Bulimia: Symptoms, Prevention and Treatment

What is bulimia, and what are the warning signs? What can you do when you find yourself, or a person you're close with, dealing with an eating disorder? Our experts are here with all the answers.

Hani Sakal, Chief Dietician, Leumit Health Services

Eating disorders come in all shapes and sizes. You don’t have to be extremely underweight or overweight to suffer from an eating disorder. In fact, social stigmas about looking a certain way while dealing with eating disorders can affect early-stage diagnosis, making it harder to detect.
Bulimia nervosa (in short - bulimia) is one of the eating disorders one might suffer from without necessarily “looking” like they have an eating disorder.

What is Bulimia?

Bulimia is an eating disorder, characterized by uncontrolled episodes of overeating, followed by a “purging” stage that prevents weight gain.
These episodes usually lead to a sense of guilt, shame, and lack of control.
Bulimia can be deadly when experiencing dehydration, the loss of vital minerals, cardiac arrest, and more.
To diagnose bulimia, we need to look for the following criteria:

  • Recurrent episodes of binge eating in which the amount of food is significantly larger than usual.
  • Behaviors that prevent weight gain such as self-induced vomiting, inappropriate use of laxatives or diuretics, or excessive exercise.
  • When their self-esteem is deeply affected by the way their body looks and weighs - a person who suffers from bulimia will feel better when slim, and much worse when they gain weight.

What Causes Bulimia?

Much like other eating disorders, bulimia has many causes.
Several aspects may play a role in the development of bulimia - genetic and biological features, negative body image, social influences that encourage weight loss, and a family history of eating disorders.
Bulimia, like other eating disorders, most often affects females, but it can also affect males. It is important to remember that, so we don’t overlook men who suffer from eating disorders and help them get the support and treatment they need.

What Are The Symptoms of Bulimia?

Aside from the mentioned criteria for diagnosing bulimia, there are several symptoms one might show indicating their struggle:

  • Cuts and bruises on their knuckles.
  • Fainting and overall weakness.
  • Dental damage such as blemishes on the teeth, discoloration, cavities, etc.
  • Bloated cheeks.
  • Frequent visits to the toilet after a meal.
  • The disappearance of large amounts of food from the pantry or fridge; hidden empty wrappers.
  • Extreme changes in eating habits - eating large amounts of food, followed by a long fasting period or extreme dieting.

What Are The Complications of Bulimia?

Physically, there are several side effects of bulimia in various body systems.
Physical complications may differ according to the “purging” technique since vomiting can cause different complications than misusing laxatives.
Common complications include digestive disorders, such as stomach pain, bloating, diarrhea, and constipation; dehydration and loss of vital minerals; esophageal bleeding, teeth and bone damage, and more.

How Does Bulimia Affect Mental Health?

Bulimia may cause deep emotional distress, depression, anxiety, and more.
Like other eating disorders, it is important to know that people who suffer from it might harm themselves in ways that are not related to their eating disorder. In some cases, they might have suicidal thoughts or even try actual attempts.
It is very important to be mindful of these situations. If you see any harmful behavior or signs of suicidal attempts by a person close to you, seek professional help immediately. If you are struggling with this type of emotions yourself, there is no shame in asking for help. You do not have to be alone with these thoughts.

A boy sits on the sofa, hugs a pillow and thinks

What To Do To Prevent Vomiting and Other Purging Methods

People who suffer from bulimia deal with a cycle of uncontrollable behaviors - binge eating, followed by different methods of purging, such as vomiting. This cycle usually turns into some sort of addiction.
Like other addictions, not everyone understands how difficult this is. In the case of smoking, for example, a non-smoker might not understand the struggle of having to quit this harmful habit, when in fact, it can be a difficult process. Try not to get upset with the person dealing with bulimia for not being “successful” at refraining from their purging methods. Not only is it not helpful, their sense of helplessness might increase, encouraging them to continue with their harmful habits.
An important part of treating bulimia is to try and stop these habits from happening, in order to restrain addiction as much as possible. One can try to embrace new habits that might help prevent binge eating and different purging methods.

  • Looking for alternatives: In times of struggle, they can find some sort of distraction, such as taking a soothing shower, talking to a close friend, listening to music, or playing with a small object like a stress ball.
  • Try to fight the urge: Binge-purge cycles often occur in difficult times. When feeling distressed, one might think of it as a way of coping. This sort of behavior gradually becomes their automated response. It is important to be aware of that urge and try to stifle it as much as possible.
  • Create a time frame and gradually increase it: It is not easy to fight these urges that have become habits. One might try creating a time frame for some sort of distracting activity. For example, when feeling the urge to binge eat, they can postpone it for 2 minutes, and in that time focus on something else they can do. Eventually, the time frame can increase from 2 minutes to 5, from 5 to 10, and so on.

    These instructions are not a replacement for professional help.
    Rehabilitation from a binge-purge cycle is a delicate and slow process. Both body and soul will need time to adjust, trying to get back to “normal” by letting go of these habits. The instructions above simply suggest small steps one can take when dealing with this complex eating disorder.

How is Bulimia Treated?

Much like other eating disorders, early treatment is crucial when it comes to recovering from bulimia. Dealing with a longtime eating disorder makes it much harder to treat. Since bulimia affects so many aspects of life, treatment must be as comprehensive as possible, including therapy, nutritional support, medicinal care, and treating any physiological symptoms resulting from the eating disorder.
Therapy mostly consists of psychotherapy. Psychotherapy treatment may include different approaches such as cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), and more.

How Can We Help Our Loved Ones Who Are Struggling With Bulimia?

Apart from professional help, family and friends play a huge role in a person’s support system. Family involvement helps them get the treatment they need and can increase the odds of recovery. If someone you’re close with is dealing with an eating disorder, it is important to remember that they need your support right now. Reassure them that they are not alone in this. Dealing with an eating disorder is a long and complicated journey, but with the right treatment and support, one can recover.
Whether you are dealing with it yourself or supporting a loved one, know that many people suffer from eating disorders, and there is no shame in seeking help.
There are trained professionals in this field that can help you with this journey.
You are not alone.

 

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