When Eating Gets Out of Control: Bulimia Nervosa

Many men and women of all ages experience an occasional binge, whereby they indulge in a favorite dessert or eat too much at a dinner buffet. These people are generally not suffering from an eating disorder, as they feel in control of their eating habits most of the time. Bulimia Nervosa (BN), on the other hand, is characterized by a cycle of binge eating and purging (of which can occur in several ways). The binges are not occasional, and instead can occur up to several times per day. The guilt of bingeing is often so intense for a bulimic that he/she feels a strong compulsion to rid him/herself of the food that was just consumed. The most popular method of purging is to induce vomiting; however, excessive exercising and abusing laxatives is also considered purging behavior. If you or someone you know is suffering from bulimia, please contact my San Diego office about counseling for eating disorders. Eating disorders are very serious, and without treatment could result in malnourishment, organ failure, and even death. It is imperative that a person with bulimia seek therapy for his/her disorder, as this is a life-threatening condition. Please continue to read this post to learn more about the signs, symptoms, and dangers of bulimia nervosa, and do not hesitate to give my San Diego counseling office a call today at 858-481-0425 for a consultation.

What is Bulimia Nervosa?

When most people think of a person with an eating disorder, they envision a malnourished, frail-looking individual who is unmistakably underweight. This could not be further from the truth! In fact, many eating disorder sufferers are of an average weight, with some even being overweight. Anorexia Nervosa (AN), which is characterized by starvation and therefore an extremely low body weight, is what the majority of people are picturing when they think of someone with an eating disorder. While anorexia is definitely a serious disease which may also be life-threatening, Bulimia Nervosa (BN) and Binge-Eating Disorder (BED) are two eating disorders that often get overlooked since the sufferers are usually of a healthy body weight. To clarify, bulimia is a vicious cycle of binge eating and purging behavior. The purging behavior (be it exercising, vomiting, or laxative abuse) is done in an attempt to rid oneself of all the food that was just consumed during the binge in order to avoid weight gain. What most people don’t realize is that once we consume food, the components of that food (calories, fat, nutrients, etc.) are almost immediately absorbed by our bodies. Therefore, purging behaviors such as vomiting and laxative abuse do not work for weight loss, because the body has already absorbed most of the calories contained within the food. This is generally why most bulimia sufferers are of an average/healthy body weight, and often why bulimia is more difficult to diagnose than anorexia – the problem is less obvious in a bulimic because he/she is typically of a healthy weight. A bulimic may feel the compulsion to purge after a binge because he/she believes that doing so will undo the binge eating. In actual fact, taking several laxatives or inducing vomiting only rids the body of “water weight”, or the weight of the food essentially. The calories, fat, and nutrients contained within the food that was eaten have (for the most part) already been absorbed by the body.

What is a “binge”?

Typically, a bingeing episode is characterized by consuming a large amount of food in a short period of time. For example, an average binge episode is one hour or less in duration, whereby the person consumes approximately 3,000 – 5,000 calories at a time. Considering that the recommended daily intake for the majority of adult males and females is about 2,000 calories a day, we can see that a binge exceeds this, and does so in a very short amount of time.

What is “purging”?

Purging is ridding oneself of the food that was just consumed during a binge and can take many forms. The most popular form of purging is to induce vomiting, which is usually done by inserting one’s fingers into the back of the throat to stimulate the gag reflex. Ipecac syrup, which is typically used in emergency situations (i.e. if someone has accidentally ingested poison and has to be made to throw up) is often used and abused by persons with bulimia. Other forms of purging behavior include excessive exercising, crash dieting/starving oneself, and laxative abuse – these are other means of ridding the body of the calories and fat that was consumed.

