Bulimia nervosa belongs to the group of eating disorder (ED). It characterizes by behaviors in which people have recurrent attacks, consuming large amounts of food in a short period of time.

Bulimia is a female-dominated disease, for each man it affects about 9 women who start suffering from it over time. It usually starts between the ages of 16 and 20. In the last ten years, the prevalence and incidence rates have been stable. Bulimia affects approximately 2% of the population. About 4% of the population suffers from unspecified eating disorders, in which some overeat or purge, but do not meet the criteria of bulimia nervosa.

People with bulimia tend to restrict their diet to reduce weight. However, hunger and impulsive movements are part of the deeper psychological distress, leading to binge eating. This usually happens at night, and the foods that lead to overeating are the foods that they usually try to avoid. Candy, pastries, pasta, and bread are among the most common.

Overeating can produce and internal feeling of dissatisfaction. This causes them to adopt behaviors such as the use of laxatives or exercise excessively. This can cause physical problems such as electrolytes loss, like sodium and potassium, putting their health at risk. Bulimia Nervosa can be life threatening or cause serious physical consequences such as heart disease, low blood pressure and physical changes.

Causes of Bulimia

Bulimia is a disease that has nothing to do with make-believe. Patients suffering from bulimia often have low self-esteem, interpersonal difficulties, emotional instability, trauma, emotional disorders or feelings of emptiness. This discomfort makes them seek their identity in weight loss, and this leads them to complicated clinical complications.

Therefore, although society considers thinness as the business card of success, it is this psychological discomfort that makes patients want to lose weight. This way, biological, psychological and social factors interfere with the origin of this disease, causing patients to distort their own vision. The food restriction imposed by the patient causes a strong state of anxiety and the need to eat large amounts of food.

So far, the biological factors involved in the development of the disease are not clear. On the other hand, some triggers related to social environment, such as diet and fear of being body shamed, are well known. Many factors are compatible with bulimia. Such as affective disorders that occur within the family, drug abuse, obesity, diabetes, and distortions of the body itself.

It is important to clarify that eating disorders do not usually appear when any of these factors are manifest solely, but the combination of multiple factors can lead to bulimia.

What are the symptoms of Bulimia?

Patients who suffer from Bulimia often try to cover up their binging behavior. And as most patients do not tend to lose weight, it can pass unnoticeable for a long time. Typical symptoms of bulimia are as they follow:

Overeating or binge eating:

The person eats a lot of food in a short period of time and cannot control their intake. The objective of the binge is to achieve satisfaction. Patients try to avoid places with food and try to eat alone. Their behavior is often asocial, they tend to isolate themselves, and food is their only topic. Also, a lack of control over food can produce a great sense of guilt and shame.

Use of laxatives:

To prevent weight gain and compensate for excessive or excessive intake, patients vomit, use laxatives, diuretics, or drugs. They also resort to other methods that allow weight control, such as in sports activities.

Repeated Behaviors:

Binge-vomiting cycles occur at least twice a week.

Low self-esteem.

In addition to overall performance, the following symptoms can also appear:

Metal disorders

Patients with bulimia nervosa characterize by having strong impulsivity and low self-control. This can also lead patients to get into dangerous situations or get into arguments easily, or have big mood swings. Also, the frequency of low self-esteem leads to symptoms of depression and anxiety. Some patients might even develop problems with addiction to alcohol, drugs or substances.

Physical symptoms

There are many physical symptoms that manifest with bulimia. Some of them are weakness or headache, swollen face by an increased salivary gland (especially parotid glands). Others include dental problems, dizziness, hair loss, irregular menstruation and sudden weight gain and loss. However, patients with Bulimia usually do not seem to lose weight, this is more frequent in anorexia. Bulimia can coexist with other diseases or behaviors, such as sexual promiscuity. The clinical consequences are:

– Arrhythmias that can lead to a heart attack.

– Dehydration

– Irritable Intestine.

– Gastroesophageal reflux.

– Hiatal hernia.

– Dental cavity.

