Bulimia
What is it
Bulimia nervosa is a disorder of eating behavior that is characterized because people who suffer from it usually have binge eating in which they eat large amounts of Food in a short space of time, that is, they eat more food than most people. people at the same time.
Bulimics are unable to master the impulses that lead them to eat and have the feeling that they can not stop eating. However, the feeling of guilt and shame after eating a lot of food leads to a purge (self-induced vomiting or use of laxatives or diuretics or both), rigorous regimens or excessive exercise to counteract the effects of the abundant meals and avoid getting fat.
These people have about 15 episodes of bingeing and vomiting per week and, in general, their weight is normal, so it is difficult to detect the disease. In a single binge you can consume 10,000 to 40,000 calories.
Causes
In the origin of this disease biological, psychological and social factors intervene that distort the vision that the patient has of himself and respond to a great fear of fattening.
The patient with bulimia is always very worried about his weight , even when it is normal, but he can not repress his desire to eat. In addition, bulimics are not well with themselves (not only physically, nor are they valued). Bulimia usually manifests itself after having made numerous harmful diets without medical control. The limitation of food imposed by the patient leads to a strong state of anxiety and the pathological need to eat large amounts of food.
So far the biological vulnerability involved in the development of the disease is unknown and some trigger factors related to the social environment, the diets and the fear of ridicule over the physical are more known. Many of the factors coincide with those of anorexia , such as affective disorders arising in the family, drug abuse, obesity , diabetes mellitus , certain personality traits and distorted ideas of the body.
Finally, the sociocultural factors, such as the ideals of thinness that are imposed from the media, and fashions make society tend to try to achieve them and when it is not achieved it causes frustration . This increases in the adolescent era.
It is important to clarify that eating disorders do not usually appear when one of these factors is manifested, but that it is the confluence of several that can lead to the appearance of bulimia.
symptoms
Generally people suffering from bulimia have been obese or have made numerous diets without medical control. Bulimics try to hide vomiting and purges, so the disease often goes unnoticed for a long time . The typical symptoms of a bulimia picture are the following:
- Binge eating or over food intake : The patient eats a large amount of food in a very short space of time and has no control over the intake: he has such anxiety that he thinks he can not stop eating.
The bulimics do not feel any pleasure when eating or have preferences regarding the type of food, they only seek to satisfy themselves. They try to avoid places where there is food and try to eat alone, so their behavior is usually asocial, they tend to isolate themselves and food is their only topic of conversation. In addition, the lack of control over food produces great feelings of guilt and shame. - Use of laxatives : To prevent weight gain and compensate for binge eating or overeating, the patient is vomiting, using laxatives, diuretics, drugs, or resorting to other means to control weight, such as abusive practice. sport activities.
- Repetition : The cycles of bingeing and vomiting are manifested a minimum of twice a week.
- Low self – esteem .
In addition to the general manifestations can be distinguished:
Psychological alterations
Patients with bulimia nervosa are characterized by great impulsivity and low self-control . This can cause that, in addition to binges, bulimics tend to get into dangerous situations or get into discussions easily, having great mood swings.
In addition, because their self-esteem is very low, symptoms of depression and anxiety often appear and they abuse alcohol and drugs. Bulimics can also be kleptomaniacs and gamblers.
Physical symptoms
As for the physical signs that show the disease are weakness, headaches ; swelling of the face due to the increase of the salivary glands, especially the parotid glands, problems with the teeth, dizziness, hair loss , menstrual irregularities, and sudden increases and reductions in weight, although they generally do not suffer a weight oscillation as important as which manifests itself in anorexia. Bulimia may be accompanied by other disorders, such as sexual promiscuity.
The clinical consequences are:
- Arrhythmias that can lead to heart attacks .
- Dehydration
- Irritable bowel and megacolon.
- Gastroesophageal reflux.
- Hiatal hernia
- Dental cavities.
- Loss of bone mass.
- Esophageal perforation.
- Gastric ruptures.
- Pancreatitis
Prevention
The prevention of bulimia has to be done with a multidisciplinary approach . Specialists emphasize the importance of social prevention and the collaboration of models, designers, TV presenters, publicists and athletes, among other professions to reduce the messages that are released to the population that affect weight loss in a non-responsible manner and deceptive and in clothing sizes.
At a family level, it is important to insist that families follow a balanced diet , such as the Mediterranean diet , and to avoid obsession with diet, weight or body image.
On the other hand, it is recommended that there is no excessive protection of parents over their children. This will facilitate the adolescent’s autonomy and that the adolescent will be able to solve problems and make his own decisions.
Finally, from school you can educate children about food and nutrition as well as foster self-esteem, social and communication skills.
Types
In this disease, two subtypes can be distinguished:
Purgative
During the episode of bulimia nervosa the patient resorts to vomiting or other purgative methods, such as laxatives and diuretics, to avoid weight gain.
Not purgative
In this case the bulimic uses other compensatory behaviors such as fasting or compulsive physical exercise, but does not resort to vomiting, diuretics or laxatives in order not to gain weight.
Diagnosis
The doctor suspects a bulimia nervosa if a person is too concerned about the increase in their weight and has large fluctuations , especially if there are obvious signs of excessive use of laxatives.
Other clues include swelling of the salivary glands of the cheeks, scars on the knuckles from using the fingers to induce vomiting, erosion of the tooth enamel due to stomach acid, and a low blood potassium value. However, the diagnosis will depend on the patient’s description of a behavior with the food that suggests excessive intake and subsequent purging.
However, the diagnosis is complicated because episodes of voracity and vomiting are easily hidden . In addition, some symptoms can be confused with those of other pathologies.
For a proper diagnosis a psychiatric interview is necessary that reveals the perception that the patient has of the own body and the relation that maintains with the food. Likewise, a complete physical examination is necessary to detect the disorders resulting from their eating behavior.
Treatments
The treatment of this eating disorder has to be multidisciplinary and adapted to each patient individually .
The two approaches to treatment are psychotherapy and drugs . It is better that psychotherapy is performed by a specialist with experience in eating disorders. This will also decide if the patient needs to follow a therapy with antidepressants that helps control bulimia nervosa.
By virtue of the severity, the patient may require outpatient treatment or be hospitalized.
The first steps should be directed to avoid vomiting , normalize the metabolic functioning of the patient and teach him to maintain a balanced diet and have good eating habits.
Along with this treatment, directed towards the physical recovery, in parallel a psychological therapy will be developed in order to restructure the rational ideas and correct the erroneous perception that the patient has of his / her own body .
The treatment also implies the collaboration of the family, since sometimes the factor that triggers the disease is found in their breast.
The cure of bulimia is reached in 40 percent of cases, although it is an intermittent disease that tends to become chronic. Mortality in this disease exceeds that of anorexia due to complications derived from vomiting and the use of purgatives.
Other data
How can people close to the patient act?
The best way to help a bulimic person is to become aware that they have a eating disorder. Some recommendations that your environment can follow are:
- Avoid critical comments about weight , food, etc.
- Understand that bulimia is a serious problem, not nonsense of the person who suffers.
- Try not to control the patient all the time and talk only about the problem. In this way they will prevent you from feeling overwhelmed and will encourage you to have the perception of support and understanding.
- Put aside blackmail such as “if you eat, I’ll buy you something you want”. These formulas are useless and worsen the situation.
The post Bulimia appeared first on HealthBodha.com.