The Binge-Purge Cycle:

Most bulimics describe feeling in a “trance” while binge eating. They describe the experience as surreal – almost as though they cannot control what is happening to them. They may eat a larger than normal amount of food very quickly, in just one sitting. Bingeing is usually a private event for a bulimic, as they generally feel ashamed of their seemingly uncontrollableable eating. Typical binge foods are chips, ice cream, candy, donuts, and pretty much anything with a high fat content or that is highly caloric. Some bulimics report eating entire pizzas or tubs of ice cream at a time. They may feel as though they have no control over what they are putting in their mouth, and no matter how hard they try, they feel they cannot stop. After the bingeing is over, guilt sets in. The overwhelming feelings of shame and remorse fuel the compulsion to rid oneself of the food that was just consumed. The binge-purge cycle often begins when a person goes on a strict diet, depriving him/herself of certain foods. This causes the body to crave these “forbidden foods” even more, causing the mind to become fixated on them. When the individual gives in and has even just one bite of that chocolate brownie, he/she figures “I blew it so I may as well eat the whole thing now”. Then begins the bingeing episode, which in turn triggers intense feelings of guilt for “blowing” the diet in the first place, which then prompts the purging behavior. As you can see, it is a vicious cycle and once it has begun, it can be very difficult to break free from.

Signs & Symptoms of Bulimia:

Here are some “red flags” of the eating disorder Bulimia Nervosa:

  • Obsession with body weight and shape
  • Obsession with food
  • Fear of not being able to control one’s eating habits
  • Eating beyond the point of fullness
  • Eating unusually large quantities of food in a relatively short period of time
  • Secrecy about eating habits (i.e. eating in private and completely alone)
  • Having a hidden stash of junk food
  • Excessive feelings of guilt and shame after binge eating
  • Purging behaviors after bingeing as a means to control weight gain (i.e. excessive exercising, abusing laxatives, inducing vomiting, etc.)

Other physical signs of bulimia, which may not be immediately obvious to the bulimic him/herself, are:

  • “Chipmunk Cheeks” – puffy cheeks caused by regular vomiting
  • Tooth discoloration or decay – often times a dentist is the first to notice signs of bulimia, because the stomach acid from the frequent vomiting wears away the enamel of the teeth
  • Red or callused knuckles – from pushing fingers down the throat in order to induce vomiting
  • Weight gain or weight fluctuations – weight gain can occur from frequent binge eating of foods that are highly caloric, and weight fluctuations may occur if the person uses fasting as a means of purging

The Dangers of Bulimia:

Our bodies are meant to consume just enough calories in order to function optimally and maintain a healthy weight. Any more or less than our individual body’s “optimal” caloric intake could result in poor overall (physical and mental) health. While all eating disorders are severe and potentially life-threatening, bulimia is particularly problematic since most bulimics appear “normal” and “healthy” on the outside. They are usually at or above the recommended weight for their age and height, making bulimia difficult to diagnose early on. Another reason why bulimia is so dangerous is because of the frequent purging behavior – specifically the use of laxatives and/or excessive vomiting. Both of these methods can quickly lead to dehydration, which can be deadly. When the body’s electrolytes are off-balance, the physical health of the individual is compromised. I’m sure if you’ve ever had a bad flu virus, you know what it feels like to be severely dehydrated. Excessive vomiting and diarrhea rid the body of fluids, which in turn rids the body of the electrolytes that are essential for optimal functioning. When electrolytes become imbalanced, the person may feel dizzy, lethargic, and weak. If the behavior continues, serious side effects develop, such as organ failure and an irregular heartbeat, both of which could lead to death.

Recovering from Bulimia:

Bulimia does not discriminate, and can affect both males and females of varying ages. Most people think that eating disorders only affect teenage girls. This is a myth. While the majority of eating disorder sufferers are female and the onset typically begins during the mid-teenage to early-twenty years, this does not mean that individuals (both male and female) younger or older cannot suffer from an eating disorder. Like any other psychological disorder, recovery from bulimia is not easy – but it is possible. There are many happy and healthy people out there today who once battled with an eating disorder. Recovery is possible. Regardless of how long you have been engaging in your bingeing and purging cycle of bulimia, it is possible to break free and acquire healthier eating habits and attitudes toward yourself and food in general. If you feel out of control with regards to your eating habits, or think that you may be suffering from an eating disorder, please give me a call today. Together, we can help you to break free from the vicious binge-purge cycle of bulimia, resolve any underlying emotional or psychological issues that may be triggering the behavior, and help you adopt a more positive, healthy outlook on your body and the food you eat.

Copyright ©2012 Jan Rakoff. All Rights Reserved.


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