– Bone loss

– Perforation of the esophagus

– Stomach rupture

– Pancreatitis

What is the treatment of Bulimia?

In treating bulimia, the first step is to have a psychiatrist evaluate the patient. After this, there are two methods of treatment: medication or psychotherapy, although the ideal method is to combine the two.

Medication use can improve binge eating, impulsivity and binging behavior. In addition, they can also be psychotherapeutic and effective. Through this psychological method, patients can control impulsivity, emotional instability and improve their mood. It will also increase self-esteem and interpersonal relationships.

The other part of the treatment should focus on nutritional methods. Working closely with endocrinologists and nutritionists will ensure the physical and organic health of the patient. Ultimately, it is about establishing healthy lifestyle habits and self-care so that patients can control their health. Patients need to understand that nobody wants them to gain weight, but to stay healthy within the weight standard, the goal is to stop the pain of weight gain.

How can family members help the patient who has Bulimia?

– The best way to help a person with binge eating disorder is to realize that they have an eating disorder. Some suggestions your environment can follow are:

– Avoid commenting on weight, food, etc.

– Understand that bulimia is a serious problem, not silly of people who suffer.

– Try not to control the patient all the time, just talk about the problem. This will keep the patient from feeling overwhelmed and will promote your understanding.

– Put aside the blackmail and wait “If I eat, I’ll buy you what you want.” These formulas are useless and make the situation worse.

REFERENCES

  1. Castillo, M., & Weiselberg, E. (2017). Bulimia Nervosa/Purging Disorder. Current Problems in Pediatric and Adolescent Health Care, 47(4), 85–94. doi:10.1016/j.cppeds.2017.02.004 (LINK)
  2. Gibson, D., Workman, C., & Mehler, P. S. (2019). Medical Complications of Anorexia Nervosa and Bulimia Nervosa. Psychiatric Clinics of North America, 42(2), 263–274. doi:10.1016/j.psc.2019.01.009 (LINK)
What is anorexia nervosa

Society’s imposing beauty standards are rising. Although we are experiencing many revolutions aimed at changing them, they still have a profound impact on people’s thinking and self-esteem. One of the direct consequences of these cosmetic models is the appearance and increase of eating disorders (including anorexia nervosa). Throughout this article, we will analyze the characteristics, symptoms, causes, and possible treatments of this disease.

What is Anorexia Nervosa?

In the classification of eating disorders, we find a disease called anorexia nervosa, or anorexia for short. While this disease occurs mainly in women, it increasingly affects more men. Anorexia Nervosa can lead patients who suffer it to restrict their food intake, causing weight loss.

The goal of this behavior is to lose weight. People with anorexia will feel overweight, even if their height and age are below the recommended weight. This makes anorexia an extremely dangerous disease. It can lead to death due to malnutrition, or illness due to weak human tissues and immune system

Weight loss can reach dangerously low levels because dietary restrictions are caused by the wrong perception of one’s own body. This means that no matter how much or how much people lose weight, it is far from being enough. Because when looking in the mirror, they will continue to perceive distorted shapes that do not correspond to reality. This causes the patient to make various sacrifices around food.

What are the causes of Anorexia Nervosa?

At present, it is not yet possible to determine the specific cause or exact cause of anorexia nervosa. Due to this, a series of biological, psychological, and environmental factors favor its appearance. The experience of personal or social traumatic or emotional events can play a fundamental role in determining the appearance of this eating disorder.

In addition, recent studies have indicated that there may be a number of genes related to the behavior of anorexia. They include symptoms such as compulsion, depression, perfectionism, and emotional sensitivity. However, there is no genetic or organic disease directly related to anorexia.

What are the symptoms of Anorexia Nervosa?

Anorexia has many different symptoms, and they are not all the same. If you have anorexia, your weight may be much lower than expected for your height and age. If you suffer from Anorexia Nervosa you can have one of the following behaviors:

  • Eat less or restrict certain foods, such as fatty foods.
  • Cut food into small pieces to make it look like you have eaten something and then become obsessed with another meal.
  • Observe your body insistently, weigh yourself and measure yourself constantly.
  • Restlessness
  • Taking appetite suppressants, such as weight loss pills.
  • Forced vomiting after meals or taking laxatives or pills to remove water from the body (diuretics)
  • Wear loose clothing to cover weight loss.
  • Make yourself vomit.       

