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Bulimia is an eating disorder where the person overeats a large amount of caloric foods in a short period of time, followed by guilt and attitudes to compensate and avoid weight gain.
Among the compensatory behaviors, the most common are: inducing vomiting, use of medication (laxatives, diuretics, appetite suppressants, syrups that make you vomit, …), fasting for long periods, drastic diets, exercising exaggeratedly, etc. This disease is not necessarily related to the induction of vomiting, but to any compensatory behavior and episodes of overeating.
One of the factors that most contribute to the development of bulimia is the cult of the “ideal” (thin) body that the media disseminates and society supports. The role of the family of extremely valuing beauty is often also present. Other factors such as genetic, psychological, trauma, cultural factors also influence the development of the disease.
Middle to upper class adolescent and young adult women are most affected. The incidence in developed countries is even higher.
In addition to eating and compensating episodes, other frequently associated symptoms are: wear on tooth enamel, hypotension, stomach problems, tachycardia, dry skin, malnutrition, anxiety, mood swings, changes in menstruation, among others.
Thinness is not something that draws attention, unlike anorexia. People are usually normal weight, overweight or obese.
The diagnosis is made based on the person’s history. Some exams can help, such as dental exams, blood tests, liver function, among others.
The treatment requires a multidisciplinary approach with a physician, nutritionist and therapist encompassing nutritional rehabilitation and psychotherapy (cognitive behavioral therapy and psychosocial therapy). The use of medications such as antidepressants may or may not be part of the treatment plan.
Phytotherapy can be used to reduce anxiety and thus reduce episodes of overeating.
Support from family and close people is very important, but often they also need help, such as family therapy.
Bulimia can be prevented, starting with education at home for healthy eating and not the cult of beauty and thin body.
Definition bulimia
In 1979 bulimia was distinguished from anorexia. Bulimia nervosa is an eating disorder characterized by episodes of uncontrolled eating (overeating in a short period of time) and compensatory behaviors to avoid weight gain, such as inducing vomiting, drug abuse (laxatives, diuretics, etc.) .
Guilt about eating is often present and the struggle to control the urge to eat is constant. During an episode of uncontrolled eating, around 3000 to 5000 are consumed in more or less 1 hour. Afterwards, the feeling of guilt and the fear of gaining weight surface along with compensatory behaviors (inducing vomiting, laxatives, diuretics, excessive exercise, long periods of fasting, etc.).
Bulimia is not necessarily related to the act of inducing vomiting.
bulimia statistics
It is estimated that in the United States 1.5% of women and 0.5% of men suffer from bulimia. As we can see, this disease is 3 times more common in women than in men.
An epidemiological study found that 78% of people with bulimia had at least moderate psychosocial problems (home, work, personal life, social life), with 16% having severe problems.
bulimia causes
The exact cause of bulimia is unknown. Genetic, psychological, trauma, family, social or cultural factors influence the development of the disease, usually more than one factor.
There is evidence that genetic predisposition contributes to the development of eating disorders, such as abnormal concentrations of several hormones, the main one being serotonin.
One of the factors that most contribute to the development of bulimia is the concept that the media passes on from the cult of the ideal body. A survey carried out in Nadroga, a province of Finji (an island), with girls between 15 and 18 years of age showed that the incidence of spontaneously reported induced vomiting in 1995 (a few weeks after the introduction of television on the island) was 0% and rose to 11% in 1998.
In addition to the media, the extreme appreciation of beauty by the family and low self-esteem are factors that contribute a lot.
Bulimia risk groups
Eating disorders are more common in women than in men, with teenagers and young adults being the most affected.
It occurs more frequently in developed countries and in the middle to upper class.
Groups that idealize the physique are more likely to develop eating disorders, such as: dancers, models, gymnasts, runners, actors, etc.
Bulimia symptoms
In bulimia, the concern with weight and body shape is constant, but unlike anorexia, there are episodes in which the person eats a lot. Generally the sequence of behavior is as follows:
– periods of food restriction (periods of fasting and/or low-calorie meals)
– episodes of eating excessively large amounts in a short period of time (such as 2 hours).
– compensatory behaviors to prevent weight gain (inducing vomiting, use of laxatives, diuretics or enema). Some people do not induce vomiting or use medication, but fast for long periods or exercise excessively.
