Bulimia

What is bulimia?

Bulimia is a psychological condition characterized by recurrent and uncontrollable binge eating episodes that occur within a specific time frame (typically 2 hours or less). The amount of food consumed during these episodes is often quite large, and can exceed 5,000 to 20,000 calories for some individuals in any one sitting.

Diagnostic criteria for bulimia

• Episodes of binge eating characterized by eating in a discrete period of time an amount of food that is larger than normal and,

• Experiencing a sense of loss of control during the eating episode.

• Recurring behavior that is inappropriate with regard to weight gain, including self-induced vomiting, laxative use, diuretics or excess exercise.

• Binge eating behavior and associated compensatory behaviors that have occurred at minimum twice per week for 3 months or more.

• Self perception and identity that unduly emphasizes physical appearance and weight.

Bulimia is also referred to as “bulimia nervosa” or binging and purging. Eating binges may occur several times during the course of a day. Bulimia is not to be mistaken for Anorexia Nervosa, a different eating disorder that may also involve recurrent and inappropriate eating behavior.

Purging Behaviors Associated With Bulimia

Individuals with bulimia do not have control over their eating episode, and frequently binge and purge as a compensatory response to stress, anxiety or other emotional factors. Other behaviors often adopted by a bulimic include excessive exercise in order to prevent weight gain, self induced vomiting, use of laxative, diuretics or other purgatives.

Self induced vomiting and use of laxatives or purgatives are referred to as “purging” behaviors, whereas fasting and excessive exercise fall into the category of “non-purging” behaviors.

A person with bulimia will either be diagnosed as having “purging” bulimia or “non-purging” bulimia, though an individual might engage in behaviors common to both. For example, someone who typically uses vomiting and laxatives to “purge” may occasionally engage in excessive exercise to avoid weight gain after a perceived “lapse” or binge.

Emotional Factors Contributing to Bulimia

Bulimia is often linked to emotional disorders as coping mechanism. It is not a response to intense hunger in most instances. Typically a person with bulimia will exhibit depression, stress, anxiety or self esteem issues. Often binges occur when an individual is suffering from a sense that they are not in control.

A cycle of binging and purging often becomes an obsession for individuals with bulimia. At the end of a binge and purge, most bulimics will feel a temporary sense of calm. A person with bulimia is usually aware that their behavior may not be perceived as normal, and thus hides their activity from others. Often fear and guilt accompanies binging and purging episodes.

There are no known exact causes for bulimia at this time, however several factors have been identified that may contribute to bulimic tendencies, including: depression, self-identity or self-esteem issues, perceived overweight or poor body image, cultural and environmental factors and excessive anxiety.