When you have anorexia, you might feel lost due to a misguided perception of your weight or height. Some emotional symptoms include:

  • Distorted body image
  • Denies diet problems or low weight
  • You have sudden mood swings.
  • Feeling depressed
  • Lose interest in others
  • Lost interest in sex

In addition to weight loss, the physical symptoms of anorexia include:

  • Thin hair on your body and face.
  • Having permanent or recurrent colds.
  • Constipation
  • Swelling of the face and ankles.
  • Weakness and dizziness
  • Fatigue
  • Trouble sleeping
  • Delayed puberty (because anorexia affects hormones)
  • Inability to achieve or maintain an erection (male or boy)

What is the difference between Anorexia Nervosa and Bulimia?

Although the laxative behavior described above may be related to another eating disorder (called bulimia), there are still many essential differences between the two disorders. These laxative episodes do not always occur in anorexia, but rather in bulimia. In eating disorders, this is the basic requirement for diagnosis.

In bulimia, the person eats a lot of generally high-calorie foods in a short period of time. They are called binge eating. However, in anorexia, the person avoids eating at all costs and controls calories thoroughly.

People with anorexia are characterized by being underweight, while in bulimia their weight is usually normal, even exceeding the recommended weight.

How to detect Anorexia Nervosa?

At first glance, some symptoms of anorexia nervosa can be difficult to identify. Some patients might be aware of these symptoms and do their best to hide them. If we want to determine if someone in the environment has this condition, we can observe many warning signs or behaviors. These signs include:

  • Some patients eat nonstop.
  • While others give an excuse not to eat.
  • Choose foods strictly, generally low in calories.
  • Keep weighing themselves constantly.
  • Ongoing complaints about the weight.
  • Some patients avoid eating in public places.
  • Wear more and more layers to change the dress code.

What is the treatment of Anorexia Nervosa?

Anorexia nervosa is a very serious disease that, if left untreated, can have fatal consequences. So far, statistics show that 10% of patients with severe anorexia who do not receive treatment will terminate due to death. Due to the seriousness of the situation, an effective diagnosis should be made and treatment started as soon as possible.

In the environment of the patient participating in the treatment, the key to effectiveness is having compromise. The interventions include psychotherapy, in which psychological work is done on the emotional and cognitive aspects of the disease (including distorted physical perception).

Similarly, people need to be monitored for their physical conditions. Due to this a series of nutrition guidelines should be developed to help people reconcile with food.

Finally, in some cases of Anorexia Nervosa, it is possible to resort to medical treatment with antidepressants or anxiolytics. This will reduce the intensity of the symptoms and promote psychological work. Unfortunately, anorexia nervosa is a disease with a high risk of recurrence. Family members and medical professionals must pay attention to the signs and treatment of the patients.

eating disorders

In a society that highly values appearance, it is common for some people to be concern about their physical appearance. This is when people start dieting, but when do we know that we are having a healthy diet? A healthy diet comes from eating the correct amount of food in the correct proportion, continuously. Eating an adequate proportion of foods from the major groups will increase everyday wellbeing. This will reduce the risk of having multiple diseases in the long term.

When patients do not have a balanced diet, cannot maintain their food habits, this is when eating disorders come into play. These are diseases characterized by the appearance of serious disturbances in the daily diet of the affected patients.

A person who has an eating disorder may either started by eating small or large amounts of food. But the important aspect is that, at some point, this urges to eat more or less food spiraled out of control. Severe anguish or concern about the shape or weight of the body can also be part of an eating disorder. These symptoms that present with eating disorders often coexist with other illnesses such as substance abuse, depression or anxiety disorders. In the end, if these symptoms worsen, can lead to premature death.

Some statistics about Eating Disorders

– People with anorexia nervosa are 18 times more likely to die at a younger age. This compared to people of similar age in the general population.

