Synonyms in a broader sense
- Bulimia nervosa
- Anorexia nervosa
- Anorexia
- Anorexia
- Binge Eating Disorder
- Psychogenic Hyperphagia
Definition
The main feature of bulimia disorder is recurrent eating fits. During these eating fits the patient eats a very large amount of food in a short period of time. This amount is significantly larger than that consumed by a healthy person in a comparable period of time. The eating fits can be followed by self-induced vomiting, but this is not necessary.
Epidemiology
Bulimia nervosa (bulimia) is more common in the general population than anorexia nervosa (anorexia). According to American studies, the probability of developing bulimia in women (aged 15-30) is about 2%. The gender distribution corresponds approximately to the distribution for anorexia (anorexia) (women to men = 12:1). The probable age of onset of the disease is very similar to that of anorexia nervosa (anorexia) (about 16-18 years).
Differential diagnoses
Patients who suffer from obesity (overweight) can also suffer from ravenous appetite attacks. However, this usually does not include the subsequent attempts to regulate the weight by various measures (see summary of bulimia). However, conspicuous eating behaviour can also be associated with various physical illnesses (diabetes mellitus, brain tumours etc.). Last but not least, from a therapeutic point of view, it must be remembered that patients with the symptoms of schizophrenia can also show very conspicuous eating behaviour.
Co-morbidity
- Half of all people suffering from bulimia also have an anxiety disorder
- Depression or mood swings are also found in the course of the disease in about 50% of all patients. – In about 1/5 of all patients, the diagnostic criteria for an alcohol or drug addiction are fulfilled.
Summary
Apart from the recurrent attacks of ravenous appetite with binge eating, patients generally show very controlled eating behaviour (“restrained eating”). The control of this eating behaviour is virtually done via the head and not via the stomach. Important perceptions such as feelings of hunger and satiety are ignored.
The long-term goal of this restrained eating is to reduce body weight. In any case, people suffering from bulimia are very concerned with their own body and its weight, as there is a direct connection between body and self-esteem. Since the patients are of course well aware of their eating fits, there is a great fear of the next ravenous appetite attack and the associated weight gain.
For this reason, patients take so-called counter-regulatory measures to prevent such weight gain. About 80% of the patients practice the so-called self-induced (induced) vomiting. A certain proportion also misuse repeated laxatives.
(It should be noted that this never has the desired effect. The aim is often to prevent the absorption (uptake) of nutrients. However, only water is withdrawn from the body and this is not desirable in most cases).
Some patients also use medication to reduce the appetite or diuretics (water reducers). It becomes especially dangerous for patients suffering from diabetes mellitus (“sugar”), as these often provoke an insulin deficiency in order to slow down the calorie intake (this can be life-threatening!!! ).
