Bulimia nervosa is not so often fatal, but it seriously affects the well-being of sufferers and can have serious medical complications.
About 1 in 250 women and 1 in 2,000 men will experience anorexia nervosa at some point. The condition usually develops around the age of 16 or 17.
Bulimia is around two to three times more common than anorexia nervosa, and 90% of people with the condition are women. It usually develops around the age of 20.
The most common behavior that will lead to an eating disorder like Anorexia and Bulimia is dieting.
- Anorexia nervosa
- Symptoms of anorexia
- Causes of anorexia
- Treatment of anorexia
- Bulimia nervosa
- What are the signs of bulimia?
- Causes of bulimia
- Treatment of bulimia
Anorexia nervosa is a serious mental health condition in which people see themselves as overweight even though they are dangerously thin.
About half of those with anorexia nervosa achieve this weight loss by dieting and avoiding food.
Others may achieve weight loss through a combination of diet and the use of purging behaviors, such as vomiting or the use of laxatives.
Another key feature of anorexia nervosa is that it includes an intense and irrational fear of body fat and weight gain.
Many people with anorexia also have coexisting psychiatric and physical illnesses, including depression, anxiety, obsessive behavior, substance abuse, cardiovascular or neurological complications, and impaired physical development.
There are potentially fatal aspects of anorexia nervosa.
In the short term, starvation can result in physical changes associated with problems such as heart complications.
Symptoms of anorexia
- Skipping meals or making excuses for not eating
- Adopting an excessively restrictive vegetarian diet
- Excessive focus on healthy eating
- Make your own meals instead of eating what the family eats
- Withdrawing from normal social activities
- Persistent worry or complaining about being fat and talking about losing weight
- Looking frequently in the mirror for perceived flaws
- Use of dietary supplements, laxatives, or weight loss products
- Excessive exercise
- Calluses on the knuckles due to induction of vomiting
- Problems with loss of tooth enamel which can be a sign of repeated vomiting
- Getting up during meals to use the bathroom
Other physical symptoms can develop over time:
- Loss of calcium from bones
- Brittle hair and nails
- Dry, yellow skin
- Fine hair growth on the body
- Mild anemia and muscle weakness and loss
- Severe constipation
- Low blood pressure, slow breathing and pulse
- Drop in internal body temperature, causing a person to feel cold all the time
- Infrequent or absent menstrual periods
Causes of anorexia
Specialists believe that it is likely the result of a combination of factors.
Many people who develop anorexia share certain personality and behavioral traits that can make them more likely to develop the condition:
- A tendency toward depression and anxiety
- It is difficult for them to handle stress
- Perfectionism – setting strict and demanding goals or standards
- Have feelings of obsession and compulsion, but not necessarily obsessive compulsive disorder
- Low self-esteem
Puberty appears to be a major environmental factor that contributes to anorexia.
It could be the combination of hormonal changes and feelings of stress, anxiety, and low self-esteem during puberty that triggers anorexia.
Other environmental factors that can contribute to anorexia include:
- Pressure and stress at school, such as tests or bullying, particularly teasing about body weight
- Occupations or hobbies where being slim is seen as the ideal, such as dancing, modeling, or athletics
- A stressful life event, such as losing a job, breaking up in a relationship, or grieving
- Difficult family relationships
- Physical or sexual abuse
Anorexia often begins as a form of diet that gradually gets out of control.
Biological and genetic factors
It has been suggested that changes in brain function or hormone levels may also play a role in anorexia.
These changes can affect the part of the brain that controls appetite, or can lead to feelings of anxiety and guilt when eating.
The risk of someone developing anorexia is also thought to be higher in people with a family history of eating disorders, depression, or substance abuse, suggesting that genes may play a role.
Treatment of anorexia
Treatment for anorexia nervosa generally involves a combination of psychological therapy and supervised weight gain.
Cognitive behavioral therapy
A well-established, highly effective, and long-lasting treatment is cognitive behavioral therapy, which focuses on identifying, understanding, and changing patterns of thought and behavior. The benefits are usually seen in 12 to 16 weeks, depending on the person.
Anorexia doesn’t just affect one individual – it can have a huge impact on the entire family. Family intervention is an important part of treatment for youth with anorexia.
Family intervention should focus on the eating disorder, and involves the family discussing how anorexia has affected them. It can also help the family understand the condition and how they can help.