– The people most at risk of suffering from an eating disorder are adolescent and young women. This group represents 90% of cases although it is not an exclusive problem for this population.

– Men and boys do not escape from these problems, they can also develop this type of disorder.

– Ethnic minorities have begun to suffer more eating disorders notably in recent years

– People with anorexia nervosa are 18% more likely to die at a younger age

What causes Eating Disorders?

Among the most common causes and some factors that predispose to developing these disorders are:

– Low self-esteem, dysfunctional relationships or cultural pressures can induce eating disorders.

– Certain traumas such as rape, abuse or the death of a loved one can cause Eating Disorders.

– The inability to express emotions, a deep feeling of helplessness or dissatisfaction

– Even genetics can play an important role when it comes to suffering from this kind of disease.

What are the most common Eating Disorders?

Anorexia nervosa

According to data collected by multiple researchers, most cases of anorexia begin with a weight loss diet. The problem starts when the patient cannot achieve the goals expected, that is when they start to become a true obsession. Thus, anorexia nervosa characterizes by an extreme weight loss and the incessant search for thinness. Other symptoms include the irrepressible fear of gaining weight or eating in front of others. This can lead to a distorted body image or the fear of weight gaining after following a very restricted diet.

However, some patients also resort to binge eating. This behavior the patient follows it with an exaggerated diet, a strenuous exercise routine or self-induced vomiting. Some even use laxatives, enemas, or diuretics. Other symptoms are mild anemia, muscle wasting, severe constipation, brittle hair and nails. Also, a decrease in internal body temperature which makes a person feel cold all the time or constant fatigue.

Bulimia nervosa

Bulimia nervosa characterizes by frequent and recurrent episodes of ingestion of extremely large amounts of food. This behavior comes with the feeling of lack of control over these episodes. These episodes the patients follow them with a behavior that seeks to compensate for that excess food. They include forced vomiting, the abuse of laxatives or a permanent fast. This eating disorder differs from anorexia in that patients tend to maintain what is considered a healthy weight. Some patients are even slightly overweight. In addition, the patients who suffer Bulimia Nervosa often keep it a secret, as it causes a feeling of indignation or shame.

A swollen throat, intestinal pain and irritation, severe dehydration, worn tooth enamel or a gastric reflux disorder are some of the symptoms that are part of the disease.

Binge eating disorder

In this case, people with this disorder lose control over what they eat. However, unlike bulimia, patients do not subsequently resort to purging, fasting, or extreme physical exercise. For this reason, the majority are clearly overweight or obese, also increasing the risk of developing cardiovascular diseases or high blood pressure. Guilt and shame can push them into a new round of bingeing.

Potomania

This disease occurs when patients have a frequent desire to drink large amounts of fluid, compulsively and without feeling particularly thirsty. In doing patients often experience a pleasant sensation. Although some expert nutritionist recommends this practice, the limit is usually two liters a day. The patients with potomania often exceed this limit. In fact, this often leads to overhydration, poor kidney function, fluid and electrolyte imbalance, or poor blood composition.

Orthorexia

Over the past few years, orthorexia has been gaining space among the major eating disorders that affect to society. This is in part due to the influence that weight loss diets have on the individual.

Thus, orthorexia is that obsessive preoccupation with consuming only healthy foods. A behavior that often leads to social isolation, the preference of fasting over the intake of other foods or the feeling of guilt. Excluded foods include meat, fats, foods treated with pesticides, or those that contain artificial additives. The problem arises when that concern for the origin and quality of food becomes an obsession. This is a pathological behavior, behind which there are multiple psychological and social adaptation problems. People with orthorexia focus exclusively on what they eat; food is the center of his thoughts and of his life. This causes nutritional deficits that can lead to other ailments such as anemia, vitamin deficiencies or lack of energy

REFERENCES:                                                                                                    

https://www.oliverpyattcenters.com/dieting-and-eating-disorders/

https://www.cabdirect.org/cabdirect/abstract/19741422333

– –http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.175.4255&rep=rep1&type=pdf