These people’s weight is generally considered to be in the normal range, but some people may be slightly underweight, others overweight or obese.
Most of the time, people know they have a different eating behavior and feel ashamed, so they eat exaggeratedly in secret.
Often dysphoria (sudden and transient change) is also present, as well as psychosocial problems. Anxiety, suicidal thoughts, drug abuse, are also often present.
Some physical signs are very common in bulimia:
– hypotension
– tachycardia (increased heart rate)
– dry skin
– irregular menstruation
– erosion of tooth enamel (for people who eat a lot and then throw up)
bulimia diagnosis
The diagnosis is made by a doctor, usually a psychiatrist, who analyzes the person’s behavioral history and how they see themselves. Laboratory tests (blood test, liver function tests, urine analysis,…) can also help in the diagnosis, but they are not conclusive.
Other professionals, such as psychologists, can identify behaviors indicative of bulimia, but cannot diagnose the disease.
bulimia complications
The complication of bulimia affects several organs and systems, depending on the type and frequency of compensatory behavior that the person presents (induced vomiting, use of laxatives, diuretics, fasting,…).
Below we list some complications that can occur:
– dehydration, malnutrition
– hypokalemia, metabolic alkalosis
– hypertrophy of the salivary glands (swollen cheeks)
– reflux
– diarrhea and malabsorption
– loss of esophageal motility
– constipation
– gastric dilation
– hypotension
– tachycardia
– change in electrocardiogram
– arrhythmia
– teeth problems
– aspiration pneumonia
bulimia treatment
The treatment of bulimia should be done with a multidisciplinary group of doctor, nutritionist and therapist. It usually consists of nutritional rehabilitation, psychotherapy (cognitive behavioral therapy and psychosocial therapy) and pharmacotherapy.
The goal of nutritional rehabilitation is to re-establish a consistent eating pattern, with 3 meals and 2 snacks a day.
Psychotherapy can effectively facilitate nutritional rehabilitation, in addition to working on the psychological causes of an eating disorder.
Addition of pharmacotherapy to this treatment regimen may improve effectiveness. The most used drugs are:
– selective serotonin reuptake inhibitors (eg fluoxetine, citalopram, fluvoxamine, sertraline)
– tricyclic antidepressants (desipramine, imipramine, nortriptyline)
– topiramate, trazodone
– monoamine oxidase inhibitor – MAOIs (eg phenezine)
The presence and support of family members is very important for the efficacy and effectiveness of the treatment.
Fitoterapia bulimia
In the case of bulimia, there are no medicinal plants that act directly, but those that reduce anxiety, such as:
– kava , in capsules or tablets.
– Passiflora , in capsules.
– valerian , in capsules or tablets
– lavender, in infusion or capsules.
– hops , in capsules or tablets.
– rhodiola , in capsule or tablet form.
Bulimia tips and prevention
bulimia tips
Bulimia is a chronic disease in which the treatment is not long and often painful. Family support is fundamental, so that the family can receive adequate support, family therapy may be necessary, as it is also difficult for the family.
There are several therapy techniques, if one doesn’t work, don’t despair, try another.
Recognizing and admitting the problem are the first steps to recovery.
Talk to someone. It can often be difficult to talk about it with someone, especially if you’ve kept it hidden for a long time. But it is very important that you understand that you are not alone, find someone you trust and who can support you.
Stop going places, meeting people or doing activities that make the temptation to overeat and compensatory behaviors greater.
Seek professional help, like any other illness, treatment is easier with professional support.
To family and close ones: Your support and compassion is very important. Avoid insults, scare tactics, blame tricks, or condescending comments. Accept your limits, you won’t be able to help someone get better if they don’t want to get better and understand that there’s not much you can do other than support them.
bulimia prevention
A family attitude of emphasizing the importance of healthy eating and not emphasizing weight loss. If one member of the family places a lot of importance on being thin, it can influence the rest of the family to do the same.
It is important to talk with sons and daughters about the value of the whole person and not just the outside. An overvaluation of beauty and external aspects can lead to an excessive preoccupation with following current “beauty standards”, even at the cost of one’s health.
Parents should not restrict their children’s food because they think they are overweight, only the doctor and nutritionist can decide which is the best regimen to follow.
Do not link food with negotiations and blackmail, such as rewards or punishments by parents.
Avoid restrictive remimes.
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