Bulimia – symptoms, causes and therapy

Eating disorders such as bulimia primarily affect people in the western world. Eating disorders can be associated with underweight, normal weight or  overweight  . Bulimia mainly affects young women. Despite major health risks and high levels of suffering, bulimia often goes undetected for a long time. It is therefore important to learn more about the background of the disease, the symptoms of bulimia and the corresponding therapy recommendations.

What is bulimia?

Bulimia is an eating disorder. Bulimia describes an illness in which binge eating and often intentional vomiting of food occur. According to the technical definition, the disease is called bulimia nervosa. In German, the term eating-breaking addiction is also common for bulimia   .

Other eating disorders are  anorexia nervosa, also known as anorexia nervosa, and binge eating disorder . Atypical bulimia nervosa is present when not all criteria for diagnosing bulimia apply.

What are signs of bulimia?

Typical symptoms of bulimia are  vomiting  and  binge eating.  Some sufferers also experience weight loss and weight loss in the meantime. However, this is often not the case due to the binge eating, so that one criterion for bulimia   is a normal or increased BMI (BMI > 17.5).

On the other hand, if the BMI is below 17.5 and at the same time attempts are made to lose weight with the help of vomiting or medication, it is atypical anorexia.

consequences of bulimia

In bulimia, acid-related problems in the mouth often occur due to the vomiting. Sore or inflamed areas can occur in the mouth and throat area and the enamel can be attacked. How the  teeth  can be protected should be discussed in the individual case with the treating dentist.

Because important nutrients  can be lost  when abstaining from  food  and vomiting  , hair loss occurs more frequently in those affected by eating disorders  .

Criteria for making the diagnosis

The following criteria and symptoms are decisive for the diagnosis of bulimia:

  • frequent binge eating (at least two a week for three months or more)
  • Binge eating usually in secret and alone
  • Craving for food and constant preoccupation with food
  • Avoiding weight gain from: self-induced vomiting or abuse of laxatives, diuretics, or thyroid medications
  • in self-perception, one’s own body is classified as too fat

What does bulimia do to the body?

Due to the frequent vomiting, the body loses a lot of acid. In order to produce enough gastric acid, important salts are removed from the blood. In extreme cases, this can go so far that the salt balance of the blood gets mixed up. This creates the risk of  cardiac arrhythmias .

In order to avoid such life-threatening complications of bulimia, medical blood tests, especially with regard to the potassium level in the blood, are necessary.

Causes: What can cause bulimia?

The disease peak, i.e. the largest number of cases, is in the age group between 18 and 35 years. Deviations are possible, however, so that bulimia can also occur in other age groups.

The causes of bulimia are very individual in each individual case. The question “How do you get bulimia?” cannot always be answered immediately. As with other eating disorders (anorexia, binge eating disorder), the  triggers are varied  and dependent on several factors.

The cause is usually a combination of genetic predisposition and environmental conditions. Genetically, the messenger substance  serotonin seems  to play a role. The slimness ideal of our society can  be mentioned as an example of environmental conditions  . In some cases, trauma can also be found in the history of those affected. In some cases there are problems in the regulation of emotions with frequent mood swings.

Bulimia: who is at risk? Who is affected?

There is  no test  that can show how high the risk of developing bulimia is. But in general, eating disorders seem to be more common in the western world, where there is a food surplus. The following occupational groups appear to have an increased risk of developing an eating disorder:

  • Models
  • ballet dancers
  • flight attendants
  • athletes

These can often be exposed to professional pressure to lose weight.

In addition, bulimia often occurs in connection with other mental illnesses.

Who Diagnoses Bulimia?

Eating disorders are diagnosed by either a doctor, usually a psychiatrist or a psychotherapist. Usually a doctor makes the initial diagnosis and then refers the person concerned to a psychotherapist.

Who Treats Bulimia?

Psychotherapy is necessary to treat bulimia. This is usually carried out by a psychological or medical psychotherapist. Bulimia can best be treated with the help of continuous, medically and psychotherapeutically guided therapy.

Affected people also learn what and when to eat to overcome bulimia. Structure of the day and structured eating are particularly important.

In some therapy-resistant cases of bulimia, drug therapy also helps, for example in the form of the  antidepressant  fluoxetine , a selective serotonin reuptake inhibitor (SSRI).

Suffering from bulimia: who can help?

Since bulimia often has severe negative effects on physical health, medical treatment should generally be included. Self-help groups or groups of relatives can also be a good help in therapy. Tips exchanged there and the cohesion of the group can protect against relapses.

Blogs and forums, on the other hand, are not recommended for self-help because they are not accompanied by specialist staff.

What to do to help yourself?

Prolonged starvation lasting several hours, which is typical of bulimia, is particularly problematic in the context of bulimia. Going without food for a long time increases the susceptibility to binge eating: after periods of hunger, the craving for food is so great at some point that an binge eating can hardly be averted.

The next binge eating is then followed by another period of hunger as punishment and with the aim of losing weight. This then pre-programs the next binge eating and is a vicious cycle that perpetuates bulimia.

What to do? Regular and structured food intake is crucial. This prevents binge eating and helps maintain a healthy weight.

What comes after bulimia?

It often takes a long time for those affected to seek help because the subject of eating disorders is very shameful for them. After successful therapy, many patients remain symptom-free.

Other sufferers achieve symptom-free intervals alternating with relapses. A third group requires long-term therapeutic support if symptoms of bulimia persist.

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