Bulimia is an illness in which a person binges on food or has regular episodes of significant overeating and feels a loss of control. The affected person then uses various methods -- such as vomiting or laxative abuse -- to prevent weight gain.
Many (but not all) people with bulimia also have anorexia nervosa.
Many more women than men have bulimia, and the disorder is most common in adolescent girls and young women. The affected person is usually aware that her eating pattern is abnormal and may experience fear or guilt with the binge-purge episodes.
The exact cause of bulimia is unknown. Genetic, psychological, trauma, family, society, or cultural factors may play a role. Bulimia is likely due to more than one factor.
In bulimia, eating binges may occur as often as several times a day for many months.
People with bulimia typically eat large amounts of high-calorie foods, usually in secret. The person generally feels a loack of control over their eating during these episodes.
These binges cause a sense of self-disgust, which leads to what is called purging, in order to prevent gaining weight. Purging may include: making oneself vomit, excessive exercise, and use of laxatives, enemas, or diuretics (water pills). Purging often brings a sense of relief.
Body weight is often in the normal range, although people with bulimia often see themselves as being overweight. Because weight is often normal, this eating disorder may not be noticed by others.
Symptoms or behaviors that may be noticed include:
A dental exam may show dental cavities or gum infections (such as gingivitis). The enamel of the teeth may be eroded or pitted because of excessive exposure to the acid in vomit.
A physical examination may also reveal:
A chem-20 test may show an electrolyte imbalance (such as hypokalemia) or dehydration.
People with bulimia rarely need to be hospitalized, except under the following circumstances:
Most often, a stepped approach is taken for patients with bulimia. This treatment approach follows specific stages, depending on the severity of the bulimia, and the person's response to treatments:
Patients may drop out of programs if they have unrealistic expectations of being "cured" by therapy alone. Before a program begins, the following should be made clear:
Self-help groups like Overeaters Anonymous may help some people with bulimia. The American Anorexia/Bulimia Association is a source of information about this disorder.
See: Eating disorders - support group
Bulimia is a chronic illness and many people continue to have some symptoms despite treatment. People with fewer medical complications of bulimia, and who are willing and able to engage in therapy, tend to have a better chance of recovery.
Bulimia can be dangerous and may lead to serious medical complications over time. For example, frequent vomiting puts stomach acid in the esophagus (the tube from the mouth to the stomach), which can permanently damage this area.
Possible complications include:
Call for an appointment with your health care provider if you (or your child) have symptoms of an eating disorder.
Less social and cultural emphasis on physical perfection may eventually help reduce the frequency of this disorder.
Bulimia nervosa; Binge-purge behavior; Eating disorder - bulimia