Bulimia is an eating disorder. People, usually young women, have an abnormal fear of being overweight and make themselves vomit or take drugs to lose weight. However, most bulimics aren’t overweight. They often can’t stop eating and secretly eat large amounts of food in a short time, which is called binge eating. Forced vomiting, fasting, and heavy exercise to lose weight follow binge eating. It can be treated, but most people need treatment for several years.
Bulimia is similar to another eating problem, anorexia, but in anorexia, binge eating doesn’t occur.
The cause is unclear. The disorder is more common in adolescent girls and young adult women. A personal or family history of obesity and depression appears to be a risk factor, as does society’s focus on slimness. It occurs more often in people in certain jobs (e.g., modeling) and sports (e.g., running).
Symptoms include binge eating, forced vomiting, dieting, eating in secret, fasting, guilt (after eating), nervousness, sadness, stomach pain, tooth decay, and weakness. Others are dehydration, menstrual problems, an enlarged stomach, and slowed stomach emptying.
After taking a medical history, the health care provider does a physical examination, with special attention to feelings and eating habits. The health care provider makes a diagnosis on the basis of episodes of binge eating and how often they occur. After overeating, people avoid gaining weight by vomiting or abusing laxatives. Overeating episodes occur at least twice a week for 3 months and are associated with behaviors to avoid weight gain. People are also too concerned with how they look.
The health care provider may order electrocardiography (ECG) and blood tests to check for abnormalities of potassium, magnesium, and other chemicals that may be low due to vomiting and that can cause irregular heartbeat. The health care provider may also suggest seeing a specialist in eating problems and a dentist (too much vomiting can damage teeth). Bulimics can also have other psychological disorders.
The treatment goal is to reduce and then end binge eating and behaviors for losing weight, as well as change the basis of self-esteem. People usually admit that they have a problem, which helps treatment. Most often, treatment combines cognitive (deals with abnormal thinking) and behavioral (to change behaviors) therapy. Drugs, especially antidepressants, can also be given.
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Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.
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