Purging Subtype
• The Purging Subtype of Bulimia Nervosa occurs when a person regularly induces
• vomiting or misuses laxatives, enemas or diuretics to compensate for episodes of
• binge eating.
• Non-Purging Subtype
• The Non-Purging Subtype of Bulimia Nervosa occurs when a person engages in regular
• fasting or excessive exercise, but does not demonstrate purging behaviours such as
• vomiting or misusing laxatives.
Effect
• tooth decay and staining from stomach acids released during frequent vomiting.
• l irregular menstruation
• l damage to bowel as a result of laxative abuse.
• l constipation
• l heart and kidney disease
• l intestinal damage
• l puffiness - especially face and fingers
• l increased hair growth on face and body
• l mineral imbalances in the body
• Electrolyte imbalances that can lead to irregular heartbeats and possibly heart failure and death.
Electrolyte imbalance is caused by dehydration and loss of potassium and sodium from the body as a
result of purging behaviors.
• Inflammation and possible rupture of the esophagus from frequent vomiting.
• Gastric rupture is an uncommon but possible side effect of binge eating.

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