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TOP STORIES BELOW...
What is bulimia nervosa?

Bulimia nervosa is a serious eating disorder marked by a destructive pattern of binge-eating and recurrent inappropriate behavior to
control one's weight. It can occur together with other psychiatric disorders such as depression, obsessive-compulsive disorder,
substance dependence, or self-injurious behavior. Binge eating is defined as the consumption of excessively large amounts of food
within a short period of time. The food is often sweet, high in calories, and has a texture that makes it easy to eat fast. "Inappropriate
compensatory behavior" to control one's weight may include purging behaviors (such as self-induced vomiting, abuse of laxatives,
diuretics, or enemas) or non-purging behaviors (such as fasting or excessive exercise). For those who binge eat, sometimes any
amount of food, even a salad or half an apple, is perceived as a binge and is vomited.

People with bulimia nervosa often feel a lack of control during their eating binges. Their food is usually eaten secretly and gobbled
down rapidly with little chewing. A binge is usually ended by abdominal discomfort. When the binge is over, the person with bulimia
feels guilty and purges to rid his or her body of the excess calories. To be diagnosed with bulimia, a person must have had, on
average, a minimum of two binge-eating episodes a week for at least three months. The first problem with any eating disorder is
constant concern with food and weight to the exclusion of almost all other personal concerns.

Who develops bulimia?

Bulimia nervosa typically begins in adolescence or early adulthood. Like anorexia nervosa, bulimia mainly affects females. Only ten
percent to 15 percent of affected individuals are male. An estimated two percent to three percent of young women develop bulimia,
compared with the one-half to one percent that is estimated to suffer from anorexia. Studies indicate that about 50 percent of those
who begin an eating disorder with anorexia nervosa later become bulimic.

It is believed that more than five million individuals experience an eating disorder (bulimia nervosa or anorexia nervosa) in this country
alone. It is ten times more common in women than men, with greatest prevalence occurring in adolescents and college-age young
adults. This indicates a need for concern and preventive measures on college campuses across the country, especially for female
students.

How do people with bulimia control their weight?

People with bulimia are overly concerned with body shape and weight. They make repeated attempts to control their weight by fasting
and dieting, vomiting, using drugs to stimulate bowel movements and urination, and exercising excessively. Weight fluctuations are
common because of alternating binges and fasts. Unlike people with anorexia, people with bulimia are usually within a normal weight
range. However, many heavy people who lose weight begin vomiting to maintain the weight loss.

What are the common signs of bulimia?

Constant concern about food and weight is a primary sign of bulimia. Common indicators that suggest the self-induced vomiting that
persons with bulimia experience are the erosion of dental enamel (due to the acid in the vomit) and scarring on the backs of the hands
(due to repeatedly pushing fingers down the throat to induce vomiting).

A small percentage of people with bulimia show swelling of the glands near the cheeks called parotid glands. People with bulimia may
also experience irregular menstrual periods and a decrease in sexual interest. A depressed mood is also commonly observed as are
frequent complaints of sore throats and abdominal pain. Despite these telltale signs, bulimia nervosa is difficult to catch early. Binge
eating and purging are often done in secret and can be easily concealed by a normal-weight person who is ashamed of his or her
behavior, but compelled to continue it because he or she believes it controls weight. Characteristically, these individuals have many
rules about food -- e.g. good foods, bad foods -- and can be entrenched in these rules and particular thinking patterns. This
preoccupation and these behaviors allow the person to shift their focus from painful feelings and reduce tension and anxiety
perpetuating the need for these behaviors.

Are there any serious medical complications?

Persons with bulimia -- even those of normal weight -- can severely damage their bodies by frequent binging and purging. Electrolyte
imbalance and dehydration can occur and may cause cardiac complications and, occasionally, sudden death. In rare instances, binge
eating can cause the stomach to rupture, and purging can result in heart failure due to the loss of vital minerals like potassium.

Do we know what causes bulimia?

The current obsession with thinness in our culture certainly has a large influence. There is some evidence that obesity in adolescence
or familial tendency toward obesity predisposes an individual to the development of the disorder. Parents’ anxiety over a chubby child
can perhaps also be a contributor. Some individuals with bulimia report feeling a "kind of high" when they vomit. People with bulimia
are often compulsive and may also abuse alcohol and drugs. Eating disorders like anorexia and bulimia tend to run in families, and
girls are most susceptible. Recently, scientists have found certain neurotransmitters (serotonin and norepinephrine) to be decreased
in some persons with bulimia. Most likely, it is a combination of environmental and biological factors that contribute to the
development and expression of this disorder. During the early 1970s, before the prevalence of bulimia was more widely recognized,
almost all persons with an eating disorder believed they had invented the behaviors and that no one else had such a problem. As in
anorexia nervosa, the behaviors associated with bulimia provide temporary relief from tension and allow ill persons to focus less on
problems perceived as irresolvable and to instead focus on body weight and food.

