Information about the Eating Disorder Bulimia Nervosa
Bulimia Nervosa Description
Bulimia Nervosa is an eating disorder with two components: binge eating and compensatory behavior. A binge episode is defined as overeating, i.e., consuming an amount of food (calories) that is substantially more than would be consumed by most people, which occurs over two hours. Compensatory behaviors are efforts to prevent the excessive calories from resulting in weight gain. These can include purging behaviors such as vomiting (e.g., “gagging” oneself with a finger) or using laxatives, diuretics, or enemas. Nonpurging behaviors include fasting or excessive exercise. Bulimia nervosa is very dangerous and can result in electrolyte imbalances and other medical issues influenced by the type of compensatory behaviors. It should be treated by a professional with eating disorder expertise.
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Bulimia Nervosa Clinical Diagnosis
The American Psychiatric Association classifies Bulimia Nervosa as an Eating Disorder on Axis I of the DSM-IV-TR. Symptoms must include:
Perceived loss of control over eating
Compensatory behavior aimed at preventing weight gain
Binges and compensatory behaviors cycle occurs at least two times per week for at least three months
the individual overvalues his/her appearance according to weight/body composition
The prior five symptoms cannot occur only during episodes of Anorexia Nervosa
Two types of Bulimia exist
- Purging Type
- Nonpurging Type
Bulimia Nervosa Causes and Characteristics
Ninety percent of Bulimics are female. The majority of bulimics are white and the condition is more common in Western countries. This leads many experts to conclude that the cause is primarily learned, given its cultural variability. Many Bulimics struggle with their weight and frequently diet. Approximately 2% of women and 0.2% of men in America will suffer from Bulimia Nervosa during their lifetime.
Bulimia Nervosa Treatment
Treatment should always be determined by a professional (e.g., licensed psychologist, psychiatrist, licensed social worker, or licensed mental health counselor). Fortunately, this disorder has been successfully treated by cognitive behavioral therapies (CBT) and behavior therapy (BT).
Eating Disorder- Binge Eating Disorder
Binge eating disorder is a characterized by distinct overeating episodes called a binge. Typically binges involve consuming unusually large amounts of food for a single meal. Calories may range from 3,000 to 15,000 or more. This is accompanied by a “feeling” of being out of control, or feeling compelled to do it. Anticipating a binge can involve positive feelings such as excitement or relief. Likewise the binge itself can be a temporarily respite from negative emotions. But, for many the times before and during binges can also consist of negative emotions, similar to those that follow the binge. Binges are often followed by feelings of shame, embarrassment (although usually binge eaters engage in the behavior alone), guilt, anxiety, etc.
Characteristics of Binge Eaters
Many binge eaters are obese or at least overweight as frequent binges almost always lead to steep weight increases. Those suffering with binge eating disorder are more likely to also be experiencing other emotional or behavioral problems when compared to obese individuals without the disorder, e.g., ocd or major depression.
Eating Disorders- Diagnosis of Binge Eating
The American Psychiatric Association includes Binge Eating Disorder in the Appendix as a syndrome in need of further study. It may be the most common eating disorder in the US, with estimates as high as 4%. But, currently it is not included as an Axis I disorder. A diagnosis of Eating Disorder Not Otherwise Specified can be given when appropriate. It is likely that the next version of the American Psychiatric Association’s Diagnostic and Statistical Manual for Mental Disorders will likely include Binge Eating Disorder, given the attention obesity is receiving.
Causes of Binge Eating
There is not consensus regarding the etiology of binge eating disorder. There is a great likelihood that genes and other biological factors, such as neurotransmitters or hormones play a role, but the amounts of influence are yet to be determined. In addition various situational and behavioral events are likely involved. Periods of calorie restriction (typical dieting), stress, interpersonal strife, and deficiencies in modulating emotions and other behavioral coping strategies put people at greater risk of developing the disorder. Binge episodes can be triggered by various situational, emotional, or interpersonal variables. Some of the most common include boredom, anger, anxiety, stress, loneliness, rejection, disappointment, etc.
Treatment for Binge Eating Disorder
Despite the lack of consensus on the precise diagnostic characteristics, there is agreement that binge eating can be treated. Cognitive behavioral therapy and Interpersonal Therapy are believed to be efficacious. During therapy many clients will experience a reduction in binges, weight, as well as anxiety and other emotional symptoms, and an improvement in relationships.
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