Medication alone is not usually effective in treating anorexia. Often only used in combination with the measures mentioned above to treat associated psychological problems
Two of the main types of medications used to treat people with anorexia are:
- Selective serotonin reuptake inhibitors (SSRIs) – a type of antidepressant medication that can help people with coexisting psychological problems such as depression and anxietySSRIs tend to be avoided until a person with anorexia has started to gain weight because the risk of more serious side effects is increased in people who are severely underweight. They are also used with caution in those under 18 years of age
- Olanzapine – is a medicine that can help reduce feelings of anxiety related to problems such as weight and diet in people who have not responded to other treatments
Unlike most other psychiatric disorders where there are no medical complications associated with those illnesses, anorexia nervosa and bulimia nervosa also inherently have many different medical complications.
The encouraging fact is that most of these medical complications are treatable and reversible with definitive care and the cessation of disordered eating behaviors.
Some of the complications associated with anorexia that should be treated separately are:
- Secondary amenorrhea and infertility
- Bone disease
- Cardiovascular complications
- Gastrointestinal complications
After visiting your doctor, you will find it helpful to join a self-help group where other people share problems similar to yours, these groups can provide you with both information and support in the difficult times that everyone with an eating disorder they usually go through.
Occasionally someone with anorexia may refuse treatment even though they are seriously ill and their life is at risk.
In these cases, as a last resort, doctors may decide to admit the person to hospital for compulsory treatment.
This condition generally affects a slightly older age group than anorexic patients, often women in their early 20s who have also had an overweight problem in childhood.
As in anorexics, bulimia patients suffer from an exaggerated fear of being fat.
Unlike anorexics, bulimics generally manage to keep their weight within normal limits. This is because, although they try to lose weight by inducing vomiting or taking laxatives, they also binge on food.
These binges involve ingesting, in a short period of time, large amounts of foods that are fattening and that are not usually allowed.
For example, you can eat several packages of cookies in a row, several boxes of chocolates, and several cakes in a couple of hours or even less.
Later, you will feel sick, very guilty and depressed. Binge eating or vomiting can cause your weight to go up or down above 3 kilos in a very short period of time.
This is extremely unpleasant, although for many it becomes a vicious cycle from which they cannot get out as the chaotic eating pattern dominates their lives.
As with other eating disorders, bulimia nervosa can be associated with:
- Low self-esteem
- Alcohol abuse
- Self-inflicted injuries
What are the signs of bulimia?
- Worrying more and more about your weight
- Bingeing on a lot of food in a short period of time
- Vomiting and / or using laxatives or other ways to get rid of calories
- Having irregular menstrual periods
- Feeling tired
- Feel guilty
- Maintain a normal weight, despite your best efforts with a diet.
Causes of bulimia
Our culture has an incessant idealization that thinness and the “perfect” body is synonymous with beauty and success.
Scientific research suggests that this social environment encourages diet, and diet predisposes an individual toward eating problems.
In the case of bulimia nervosa in particular, the physiological effects of dietary restriction can trigger binge eating.
Additionally, feelings of inadequacy, depression, anxiety, and loneliness, as well as problematic family and personal relationships, can also contribute to the development of eating disorders.
In some people, anorexia and bulimia seem to have been triggered by some unpleasant event (such as the breakup of a romantic relationship).
Sometimes it is not a negative event but only an important one, such as marriage or leaving the family home.
Bulimia is often related to other psychological problems.
Research has shown that bulimia is more common in people who have:
- Anxiety disorders
- Obsessive compulsive disorder
- Post-traumatic stress disorder
- Personality disorder
- Low self-esteem
- Deficiency or excess of certain brain chemicals called neurotransmitters
Treatment of bulimia
You can recover from bulimia, but it can be a long and difficult process.
Cognitive behavioral therapy
Cognitive behavioral therapy (CBT) is the most common type of psychological treatment for bulimia. It involves talking to a therapist and looking at your emotions in detail to find new ways of thinking about situations, feelings, and food.
It may also include keeping a food diary, which will help determine what triggers the binge.
As with CBT, interpersonal therapy (IPT) involves meeting with a therapist to discuss your condition. However, the focus is more on her personal relationships than her problems with food.
You are more likely to be referred for this type of psychological treatment if you have recently lost a loved one or experienced a big change in your life. The goal of TIP is to help you establish supportive relationships, which can make your approach to eating.
Antidepressants known as selective serotonin reuptake inhibitors (SSRIs) can be used to treat bulimia.
The generally recommended SSRI to treat bulimia is called fluoxetine (Prozac).
As with any antidepressant, an SSRI will normally take several weeks before it starts to work.
Usually you will start with a low dose, which is then gradually increased as your body adjusts to the medicine.
Not everyone responds well to antidepressant medications, so it is important that your progress is carefully monitored.