Bulimia
The essential features of bulimia include overeating binges followed by compensatory behaviors such as self-induced vomiting, laxative use, and/or excessive exercise.
Individuals with bulimia often have an obsessive relationship with food and weight that preoccupies their thoughts on a daily basis. Due to its secretive nature, bulimia can go undetected for years.
Unlike anorexia, there are few (if any) outward signs of this highly dangerous disorder. In fact, many bulimics maintain an average (seemingly healthy) or slightly above average weight. Sufferers often feel embarrassed and ashamed of their behaviors, which furthers their isolation, erodes their self-worth and can threaten their life.
In its fourth edition, the Diagnostic and Statistical Manual of Mental Disorders (APA, 1994) lists the following criteria that an individual must meet to be diagnosed:
- 1. Recurrent episodes of binge eating, with an episode characterized by (A) eating in a discrete period of time, usually less than two hours, an amount of food that is significantly larger than most people would eat during a similar period of time and under similar circumstances; and (B) a sense of lack of control over eating during the episode, such as feeling that one cannot stop eating.
- 2. Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induce vomiting, misuse of laxatives, diuretics, or enemas (Purging type); or through fasting or excessive exercise (non-purging type).
- 3. These behaviors occur at least twice a week for at least three months.
- 4. Self-evaluation is unduly influenced by shape and weight.
- 5. The behavior does not only occur during episodes of anorexia nervosa.
What does treatment for bulimia involve?
Bulimia, like for eating disorders, is a manifestation of deeper psychological issues. Understanding how bulimia helps one cope with these issues is essential. Treatment must explore underlying issues such as depression, anxiety, trauma and self-esteem. Treatment for bulimia must also include comprehensive screening for other problematic issues, such as alcohol and drug abuse, as well as self-harming behaviors, such as cutting and burning.
In most cases, a multi-disciplinary team approach is the most effective way to comprehensively treat bulimia. Depending on the stage and severity of the disorder, this may include medial, nutritional, psychiatric and psychological intervention.
Is recovery from bulimia possible?
I believe a full recovery is possible. Recovery will depend on many factors, but the most important one is the individual’s willingness, desire and determination to be free from their disorder.
Click here for an eating disorder self test.
“Change your thoughts and you change your world.” – Norman Vincent Peale
