Bulimia nervosa
| Bulimia nervosa | |
|---|---|
| Other names | Bulimia |
| Loss of enamel (acid erosion) from the inside of the upper front teeth as a result of bulimia | |
| Specialty | Psychiatry, clinical psychology |
| Symptoms | Eating a large amount of food in a short amount of time followed by vomiting or the use of laxatives, often normal weight |
| Complications | Breakdown of the teeth, depression, anxiety, substance use disorders, suicide |
| Causes | Genetic and environmental factors |
| Diagnostic method | Based on person's medical history |
| Differential diagnosis | Anorexia nervosa, binge eating disorder, Kleine-Levin syndrome, borderline personality disorder |
| Treatment | Cognitive behavioral therapy |
| Medication | Selective serotonin reuptake inhibitors, tricyclic antidepressant |
| Prognosis | Half recover over 10 years with treatment |
| Frequency | 3.6 million (2015) |
Bulimia nervosa (BN), also known simply as bulimia, is an eating disorder characterized by binge eating (eating large quantities of food in a short period of time, often feeling out of control) followed by compensatory behaviors, such as self-induced vomiting or fasting, to prevent weight gain.
Bulimia is more common among those who have a close relative with the condition. The percentage risk that is estimated to be due to genetics is between 30% and 80%. Other risk factors for the disease include psychological stress, cultural pressure to attain a certain body type, poor self-esteem, and obesity. Living in a culture that commercializes or glamorizes dieting, and having parental figures who fixate on weight are also risks.
Diagnosis is based on a person's medical history; however, this is difficult, as people are usually secretive about their binge eating and purging habits. Further, the diagnosis of anorexia nervosa takes precedence over that of bulimia. Other similar disorders include binge eating disorder, Kleine–Levin syndrome, and borderline personality disorder.
Signs and symptoms
Bulimia typically involves rapid and out-of-control eating, which is followed by self-induced vomiting or other forms of purging. This cycle may be repeated several times a week or, in more serious cases, several times a day and may directly cause:
- Dehydration
- Electrolyte imbalance can lead to abnormal heart rhythms, cardiac arrest, and even death
- Oral trauma, lacerations to the lining of the mouth or throat due to forced throwing up movements.
- Russell's sign: calluses on knuckles and back of hands due to repeated trauma from incisors
- Swollen salivary glands (in the neck, under the jawline)
- Gastrointestinal problems, like constipation and acid reflux
- Constipation or diarrhea
- Hypotension
- Infertility and/or irregular menstrual cycles
- Weight Fluctuations
These are some of the many signs that may indicate whether someone has bulimia nervosa:
- A fixation on the number of calories consumed
- A fixation on an extreme consciousness of one's weight
- Low self-esteem and/or self-harm
- Suicidal tendencies
- An irregular menstrual cycle in women
- Regular trips to the bathroom, especially soon after eating
- Depression, anxiety disorders, and sleep disorders
- Frequent occurrences involving the consumption of abnormally large portions of food
- The use of laxatives, diuretics, and diet pills
- Compulsive or excessive exercise
- Unhealthy/dry skin, hair, nails, and lips
- Fatigue, or exhaustion
As with many psychiatric illnesses, side effects such as delusions can occur, in conjunction with other signs and symptoms, leaving the person with a false belief that is not ordinarily accepted by others.
People with bulimia nervosa may also exercise to a point that excludes other activities.