Is treatment available for persons with bulimia?

Most people with bulimia can be treated through individual outpatient therapy because they aren't in danger of starving themselves as
are persons with anorexia. However, if the bulimia is out of control, admission to an eating disorders treatment program may help the
individual let go of their behaviors so they can concentrate on treatment.

Group therapy is especially effective for college-aged and young adult women because of the understanding of the group members. In
group therapy they can talk with peers who have similar experiences. Additionally, support groups can be helpful as they can be
attended for as long as necessary, have flexible schedules, and generally have no charge. Support groups, however, do not take the
place of treatment. Sometimes a person with an eating disorder is unable to benefit from group therapy or support groups without the
encouragement of a personal therapist.

Cognitive-behavioral therapy, either in a group setting or individual therapy session, has been shown to benefit many persons with
bulimia. It focuses on self-monitoring of eating and purging behaviors as well as changing the distorted thinking patterns associated
with the disorder. Cognitive-behavioral therapy is often combined with nutritional counseling and/or antidepressant medications such
as fluoxetine (Prozac).

Treatment plans should be adjusted to meet the needs of the individual concerned, but usually a comprehensive treatment plan
involving a variety of experts and approaches is best. It is important to take an approach that involves developing support for the
person with an eating disorder from the family environment or within the patient’s community environment (support groups or other
socially supportive environments).

What about prevention?

Prevention research is increasing as scientists study the known "risk factors" to these disorders. Given that bulimia and other eating
disorders are multi-determined and affect young women, there is preliminary information on the role and extent such factors as self
esteem, resilience, family interactions, peer pressure, the media and dieting might play in its development. Advocacy groups are also
engaged in prevention through efforts such as removing damaging articles from teen magazines on "dieting" and the importance of
"being thin."

Bulimic Danger Signs
Thermoregulatory problems:

Bulimics as well have this problem. Electrolyte imbalances from the purging usually caused the bulimic to have erratic temperature
changes, one minute feeling warm and the next getting shivers and cold chills.

Insomnia:

Mostly due from electrolyte disturbances and hormonal problems.

Anemia:

Purging wipes out precious iron from the bulimic's system.

Dental erosion:

If a bulimic does not come forward about their addiction, most likely their dentist will spot it. The acid in our intestines that digests our
food comes up when a bulimic purges, slowly detereorating the enamel that protects the teeth. A dentist is able to spot this easily for
two reasons : One is the fact that many of them have had to go through specific courses when in dentistry school that give them a list
of characteristics of a bulimic, and secondly, the way the food and acid splashed up against the teeth leaves a certain pattern that is
the trademark of a bulimic. The constant erosion of the teeth usually leads to the enamel slewing off, plus lots of cavities and root
canals.

Ruptured blood vessels in the eyes

Paratoid swelling:

Glands in the throat and mouth become irritated and swell.

Eesophageal tears:

The constant heaving of stomach acid eventually causes the stomach lining to wear off. The added pressure from purging also adds
into this and a bulimic stands a great risk of tearing their esopheagus, leading to hemorraging and then a rupture.

Delayed gastric emptying:

The tone of the stomach area becomes poor and weak so that it cannot produce the power to push out whatever food you do eat. This
can lead to a lot of toxins building up inside which also weakens the immune system and leaves you susceptible to many more
viruses.

Chronic diarrhea and/or constipation as well:

Bulimics often abuse laxatives which can cause them to forever have diarrhea. They eventually lose all control over their bowels as
well, forcing some bulimics to have to wear some form of a diaper.

Dehydration

Acidosis:

Blood gets too acidic which can lead to other sicknessess.

Osteoporosis:

Bones become significantly weakened leaving you susceptible to broken bones from just falling out of bed.

Bradycardia:

From purging, things called electrolytes become imbalanced. Electrolytes help control your heart's beat among other things, and once
they are off balance, your heart rate will suffer - most likely dropping too low.

Dysrhythmia:

Sudden death from too low of pottasium levels.

Edema:

Bloating and water retention

Ulcers:

The stomach lining slews off the more you throw up. Pretty soon the stomach has no protection against it's acids, and the stomach
acid starts to burn holes into the stomach. Eventually an ulcer forms and gets infected, causing burning holes with puss and germs to
form.

Amenorrhea:

Some people think that you can only lose your period if you are underweight, but this is untrue. If someone is bulimic and purges, that
can seriously mess up their hormones which can lead to missing periods.

Metabolic problems -

Hypocalcemia

Hypokalemia

Dry skin

Brittle nails

Urinary tract infections:

Dehydration is common in bulimics and you get a lot of bladder infections.

Loss of potassium:

Purging, laxative, and diuretic abuse is a big factor into this. All 3 of these things cause vital fluids to be lost and create a bulimic, or
anorexic's, potassium levels to drop dangerously low, setting them up for heart failure.

Chronic sore throat:

Not fun to wake up every morning feeling like you have strep throat.