Bulimia Nervosa- A Case of Binge and Purge

Binge and purge, a vicious cycle which troubles countless people around the world, involves eating large amounts of food in a short time period, and then purging oneself of that food due to feelings of guilt and shame associated with it.

This is the defining characteristic of Bulimia Nervosa, an eating disorder.

 

Eating disorders are mental disorders, specifically behavioural and emotional conditions, characterised by severe and persistent disturbances in behaviours related to eating and the stressful emotions and thoughts associated with them.

 

There is a general misconception amongst people that an eating disorder is a lifestyle choice and is controllable. This is completely false. An eating disorder is just like any other disorder, which develops due to one or more antecedent factors, and is then maintained because of certain maintaining factors, and is out of the individual’s control most of the time.

 

Bulimia Nervosa, or simply Bulimia, is a psychological eating disorder in which the individual has no sense of control over their eating and eats large amounts of food at one time (binge eating). Later on, the individual tries to get rid of the food eaten by unhealthy means such as forced vomiting, excessive exercise, or the use of laxatives.

 

Bulimia usually begins during late childhood or early adulthood, and is more prevalent in females as compared to males. Individuals who have bulimia have an unrealistic body image goal, and have a consistent fear of gaining weight. It is this fear of gaining weight, coupled with the feelings of disgust and shame after binge eating, that leads them to indulge in purging behaviour.

 

Signs & Symptoms

 

The symptoms of anorexia are physical as well as emotional and behavioural.

 

  • Consistent fear of gaining weight
  • Binge eating and then purging
  • Stained teeth (stomach acid)
  • Social Withdrawal
  • Overuse of laxatives
  • Excessive exercise
  • Unhealthy eating habits
  • Refusing to eat in front of others
  • Obsession about their body weight

 

The Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-5) mentions the diagnosing criteria of Bulimia Nervosa as:

  • Frequently occurring episodes of binge eating, with one episode of binge eating containing
    • Eating, in a short period of time (one sitting, or two hours), an amount of food which is markedly more than what an individual would normally eat within the same time frame.
    • Lack of control over one’s eating.
  • Frequently occurring unhealthy compensatory behaviour to prevent weight gain, such as self induced vomit, excessive exercise and use of laxatives.
  • The binge eating and inappropriate compensatory behaviours both occur, on average, at least once a week for three months.
  • Self worth and evaluation is associated with body weight and shape.
  • The behaviours of binging or purging do not have any association with anorexia nervosa.

 

Treatment

Treatment for Bulimia needs to be holistic in nature, in the sense that it covers not only nutritional education but also psychotherapy, along with medical assistance in case of any physical damage done to the body over the years of binge and purge cycle.

 

  • Psychotherapy- Psychotherapy can help change unhealthy eating habits, help alleviate stress, and help the individuals manage negative emotions, which will help in the overall growth of the individual.
  • Medication- Antidepressants help in the treatment of Bulimia since depression has been found to be one of the causes of bulimia.
  • Nutrition Education- Working with dieticians will help in overcoming eating challenges, and the dieticians may also help in building an eating programme for the individual.
  • Hospitalisation- Incase of serious physical damage done to the body, hospitalisation may be necessary to help stabilise the physiological system of the individual. 

 

Mind Unwynd has a plethora of well-qualified and experienced mental health practitioners who will be more than happy to help you get through such tough situations, helping you enable & empower yourself. If you need mental health support, reach out to us on the provided email id, or message us on any social media platform (Facebook, Instagram, Twitter, LinkedIn).

 

References

 

Bulimia nervosa diagnosis, DSM-5 criteria, diagnostic tests. Walden Eating Disorders. (2021, October 20). Retrieved October 31, 2021, from https://www.waldeneatingdisorders.com/what-we-treat/bulimia/bulimia-diagnosis/

 

WebMD. (2021). Bulimia: Symptoms, treatments, and prevention. WebMD. Retrieved October 31, 2021, from https://www.webmd.com/mental-health/eating-disorders/bulimia-nervosa/mental-health-bulimia-nervosa

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