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Eating Disorders
Bulimia Nervosa
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What Are the Symptoms of Bulimia?
If you are concerned that someone you love -- or maybe even yourself -- has bulimia, would you
know the signs?
It’s very common for people to keep their bingeing and purging a secret. And unlike anorexia,
someone with bulimia may not lose a lot of weight, so it can be harder to tell what’s going on.
According to the National Institutes of Health, you have this eating disorder if you do the
following at least twice a week for 3 months:
You binge eat. This means that you eat much more food than usual, beyond the point of feeling
full, in just a short time -- especially snacks or other foods high in calories. During a binge, you
feel like your eating is out of control.
You “purge.” After a binge, you try to prevent gaining weight from all the food you just ate.
You might make yourself vomit or take laxatives, diuretics, enemas, or other medications. You
also might use fasting or too much exercise as part of this harmful strategy.
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If you have bulimia, your thoughts about your body are distorted. Your thoughts about body
weight and shape determine how you feel overall.
You probably share some common feelings that people with anorexia may have. For example,
you may fear gaining weight, and always want to lose weight. But people with bulimia tend not
to be as concerned about their weight as those with anorexia.
It can also be harder to tell, from the outside, that someone has bulimia. Unlike with anorexia,
you might be able to keep your body weight in the normal range, with your bingeing and purging
a secret. But to you, bingeing can make you feel ashamed, while purging brings a temporary and
false sense of relief.
Complications
Bulimia can go along with depression.
It can also cause problems with your tooth enamel, due to the stomach acids
from vomiting often. You may get gum infections, swollen facial glands, cavities, and
discolored teeth, for the same reason. Your throat may be sore and inflamed, too.
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SLIDESHOW
Slideshow: A Guide to Understanding Eating Disorders
When does a weekend food fest or a strict diet reveal an eating disorder? WebMD's slideshow covers
the warning signs and treatments for anorexia, binge eating, and bulimia.
Also, bulimia is hard on your digestive system, which can be upset by the condition, especially if
you abuse laxatives.
You can become dehydrated due to all the vomiting or use of laxatives. This can cause
imbalances in certain minerals, called electrolytes, such as calcium and potassium. Low levels of
potassium or sodium can cause potentially life-threatening heart or kidney problems. Abnormal
electrolyte levels, as well as drops in blood sugar levels, can also cause seizures.
Call Your Doctor If:
You find yourself secretly binge eating, then vomiting or using laxatives
You avoid eating in front of other people
Your child has an unreasonable fear of being fat and thinks she's fat when she's not
Your child avoids eating with others or often visits the bathroom immediately after meals
When to Call 911
Sometimes, people with bulimia have depression as well as their eating disorder. Call 911 if you
or someone who has this condition are thinking about committing suicide.
WebMD Medical ReferenceReviewed by Joseph Goldberg, MD on August 03, 2018
Sources
© 2018 WebMD, LLC. All rights reserved.
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Mental Health
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Bulimia Nervosa
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Understanding Bulimia: Prevention
How Can I Prevent Bulimia?
Once a disease like bulimia has developed, prevention focuses on trying to keep it from getting
more severe and causing harm to a person's body and sense of self. This can be difficult,
as eating disorders can go on secretly for a long time before others suspect what is happening
and intervene.
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Mental Health
Eating Disorders
Bulimia Nervosa
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Understanding Bulimia: Treatment
What Is the Treatment for Bulimia?
The primary treatment for bulimia often combines psychotherapy, antidepressants, and
nutritional counseling.
It is helpful to find a psychologist or psychiatrist experienced in dealing with eating disorders.
The same is true for nutritional counseling, whether the patient sees the family doctor or another
health professional.
Clinics that specialize in eating disorders can often provide psychiatrists, psychotherapists, and
nutritionists. All therapists involved should work in close cooperation with one another.
Psychotherapy and Bulimia
Psychological treatments for bulimia may involve individual, family, or group psychotherapy.
Behavior or cognitive therapies are often prescribed, as well. Behavior therapy focuses on
altering habits (such as bingeing and purging). Sessions are usually devoted to analyzing the
behavior and devising ways to change it, and the patient follows specific instructions between
sessions.
Cognitive therapy focuses on exploring and countering the negative thoughts that underlie
destructive habits. Individual or group psychotherapy focuses on the underlying emotional
experiences and relationships that have contributed to the bulimia.
CONTINUE READING BELOW
Medications for Bulimia
Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) --
including Prozac, Zoloft, Celexa and Lexapro -- in combination with psychological therapies, are
now a mainstay in bulimia therapy. The antidepressant Wellbutrin, popular in part because of its
especially low risk for causing weight gain, is usually avoided because it can increase the risk
for seizures in patients with electrolyte abnormalities from vomiting.
Alternative Choices for Bulimia
Most alternative therapies for bulimia do not address the root causes of the disorder, but they can
be helpful in relieving some of the physical distress resulting from it. If you want to include this
type of treatment in your recovery, it is important to consult practitioners who are experienced in
dealing with eating disorders. And be sure to tell your doctors and therapists about any
complementary therapy you receive, such as acupuncture or biofeedback.
Bulimia and Mind/Body Medicine
Body exercises such as yoga, tai chi, qigong, and dance can help bulimics with their problems
of body image. Reprogramming mental processes to gain control over the binge-and-purge
cycles is another approach. Either hypnotherapy or EEG biofeedback may help. If you seek help
here, be sure to ask hypnotherapists or biofeedback practitioners about their experience in
treating eating disorders. And again, tell your doctor and other therapists about the care you get.
CONTINUE READING BELOW
Nutrition and Diet's Role in Bulimia Treatment
A nutrient-dense, sugar-free diet may help reduce binge eating. Also, eliminate alcohol, caffeine,
flavor enhancers, most salt, and cigarettes. Eat a balanced diet, supplemented daily with vitamin
C (1,000 milligrams), vitamin B complex (50 milligrams), and a multivitamin/multimineral
supplement.
Remember that treatment probably will include some retraining on how you think about food,
eating, and your body. Treatment may be needed over a long period to try to win control over the
binge-purge habits.
WebMD Medical ReferenceReviewed by Smitha Bhandari, MD on May 20, 2019
Sources
© 2019 WebMD, LLC. All rights reserved.
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