Bulimia nervosa is an eating disorder in which a person binges and purges. The person may eat a lot of food at once and then try to get rid of the food by vomiting, using laxatives, or sometimes over-exercising. People with bulimia are preoccupied with their weight and body image. Bulimia is associated with depression and other psychiatric disorders. It shares some symptoms with anorexia nervosa, another major eating disorder. Because many people with bulimia can maintain a normal weight, they may be able to keep their condition a secret for years. If not treated, bulimia can lead to nutritional deficiencies and even fatal complications.
People with bulimia may have the following signs and symptoms:
No one knows what causes bulimia, although there are several theories. Genes may play a part -- there is some evidence that women who have a sister or mother with bulimia are at higher risk of developing the condition. Families may put an too much emphasis on achievement, or may be overly critical. Psychological factors may also play a part including having low self-esteem, not being able to control impulsive behaviors, and having trouble expressing anger. Some people with bulimia may have a history of sexual abuse. People with bulimia may also experience depression, self-mutilation, substance abuse, and obsessive-compulsive behavior. Cultural pressures to look thin can also play a part, particularly among dancers and athletes.
People with the following conditions or characteristics are at higher risk for developing bulimia:
Often, people with bulimia are ashamed of their condition and do not ask for help for many years. By then, their habits are harder to change. If you have symptoms of bulimia, you should talk to your doctor as soon as possible. The doctor should check for physical signs such as eroded tooth enamel and enlargement of the salivary glands, as well as signs of depression. Laboratory tests may show chemical changes caused by bingeing and purging. Your doctor or a mental health practitioner will do a psychological exam and ask about your feelings and your eating habits.
The most successful treatment combines psychotherapy, family therapy, and medication. It is important for the person with bulimia to be actively involved in their treatment.
Antidepressants are often prescribed for bulimia. The most common antidepressants prescribed are selective serotonin reuptake inhibitors (SSRIs). They include:
Prozac is the only antidepressant approved by the Food and Drug Administration to treat bulimia, although some studies suggest that other SSRIs, such as Luvox, may be even more effective.
Some studies indicate that Prozac and other antidepressants may cause some children and teenagers to have suicidal thoughts. Children who are taking these drugs should be monitored very carefully for signs of suicidal behavior.
People with bulimia may not be getting the nutrients their bodies need. Your health care provider may prescribe potassium or iron supplements, or other supplements to make up for any deficiency.
Psychotherapy is a cornerstone of bulimia treatment. Cognitive behavioral therapy, which teaches you to replace negative thoughts and behaviors with healthy ones, is a common treatment method.
Other mind-body and stress-reduction techniques, such as yoga, tai chi, and meditation, may help you become more aware of your body and have a more positive body image. A 6-week clinical trial showed that guided imagery helped people with bulimia reduce bingeing and vomiting, feel more able to comfort themselves, and improved feelings about their bodies and eating. More studies are needed to see if guided imagery has long-term benefits.
Always tell your health care provider about the herbs and supplements you are using or considering using.
People with bulimia are more likely to have vitamin and mineral deficiencies, which can affect their health. Getting enough vitamins and minerals in your diet or through supplements can correct the problems.
Some natural therapies, including dietary supplements, may help general health and well-being.
Following these nutritional tips may help reduce symptoms:
If you aren' t getting enough of some nutrients, your doctor may suggest the following supplements:
Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider to get your problem diagnosed before starting any treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, you should make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day. You may use tinctures alone or in combination as noted.
These herbs are not used to treat bulimia specifically, but may be good for general overall health:
There are no scientific studies that support using homeopathy to treat bulimia. However, an experienced homeopath will consider your individual case and may recommend treatments to address both your underlying condition and any current symptoms.
There are no scientific studies that support using acupuncture to treat bulimia. However, a trained acupuncturist may be able to recommend acupuncture treatments to support your overall health. Many inpatient treatment centers for eating disorders include acupuncture in their overall treatment plan. Studies have found that acupuncture can be helpful in treating addictive behaviors and anxiety in general, which can help people with bulimia who are in recovery.
Therapeutic massage can be an effective part of a bulimia treatment plan. In one study, teen girls with bulimia got massage therapy for 5 weeks or were in a control group that didn' t get massage therapy. The 24 girls receiving massage improved, while the control group did not improve. Women in the massage group were less anxious and depressed right after their first massages. They also had better scores on the Eating Disorder Inventory, which helps health care providers assess psychological and behavioral traits in eating disorders.
Many people with bulimia relapse after treatment and need long-term care. Possible complications from repeated bingeing and purging include problems with the esophagus, stomach, heart, lungs, muscles, or pancreas. People with suicidal thoughts or severe symptoms may need to be hospitalized. Women with bulimia may find pregnancy emotionally difficult because of the changes in their body shape. The mother's poor nutritional health can affect the baby. Women who have stopped having periods because of bulimia will be unable to become pregnant.
Because bulimia is usually a long-term disease, a health care provider will need to check the person's weight, exercise habits, and physical and mental health from time to time.
Eating disorders - bulimia
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