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Eating disorders: Bulimia 101

The following is a dramatization of what living with bulimia is like:

Sam is a 19-year-old girl entering her sophomore year at college. She is upset about her closest friend transferring to a different school and begins to feel very isolated. She becomes anxious as the school year progresses and begins to turn to food for a sense of control.

She returns home for the holiday season and steps on a scale for the first time to discover she has gained weight. Horrified, she is determined to lose the extra weight by the time her next semester started. She begins exercising and dieting but is not satisfied with the results.

She becomes obsessed with her body image. The more she hates her body, the more she tries to lose weight. Eventually, she purges by throwing up. By the end of the break, Sam is throwing up five times a day. She is so withdrawn and depressed, she drops out of the little activities she has left and is left feeling trapped by the eating disorder.

Bulimia is a very serious eating disorder that affects both men and women. This article will explain the symptoms, effects, treatment options, and coping skills you or someone you know can use to overcome it.

What Is an Eating Disorder?

Eating disorders are behavioral conditions that are characterized by persistent and severe disturbances in eating behaviors. These are often associated with distressing thoughts surrounding eating. These are very serious and can affect one’s physical, psychological, and social well-being. The most common eating disorders include anorexia nervosa, binge eating disorder, bulimia nervosa, avoidant restrictive food intake disorder. However, there are many more.

All together, eating disorders affect up to 5% of people. They often develop during adolescence and young adulthood. They are more common in women (particularly anorexia and bulimia nervosa) but can occur in anyone regardless of age or gender. Eating disorders are associated with anxiety surrounding the consequences of eating certain foods. People will often restrict their eating, avoid certain foods, binge eat, purge, misuse laxatives, or obsessively exercise.

Eating disorders do not usually work alone and often coexist with other psychiatric disorders (anxiety, substance abuse problems, and obsessive-compulsive disorder are most common). There is some correlation between genetics and heritability when it comes to developing an eating disorder, but it can also affect those with no family history.

What Causes Eating Disorders?

A variety of factors contribute to an eating disorder. The first is genetics. Adoption and twin studies have shown that eating disorders could be hereditary. This research shows that, on average, if one twin develops an eating disorder, the other has a 50% likelihood of developing one, regardless of if they are raised together or in separate families.

Personality is another cause. In particular, perfectionism, neuroticism, and impulsivity are the three most common personality traits linked to a higher risk of developing an eating disorder.

Other potential causes include societal pressure to be thin and media that promotes this. ‘Thinness’ is a Western notion. Perhaps this is why some eating disorders appear to be nonexistent in other cultures. However, cultural ideas surrounding thinness are present all over the world. Yet, in some countries, very few people have eating disorders.

Experts recently agree that differences in biology and brain structure could play a role in developing eating disorders. In particular, the levels of serotonin and dopamine in the brain. However, much more research is needed to prove this.

Symptoms of Bulimia

Unlike other eating disorders, bulimia is categorized as mild, moderate, severe, or extreme based on the number of the following behaviors that occur each week. Some signs to look out for include:

  • Feeling that you cannot stop eating or control how much/what you eat,
  • Binge eating,
  • Chronically inflamed and sore throat,
  • Self-induced vomiting,
  • Misuse of laxatives,
  • Fasting,
  • Excessive exercise,
  • Acid reflux issues.

Anorexia Nervosa v. Bulimia Nervosa

Anorexia nervosa is the most talked about eating disorder. While it may be used in conversations about models, actors, or those who appear quite thin, it is a much more serious disease. People who suffer from anorexia severely restrict their food intake in order to lose weight. These people tend to believe they are overweight, even while they are becoming underweight.

This unhealthy obsession with thinness results in a fear of gaining weight. They do everything they can to stop themselves from gaining weight, including not eating, purging, taking laxatives, or other medications that reduce hunger. Someone who suffers from anorexia can become dangerously underweight and experience organ failure, brain damage, infertility, or death.

Bulimia nervosa is similar because the individual is obsessed with his or her weight and wants to lose weight until they achieve their ‘goal’. However, bulimia is characterized by periods of binging and purging. This means the person will go through periods where they eat excessively and then purge themselves by medications, vomiting, or exercising excessively to get rid of the food.

These individuals try to keep their binging and purging a secret, but it will be noticed. Guilt and shame are two of the biggest emotions attached to bulimia. People who suffer may be any weight and will likely not appear as underweight as those who suffer from anorexia often do. This is why knowing and looking for the symptoms are crucial.

Long Term Effects of Bulimia

The effects of bulimia can often last long past the acute stage of the disorder. The short-term dangers are real, but the long-term effects can have serious health effects on your mental, physical, and emotional health. Here are 5 of the most common long-term effects associated with bulimia:

● Heart Damage

Bulimia can cause long-term damage to your heart. When your body does not have enough calories to survive, it starts to consume muscle. The heart is the most important muscle in your body. Weak hearts cannot pump as well, which can lead to heart palpitations or low blood pressure. Cardiac arrest is another risk. Weight fluctuations also can damage your heart walls and cause them to weaken.

● Teeth Damage

Tooth damage and decay are one of the most common side effects of bulimia. Vomiting can erode the enamel of your teeth and lead to decay and damage. Gum disease and damage to your salivary glands are also common. Although most teeth damage is rarely fatal, it can be very expensive and painful to correct.

● Gastrointestinal Issues

Damage to your gastrointestinal tract is the result of bingeing and purging. Repeated vomiting weakens your muscles that keep food in your stomach, and so people who suffer from bulimia often experience acid reflux issues.

Some people may use laxatives to purge instead of vomiting. The overuse of laxatives can severely damage the nerve endings in your anus and intestines, making going to the bathroom very difficult.

● Metabolism Issues

The body does not receive the level of nutrients it needs when someone suffers from bulimia. Your metabolism slows down, causing you to burn fewer calories day to day. This usually persists after you begin eating normally, causing you to gain weight. It can be very difficult to come to terms with that after suffering from an eating disorder.

● Fertility Issues

Bulimia can have major effects on your fertility. Malnutrition comes with bulimia and often impacts the production of sex hormones. Women might miss periods as the body shuts down its non-essential functions, and this affects long-term fertility. Men and women will discover this as they try to have children.

Treatment

Like all disorders, the path to treatment will look different for every individual. Here are some of the most common methods:

Therapy

Therapy is a common thread. For most people, it is a major contributor to recovery. Often people will try to keep their condition a secret, so talking it out with someone can be very liberating. A therapist should always be part of the treatment process, even if you have other people to talk to. They are there to help you develop skills, manage triggers, and keep you on track for recovery.

Mental Treat’s platform has a variety of specialists who are ready to help you overcome an eating disorder or talk if you are concerned about someone else. Whatever your situation, you are not alone. Click here to get started.

Inpatient Treatment

Some people may decide that inpatient treatment is the best care. This option is better for people with a long-standing case of bulimia. Given the tendency to hide the disease, people can struggle for a very long time without receiving proper treatment.

Inpatient can help significantly reduce triggers and monitoring food intake. This is particularly important in the early stages of recovery. It also involves the same therapy methods patients would receive in outpatient care, but more supervised. It is not for everyone but can be lifesaving for those with extreme cases.

Medications

Prescription medications can be used with therapy to treat bulimia. Fluoxetine (Prozac) is approved by the FDA to treat bulimia, and antidepressants have proven very useful in reducing purging urges. People who suffer from bulimia typically have an imbalance of serotonin, and antidepressants adjust this.

Again, this approach is not right for everyone and everyone will react differently to medications. What works for someone may not necessarily work for everyone else. Regardless, seeking help and finding the treatment that works for you is the most important step. It is not always easy, but it is worth it.

Coping & Lifestyle and Home Remedies

Coping with bulimia can be very difficult. How do you cope when you are seeing messages that make thinness the sign of success? How do you sift through the mixed messages to find your path to success?

  • Do not engage with content that glorifies eating disorders.
  • Remind yourself that a healthy weight is different for everyone.
  • Resist and cope with your triggers.
  • Have a plan to deal with setbacks.
  • Look for positive role models.
  • Find hobbies that bring you joy.
  • Forgive yourself and build your self-esteem. 

Lifestyle and Home Remedies

These self-care tips will help you stay on the right track!

  • Do not skip therapy sessions or meals. Stick to your treatment plan.
  • Educate yourself about bulimia in order to motivate yourself. The more you know, the more power over your situation you have.
  • Do not isolate yourself. Stay in touch with family and friends who love you.
  • Be nice to yourself. Do not weigh yourself or stare into mirrors, acknowledge your progress and love yourself.
  • Talk to your primary care physician about nutrition. Make sure you are getting all the vitamins and minerals you need to be healthy.
  • Exercise appropriately. Talk to your doctor about what kind of physical activity is appropriate for you and how you can most successfully implement it.

A Word From Mental Treat

If you are the parent of a child who is suffering from bulimia, do not blame yourself. We know eating disorders have a myriad of causes and parenting style is not a known cause.Here is some advice for how you can help your child:

  • Listen. Be open and allow them to express themselves to you without judgment.
  • Ask what you can do. This goes a long way for kids.
  • Have regular mealtimes. Eating on a routine is important to reducing binge eating.
  • Let them know if you have concerns about them. Again, do not place judgment on them, but let them know you are there for them and that you are worried about them.

We hope that this article will help you in whatever situation you may be in. Remember, you are not alone. While the path to recovery may seem difficult, it is worth it. Please reach out for support if you need it. Take care, and be well.

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