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Bulimia Nervosa
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A person suffering with Bulimia Nervosa consume large amounts of food and then rid their bodies of the excess calories by vomiting, utilising laxatives or diuretics, taking enemas, or excessive exercising. Many sufferers will use a combination of all these forms of purging and "binge and purge" in secret to maintain normal or above normal body weight. In many cases these sufferers may successfully hide their problem from others for years.

Anorexics frequent binges and purges, is common, which can range from once or twice a week to several times a day. Dieting heavily between episodes of binging and purging is also a practice adopted. Eventually, half of those with anorexia will develop bulimia.

As with anorexia, bulimia typically begins during adolescence. The condition occurs most often in women but is also found in men. Many individuals with bulimia, ashamed of their strange habits, do not seek help until they reach their thirties or forties. By this time, their eating behavior is deeply ingrained and more difficult to change.

The patient repeatedly eats in binges. In a binge episode the patient has both of:

Consumes much more food than most people would in similar circumstances and in a similar period of time.

Feels that the eating is out of control.

The patient repeatedly controls weight gain by inappropriate means such as: fasting, self-induced vomiting, excessive exercise or abuse of laxatives, diuretics or other drugs.

On average, both of the above behaviors (binge eating and inappropriate control) have occurred at least twice a month for at least 3 consecutive months.

Weight and body shape unduly affect the patient's self-evaluation.

These symptoms do not occur solely during episodes of Anorexia Nervosa.

Specify whether:

Purging type: The patient often induces vomiting or misuses diuretics or laxatives. This is the more common type.

Nonpurging type: The patient fasts or exercises excessively but does not often induce vomiting or misuse diuretics or laxatives.

Associated Features:

Depressed Mood
Somatic or Sexual Dysfunction
Addiction
Dramatic or Erratic or Antisocial Personality

Differential Diagnosis:

Some disorders display similar or sometimes even the same symptom. The clinician, therefore, in his diagnostic attempt has to differentiate against the following disorders which one needs to be ruled out to establish a precise diagnosis.

Anorexia Nervosa.
Binge-Eating/Purging Type.
Kleine-Levin Syndrome.
Major Depressive Disorder, with Atypical Features.
Borderline Personality Disorder.

Cause:

The self esteem of individuals with eating disorders is directly related to their body shape, and weight. This eating disorder often lead to diminished concentration and attention leaving one less able to focus on academic course or professional work. Preoccupation with food and body image result in feelings of anxiety which may also interfere with daily functioning. In severe cases medical problems may arise such as hypotension, dental enamel erosion, malnutrition, impaired renal functioning, electrolyte imbalance, and cardiovascular problems which require medical attention and possible hospitalization.

Treatment:

Counseling and Psychotherapy [ See Therapy Section ]:

Education about medical complications, supportive and cognitive behavioral therapy and nutritional counseling is extremely important.

Psychotherapeutic interventions may include individual or group therapy. Often simply beginning a course of treatment will result in a feeling of relief at no longer having to keep such an important part of one's life a secret. The focus of psychotherapy is often on improving self-esteem, but may be supplemented with nutrition education, discussions of eating habits, exploration of the role that food and eating play in one's life and underlying family and interpersonal dynamics

Pharmacotherapy [ See Psychopharmacology Section ] :

May include medical stabilization.

Prozac. May lessen the number of binge episodes and associated dysphoria. Treat comorbid depression if present. Hospitalization in a minority of patients (admission criteria similar to those of anorexia nervosa except for weight loss).

 


DSM Code

307.51 Bulimia Nervosa

F50.2 Bulimia Nervosa.

Disorder Sheets

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Recommended Book

Bulimia Nervosa: a Cognitive Manual: A Cognitive Manual Click Here to View

 

Bulimia Nervosa

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