What is Bulimia Nervosa?

Bulimia is an eating disorder in which a person regularly binge eats, then tries to prevent weight gain by self-induced vomiting, water pills, laxatives, fasting or extreme exercising.

What are the symptoms of Bulimia?

Symptoms of Bulimia include:

• Frequent binge eating (eating very large amounts of food in a short period of time)
• Feeling a lack of control over eating
• Regular self-induced vomiting
• Using laxatives or water pills
• Strict dieting, fasting or vigorous exercise to prevent weight gain
• Judging oneself mainly by body shape and weight

Other symptoms may include:

• Cutting down strictly on food or liquids
• Ipecac or enema abuse (also called purging)
• Loss of appetite
• Weight gain or loss of 10 pounds or more
• Physical changes including salt and fluid imbalance, menstrual problems, hair loss, chronic sore throat, swollen parotid glands (the saliva glands below the ears) or severe tooth decay

What causes Bulimia?

The exact cause of Bulimia is unknown, but a number of psychological, social, cultural and biochemical theories are being looked at.

What happens to people who have Bulimia?

Bulimia usually starts in the teen or early adult years and is far more common in females than in males. The illness may be constant or it may get better and worse over a period of many years. Usually bingeing alternates with periods of normal eating and/or fasting. In severe cases, there may be periods of bingeing and fasting with no periods of normal eating.

What is the treatment for Bulimia?

Treatment of bulimia usually includes individual, group and/or family psychotherapy, and nutrition counseling. Depending on the patient's state of physical health, there will be greater or lesser control of the person's eating and total environment. When binge eating and purging have led to extreme physical danger, medical or psychiatric hospitalization is required and all eating and elimination (urinating, bowel movements and vomiting) are controlled and carefully observed at every moment. As symptoms are brought under control and eating behaviors and weight are stabilized, control is gradually and slowly returned to the patient. At all levels of care, treatment involves high levels of structure and a behavioral treatment plan based on the weight and eating behaviors. Long-term psychotherapy and medical follow-up are essential.

What Can I do to help get my Bulimia under control?

• Participate actively in the treatment plan.
• Complete an inpatient program when necessary.
• Maintain weight independently within 5 pounds of target weight.
• Function independently in activities of daily living.
• Regularly attend individual, group and/or family therapy.
• Make all scheduled medical follow-up visits.
• Learn and use healthy coping skills.
• Ask for help when it's needed.
• Be honest with the health care professionals who are treating you. Never hold back information.

What happens if the symptoms return after I get them in control?

When signs of relapse appear, always contact the professional responsible for psychiatric and medical follow-up. Signs of relapse may include:

• increase or decrease in weight that is 5 pounds or more out of target range
• increase in any addictive behavior (food, exercise, drugs, alcohol)
• decreased appetite or inability to eat
• a return of binge eating, purging or vomiting
• use of diet pills or water pills
• marked increase or decrease in sleep

Where can I get more information about Bulimia?

There are several good books about Bulimia:

Hilde Bruch. The Golden Cage. Random House, 1979.

Hilde Bruch. Eating Disorders--Obesity, Anorexia Nervosa, and the Person Within. Basic Books, 1985.

Hilde Bruch. Conversations with Anorexics. Basic Books, 1995.

Joan Jacobs Brumberg. Fasting Girls. Harvard University Press, 1989.

Christopher G. Fairburn. Overcoming Binge Eating. Guilford, 1995.

Jack Gorman. Essential Guide to Psychiatric Drugs. St. Martin's Press, 1998.

Harriet Goldhor Lerner. The Dance of Anger. Harper and Row, 1997.

Harriet Goldhor Lerner. The Dance of Intimacy. Harper and Row, 1991.

Craig Nakken. The Addictive Personality. Hazelden Press, 1996.