Bulimia nervosa is characterized by cycles of binge eating and purging, usually through vomiting or laxatives. It commonly begins in adolescence and is triggered by dieting attempts that fail and lead to binge eating. Risk factors include age, gender, ethnicity, and personality disorders. While concerns about body image play a role, the actual causes seem to be genetic, biological, cultural, and related to family and emotional factors. Medical complications can include tooth decay, esophagus damage, and irregular periods. Treatment may involve support groups, cognitive behavioral therapy, antidepressant drugs, and hospitalization in severe cases requiring withdrawal from purging behaviors or treatment of depression.

1. Bulimia NervosaBy: Kathryn Johnston

2. BackgroundBulimia nervosa is more common than anorexia, and it usually begins early in adolescence. It is characterized by cycles of bingeing and purgingBulimia is often triggered when young women attempt restrictive diets, fail, and react by binge eating.In response to the binges, patients compensate, usually by purging, vomiting, or taking laxatives, diet pills, or drugs to reduce fluids.Patients then revert both to severe dieting and excessive exercise. The cycle then swings back to bingeing and then to purging again.

3. Risk FactorsAgeGenderEthnic FactorsPersonality Disorders

4. CausesThere is no single cause for the eating disorder. bulimia. Although concerns about weight and body shape play a role in all eating disorders, the actual cause of these disorders appear to result from many factors, including cultural and family pressures and emotional and personality disorders. Genetics and biologic factors may also play a role.

5. ComplicationsMany medical problems are directly associated with bulimic behavior, including: Tooth erosion Fluid loss Cavities Swallowing problems Gum problems Esophagus damage Water retention Irregular periods Swelling Abdominal bloating

6. SymptomsPossibly the most bewildering symptom of eating disorders is the distorted body image. People with bulimia were more likely than those with anorexia to overestimate their size. There were also a greater disparity between what they wanted to look like and what they believed they looked like.

7. Regularly going to the bathroom right after mealsSuddenly eating large amounts of food or buying large quantities that disappear right awayCompulsive exercisingBroken blood vessels in the eyes Pouch-like appearance to the corners of the mouth due to swollen salivary glandsSmall cuts and calluses across the tops of finger joints due to self-induced vomitingDry Mouth

8. Diagnosing BulimiaYounger and female doctors are more likely to detect bulimia. A doctor should make a diagnosis of bulimia if there are at least two bulimic episodes per week for 3 months. Because people with bulimia tend to have complications with their teeth and gums, dentists could play a crucial role in identifying and diagnosing bulimia as well.

9. TreatmentSome experts recommend a stepped approach for patients with bulimia, which follow specific stages depending on the severity and response to initial treatments:Support groups: This is the least expensive approach and may be helpful for patients who have mild conditions with no health consequences.Cognitive-behavioral therapy: Along with nutritional therapy is the preferred first treatment for bulimia that does not respond to support groups.Drugs: Drugs used for bulimia are typically antidepressants known as selective serotonin-reuptake inhibitors

10. Patients with bulimia rarely need hospitalization except under the following circumstances:Binge-purge cycles have led to anorexiaDrugs are needed for withdrawal from purgingMajor depression is present

11. Therapy Eating disorders are nearly always treated with some form of psychiatric or psychological treatment. Depending on the problem, different psychological approaches may work better than others.Cognitive Behavioral TherapyInterpersonal TherapyFamily Therapy