Bulimia nerviosa

Bulimia Nervosa

Bulimia Nervosa, commonly known as bulimia, is an eating disorder in which the subject engages in recurrent binge eating followed by feelings of guilt, depression, and self-condemnation. The sufferer will then engage in compensatory behaviors to make up for the excessive eating, which are referred to as "purging". Purging can take the form of vomiting, fasting, the use oflaxatives, enemas, diuretics or other medications, or overexercising. [1]
The word bulimia comes from the Latin (būlīmia) from the Greek βουλῑμια (boulīmia), ravenous hunger, compounded from βους (bous), ox + λῑμος (līmos), hunger.[2]

[edit] Diagnosis

The criteria for diagnosing a patient with bulimia are [3]:
1. Recurrent episodes of binge eating. An episode of binge eating is characterizedby both of the following:
1. Eating, in a fixed period of time (e.g., within any two-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances.
2. A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one iseating).
2. Recurrent inappropriate compensatory behavior to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics or other medications; fasting,or excessive exercise.
3. The binge eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for three months.
4. Self-evaluation is unduly influenced by body shape and weight.5. The disturbance does not occur exclusively during episodes of anorexia nervosa.
See the Diagnostic and Statistical Manual of Mental Disorders. If any of these symptoms are noticed, a doctor or psychologist should be contacted. However, these symptoms are often difficult to spot. Unlike anorexia nervosa, the person must be of normal or higher weight and is less likely to drop a significantamount of weight on a continual basis. Because bulimia carries a great deal of shame, the bulimic desperately tries to hide the symptoms from family and friends. Bulimia is more likely to span over a lifetime unnoticed, causing a great deal of isolation and stress for the suffering individual. Despite the frequent lack of obvious physical symptoms, bulimia has proven to be fatal, as malnutrition takesa serious toll on every bodily organ.[4]

[edit] Cyclic patterns

Bulimics go through cycles of over-eating and purging that can be very destructive to the body. These cycles often involve rapid and out-of-control eating, which may stop when the bulimic is interrupted by another person or when his/her stomach hurts from over-extension, followed by self-induced vomiting or other forms ofpurging. This cycle may be repeated several times a week or, in serious cases, several times a day.[5]
Some bulimics eat secretly; others eat socially but are bulimic in private. They also differ in "how much" they purge. Some can vomit without gagging themselves after eating. Often when the urge hits, they go to great lengths to purge, as if an uncontrollable urge is making them do so. Medicalevidence shows that the chemicals released when purging may make a person feel "high".[citation needed] This can also lead to extreme dehydration and electrolyte imbalances.
Some bulimics do not regard their cycles as a problem, while others despise and fear the vicious and uncontrollable cycle.[6] Bulimics may appear underweight, normal weight or overweight.

[edit] Types

There are two sub-typesof bulimia nervosa: purging and non-purging.
Purging type is the more common type of bulimia, and involves any of self-induced vomiting, laxatives, diuretics, enemas, or Ipecac, to rapidly extricate the contents from their body.[7]
Non-purging type occurs in only approximately 6%-8% of bulimia cases, as it is a less effective means of ridding the body of such a large number of calories. It...