Bulimia Nervosa: The Disorder Of Binge Eating And Vomiting
The bulimia nervosa It is an eating and psychological disorder with severe consequences on the physical integrity and mental health of the people who develop it. As such, it is a psychopathology that must be treated as soon as possible by mental health professionals.
In this article we will see what are the main characteristics, symptoms and treatment of this alteration.
Bulimia nervosa is a psychological disorder characterized by the tendency to binge eat in a practically uncontrolled manner, and shortly after feeling the need to eliminate those ingested foods from the body. In addition, it is associated with purging behaviors or behaviors aimed at compensating for the acquisition of calories (inducing vomiting, doing intense exercise, etc.) that appear right after these binges, and which are associated with feelings of guilt and worry for having been eating unnecessarily.
Consequently, it is an eating disorder, since it is based on a pathological dynamic of relationship with food through eating. Furthermore, by affecting something as important as food intake and the functioning of the digestive system, seriously compromises health not only because it causes malnutrition problems, but also because purging behaviors can lead to very serious infections and injuries.
Diagnosis
He bulimic syndrome It is an eating disorder that is characterized by abnormal eating patterns, with episodes of massive food intake followed by maneuvers that seek to eliminate those calories. After these episodes, the subject usually feels sad, in a bad mood and has feelings of self-pity.
This disorder has a higher incidence rate among Western women between 18 and 25 years oldcoming from any sociocultural stratum.
Although bulimia nervosa encounters certain diagnostic difficulties, the criteria provided by the DSM-IV and ICD-10 are very useful. According to the DSM-IV, these are the diagnostic criteria:
On the other hand, bulimia nervosa must be distinguished from binge eating disorder, a very similar psychopathology but in which compensatory behaviors for food intake do not appear.
Types of Bulimia Nervosa
These are the main types of bulimia nervosa.
purgative type
During the episode of bulimia nervosa, the subject vomiting is regularly induced or use laxatives, diuretics or enemas. In this way, the body itself is intervened once food has been ingested.
Non-purgative type
During the bulimic episode, the individual uses other inappropriate compensatory behaviors, such as fast or the excessive exercisebut does not resort to purgative methods. In this way, an attempt is made to prevent the ingestion of food (at least in the short term) or to ensure that the effects of this ingestion do not affect the body too much. through an obsessive tendency to exercise.
Clinical picture of bulimia
These are the aspects that characterize the development of this psychopathology.
Behavioral alterations
The person affected by bulimic disorder generally presents disorganized behavior, initially only linked to eating, but later also in other facets of their life. The behavioral pattern associated with eating is disorganized and unpredictable, unlike in the case of Anorexia.
Binge eating can vary in frequency depending on mood and availability. Purging behaviors are not regular and the fear of gaining weight is dependent on mood or other circumstances.
After episodes of large food intake, bulimia sufferers become aware that the food they eat will make them gain weight; This possibility terrifies them, creates anxiety, and they resolve these thoughts by eliminating what they ingest through induced vomiting, the abuse of laxatives, diuretics, or intense physical exercise.
The most common behavior is the provocation of vomiting, and the least common is the consumption of diuretics. Additionally, vomiting and laxatives are often linked methods.
Alterations in cognition
The bulimic patient, in the same way as the anorexic, presents altered thoughts about food, body weight and figure. Both pathologies show a great rejection of the possibility of being overweight or obese.
Some bulimic patients come from anorexia nervosa when, when said disorder becomes chronic, it evolves into bulimia. At that moment they go from strict control of their diet to intermittent control, resulting in binge eating and purgative behaviors.
Psychopathologies associated with Bulimia nervosa
People who develop a bulimic-type eating disorder mostly show extensive associated psychopathology. Depression is the disorder most frequently related to bulimia, although it has also been detected that bulimic patients score high on anxiety scales.
It is also very common for patients with this psychological alteration to present Typical characteristics of Body Dysmorphic Disorderwhich, although it does not focus solely on weight or fat accumulation, generates an obsession with one’s own appearance. This last psychological disorder is characterized by non-conformity with one’s own appearance, usually focused on very specific physical features.
Medical complications associated with Bulimia nervosa
There is a general symptomatology that is likely to occur in the majority of people affected by bulimia nervosa. This set of symptoms It is nonspecific and, generally, does not allow the disorder to be identified from these data. Apathy, fatigue, sleep disturbances, and irritability can accompany loss of academic or work performance and neglect of personal care.
In the examination of the patients in the early stages of the disease, slight abdominal distensions with constipation, hypertrophy of the parotid glands, wear on the tooth enamel and abrasions on the back of the hands can already be seen.
The complications in cardiovascular system They include hypokalemia, which can produce severe alterations in the ECG, with dire consequences. This great risk factor is due to the loss of potassium in the blood caused by regular purges.
As for the endocrine systembulimia patients may have a normal menstrual cycle, but it is not uncommon for them to have irregularities or even amenorrheawith low levels of estradiol and progesterone.
Treatment of bulimia nervosa
In a particularly summary way, these are the main therapeutic objectives for bulimia nervosa:
