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Bulimia Nervosa: The “purging “ Disorder?

Bulimia Nervosa: Is it really that different from anorexia?

bulimia nervosaBulimia Nervosa is characterized by frequent binge eating and compensatory behaviors to avoid gaining weight. Bulimia nervosa differs from anorexia nervosa in that individuals with this eating disorder are not usually significantly underweight, and may actually be of normal weight, or may be even slightly overweight. Like anorexia, bulimia nervosa is a disorder relatively specific to girls of late adolescence to early adulthood, and is rarely found in men. Because of the overlapping symptoms between anorexia and bulimia, there have been challenges to the distinction between the two. The fact that many individuals may move from one diagnosis to the other depending upon fluctuations in body weight and the presence or absence of menses, suggests to some experts that both disorders may be more accurately defined as a subtype of a more inclusively defined eating disorder. While binging and purging may be present in both, some individuals have pure cases of anorexia (without binging in purging) and pure cases of bulimia nervosa, in which their body weight never falls below the normal level.


What are the signs and symptoms of bulimia nervosa?

The DSM-IV, which is used to define emotional disorders by mental health clinicians, has concluded that bulimia nervosa is present under the following circumstances: There must be recurrent episodes of binge eating in which an individual eats a large amount of food within a very short period of time, and has a definite sense of lack of control over eating during this episode. They also have recurrent, inappropriate compensatory behaviors, such as the misuse of laxatives, self-induced vomiting, diuretics, enemas, inappropriate use of medications, fasting or excessive exercise to keep from gaining weight. Both the binge eating and inappropriate compensatory behaviors must occur on an average of at least twice a week for three months. Their body weight must remain at a normal level or above, in order for them not to receive a diagnosis of anorexia. Finally, they must have a self-evaluation which is unduly influenced by their body shape and weight.

If I have these symptoms, what do I do?

If you recognize that you have the symptoms of bulimia nervosa, you have already taken the first step. The next thing that you would do would be to consult your physician or a mental health clinician, to find a psychologist, psychiatrist or other mental health clinician who specializes in these disorders. They will do an assessment to help decide whether you truly have an eating disorder. They will help you to discuss your attitudes about your self-image, eating behaviors and various other subjects, and may even consult with members to your family. Sometimes they may ask you to take a blood test. Frequently, bulimia nervosa may be treated on an outpatient basis rather than requiring hospitalization. The emphasis will be in getting back to a regular routine of eating three meals a day, reestablishing a “normal” pattern of eating, and re-establishing a sense of control. The goal will be to maintain steady weight control without starving or vomiting. Dietary information is usually given along with psychotherapy to assist with meeting goals and providing support. Also, you will probably want to deal with problems which may underlie your eating disorder. You may also get additional assistance by joining support groups and reading. The longer you let this problem go, the more severe it may become. Help is available today.

Information and webpage by Paul Susic Ph.D. Licensed Psychologist (Health Psychology  

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