Eating disorders such as bulimia mainly affect people in the Western world. Eating disorders can be associated with being underweight, normal weight or overweight. Bulimia mainly affects young women. Despite great health risks and high suffering, bulimia often remains undetected for a long time. Therefore, it is important to learn more about the background of the disease, the symptoms of bulimia and about appropriate therapy recommendations.
What is bulimia nervosa?
Bulimia is an eating disorder. Bulimia describes an illness in which there are increased binge eating episodes and often deliberate vomiting of food. According to professional definition, the disease is called bulimia nervosa. In German, the term Ess-Brech-Sucht (binge eating) is also commonly used for bulimia nervosa. Other eating disorders include anorexia nervosa, also known as anorexia, and binge eating disorder. Atypical bulimia nervosa is when not all of the criteria for diagnosing bulimia apply.
What are signs of bulimia nervosa?
Typical symptoms of bulimia nervosa include vomiting and binge eating or overeating. Some sufferers also experience weight loss and slimming in the meantime. However, this is often not the case because of the binge eating, so one criterion for bulimia is a normal or increased BMI (BMI > 17.5). If, on the other hand, the BMI is below 17.5 and an attempt is made to lose weight at the same time with the help of vomiting or medication, it was an atypical anorexia.
Consequences of bulimia nervosa
In bulimia, acid-related discomfort in the mouth often develops because of the vomiting. Thus, sore or inflamed areas may occur in the mouth and throat, and tooth enamel may be attacked. How to protect the teeth should be discussed in individual cases with the treating dentist. Because important nutrients can be lost when abstaining from food and vomiting, hair loss occurs more frequently in those affected by eating disorders.
Criteria for making the diagnosis
The following criteria and symptoms are relevant to the diagnosis of bulimia nervosa:
- Frequent binge eating (at least two per week for three months or longer).
- Eating binges mostly in secret and alone
- Greed for food and persistent preoccupation with the subject of food
- Avoiding weight gain due to: self-induced vomiting or misuse of laxatives, diuretics, or thyroid medications
- In self-perception, the own body is classified as too fat
What does bulimia do to the body?
Due to frequent vomiting, the body loses a lot of acid. In order to still produce enough stomach acid, important salts are removed from the blood. In extreme cases, this can go so far as to upset the salt balance of the blood. This creates the risk of cardiac arrhythmias. To avoid such life-threatening complications of bulimia, medical blood checks are necessary, especially with regard to the potassium level in the blood.
Causes: What can cause bulimia?
The peak of the disease, that is, the largest number of cases, is in the age group between 18 and 35 years. However, variations are possible, so bulimia can occur in other age groups as well. The causes of bulimia are very individual in each case. Therefore, the question “How do you get bulimia?” cannot always be answered in the same way. Just as with other eating disorders (anorexia, binge-eating disorder), the triggers are varied and depend on several factors. The cause is usually an interplay of genetic predisposition and environmental conditions. Genetically, the neurotransmitter serotonin seems to play a role. The slimness ideal of our society can be mentioned as an example of environmental conditions. In some cases, traumatization can also be found in the history of those affected. In some cases, there are concurrent problems in emotion regulation with frequent mood swings.
Bulimia: who is at risk? Who is affected?
There is no test that can show how high the risk of developing bulimia is. But in general, eating disorders seem to be more common in the Western world, where there is a surplus of food. The following occupational groups seem to have an increased risk of developing an eating disorder:
- Models
- Ballet dancers
- Flight attendants
- Athletes
These can often be professionally exposed to slimming pressure.In addition, bulimia occurs more frequently in conjunction with other mental illnesses.
Who diagnoses bulimia nervosa?
Eating disorders are diagnosed by either a physician, usually a psychiatrist or a psychotherapist. In most cases, a doctor makes the initial diagnosis and then refers the person to a psychotherapist.
Who treats bulimia nervosa?
Psychotherapy is needed to treat bulimia nervosa. This is usually provided by a psychological or medical psychotherapist. With the help of continuous, medically and psychotherapeutically guided therapy, bulimia can be treated best. Here, those affected also learn what and when it is best to eat to beat bulimia. Daily structure and structured eating are particularly important. In some therapy-resistant cases, drug therapy also helps with bulimia, for example in the form of the antidepressant fluoxetine, a selective serotonin reuptake inhibitor (SSRI).
Suffering from bulimia nervosa: who helps?
Because bulimia often also has strong negative effects on physical health, medical co-treatment should generally be provided. Self-help groups or groups of relatives can also be a good help in therapy. There, exchanged tips and the cohesion of the group can protect against relapses. Blogs and forums, on the other hand, are not recommended for self-help because they are not accompanied by professionals.
What to do for self-help?
Problematic in the context of bulimia is especially long starvation for several hours, which is typical for bulimia. Prolonged abstinence from food increases susceptibility to binge eating: After periods of starvation, the craving for food is at some point so great that an eating attack can hardly be averted. The next eating attack is then followed by another hunger period as punishment and with the aim of losing weight. This then preprograms the next binge eating episode and is a vicious cycle that perpetuates bulimia. What to do. Regular and structured food intake is crucial. This prevents binge eating and helps maintain a healthy weight.
What comes after bulimia?
It often takes sufferers a long time to seek help because the topic of eating disorders is very shameful for them. After successful therapy, many patients remain symptom-free. Others achieve symptom-free intervals alternating with relapses. A third group requires long-term therapeutic support if symptoms of bulimia persist.
