Food and eating can be a source of comfort for many people, but for others, it can be a source of anxiety, stress, and shame. Thanks to the massive influence of media and entertainment in modern society, many people have developed unrealistic ideas about body size and shape, and this has contributed to the development of mental health disorders related to eating for many men and women around the world.
There are several different eating disorders, and each one of them involves different struggles related to restricting or controlling the way a person eats and what they eat as well. No matter the type, eating disorders usually arise due to a person experiencing a severe lack of confidence in their appearance that causes them to engage in unhealthy behavior that can be life-threatening if it is not treated. One common type of eating disorder is bulimia nervosa.
What is Bulimia Nervosa?
Bulimia, or bulimia nervosa, is a serious eating disorder that entails eating and purging large amounts of food. Symptoms of bulimia include:
- Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
- Eating, in a discrete period (e.g. within two hours), an amount of food that is larger than what most people would eat during a similar period and under similar circumstances.
- Lack of control overeating during the episode (e.g. a feeling that you cannot stop eating, or control what or how much you are eating).
- Recurrent inappropriate compensatory behavior to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics, or other medications, fasting, or excessive exercise.
- The binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for three months.
- Self-evaluation is unduly influenced by body shape and weight.
- Binging or purging does not occur exclusively during episodes of behavior that would be common in those with anorexia nervosa.
Researchers believe that nearly 30 million Americans have been diagnosed with some form of an eating disorder. Eating disorders are much more frequently diagnosed in women than in men, and studies have shown that 1.5% of American women have been diagnosed with bulimia.
People who struggle with bulimia engage in what is called “binge eating”; this involves eating to excess in large quantities, then engaging in problematic behaviors to get rid of the food to avoid gaining weight.
This could mean vomiting, using laxatives or other diuretics, excessive exercise, or any other strategy to compensate for the number of calories that have been eaten. Continued binging and purging of food can lead to life-long health consequences if not remedied. For example, repeated incidents of binging and purging can cause a person to become dehydrated, losing key electrolytes needed to keep the body running appropriately. Recurrent vomiting can also cause internal damage, including tears or ruptures in the digestive tract, heart problems, nutritional deficiencies, tooth decay, and many more problems that could even lead to death.
The Dangers of of Bulimia Nervosa
While bulimia can lead to severe physical health complications and is considered a medical problem, it is primarily a mental health condition that is frequently accompanied by other mental health issues, such as depression or anxiety.
Studies have found that almost half of those surveyed who are struggling with bulimia also have a diagnosis of bipolar disorder or depression and more than half have an anxiety disorder diagnosis.
The combination of these mental health concerns can cause increased feelings of guilt or shame in people experiencing bulimia and could cause them to withdraw and not seek out treatment or help when they need it. That is why all of us need to know the signs and red flags to look out for regarding bulimia so that we can identify when a loved one (or ourselves) is struggling and get the help that is needed.
Getting Help
Suppose you or someone you know is experiencing any of these symptoms and they seem to disrupt the person’s overall functioning in life. In that case, it is important to get assistance from a mental health professional.
When someone can identify that they are struggling with symptoms of bulimia, that can be the first step in helping them to get the help that they need. Symptoms of bulimia often require psychological treatment to help a person recognize where their struggles with their body image are coming from and how to use healthier coping skills to improve their overall health and functioning.
Those experiencing minor signs or symptoms of bulimia may be able to work with a mental health professional in an outpatient setting where they can meet weekly and work on helping the person develop insight into their struggles and find new ways to manage their self-image distortions. Suppose a person is experiencing severe signs of bulimia where they cannot function on their own without engaging in binging and purging behavior. In that case, they may need to participate in a treatment recovery program that is in a residential setting. These kinds of environments can help a person begin to understand how their bulimia symptoms developed and how they can relearn to manage food and nutrition healthily.
Overall, seeking a consultation with a mental health professional who is an expert on eating disorders is the first step to learning what may be the best option for you.
Here are some resources that can get you the help that you need:
- National Eating Disorders Association (NEDA): 1-800-931-2237
- National Eating Disorder Referral and Information Center: 1-858-481-1515
- Bulimia and Self-Help Hotline: 1-314-588-1683
- National Mental Health Association Information Center: 1-800-969-6642
- Overeaters Anonymous: 1-505-891-4320
Sources:
- DSM-5 fact sheets. (n.d.). https://www.psychiatry.org/psychiatrists/practice/dsm/educational-resources/dsm-5-fact-sheets
- G, A. (2023b, December 18). Eating Disorder Statistics | ANAD – National Association of Anorexia Nervosa and Associated Disorders. National Association of Anorexia Nervosa and Associated Disorders. https://anad.org/eating-disorder-statistic/
- Statistics & Research on Eating disorders – National Eating Disorders Association. (2018d, February 19). National Eating Disorders Association. https://www.nationaleatingdisorders.org/statistics/
- Rushing, J. M., Jones, L. E., & Carney, C. P. (2003). Bulimia Nervosa: A Primary Care Review. Primary care companion to the Journal of clinical psychiatry, 5(5), 217–224. https://doi.org/10.4088/pcc.v05n0505
- Gravina, G., Milano, W., Nebbiai, G., Piccione, C., & Capasso, A. (2018). Medical Complications in Anorexia and Bulimia Nervosa. Endocrine, metabolic & immune disorders drug targets, 18(5), 477–488. https://doi.org/10.2174/1871530318666180531094508
- Castillo, M., & Weiselberg, E. (2017). Bulimia Nervosa/Purging Disorder. Current problems in pediatric and adolescent health care, 47(4), 85–94. https://doi.org/10.1016/j.cppeds.2017.02.004
Dr. Shannon McHugh is a Licensed Clinical and Forensic Psychologist in Los Angeles, California. She specializes in assessment and treatment of children, adolescents, and adults who have developmental and social delays, behavioral difficulties, and those who have experienced traumatic events