Bulimia nervosa, mostly known as bulimia or "mia", is an eating disorder in which the subject engages in recurrent binge eating followed by feelings of guilt, depression, and self-condemnation. The sufferer will then engage in compensatory behaviors to make up for the excessive eating, which are referred to as "purging". Purging can take the form of vomiting, fasting, the use of laxatives, enemas, diuretics or other medications, or overexercising.
Diagnosis
The criteria for diagnosing a patient with bulimia are:
1. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
1. Eating, in a fixed period of time (e.g., within any two-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances.
2. A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating).
2. Recurrent inappropriate compensatory behavior to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics or other medications; fasting, or excessive exercise.
3. The binge eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for three months.
4. Self-evaluation is unduly influenced by body shape and weight.
5. The disturbance does not occur exclusively during episodes of anorexia nervosa.
See the Diagnostic and Statistical Manual of Mental Disorders. If any of these symptoms are noticed, a doctor or psychologist should be contacted. However, these symptoms are often difficult to spot. Unlike anorexia nervosa, the person must be of normal or higher weight and is less likely to drop a significant amount of weight on a continual basis. Because bulimia carries a great deal of shame, the bulimic desperately tries to hide the symptoms from family and friends. Bulimia is more likely to span over a lifetime unnoticed, causing a great deal of isolation and stress for the suffering individual. Despite the frequent lack of obvious physical symptoms, bulimia has proven to be fatal, as malnutrition takes a serious toll on every bodily organ.
Treatment
Treatment is most effective early in the development of the disorder, but since bulimia is often easy to hide, diagnosis and treatment often come when the disorder has already become a static part of the patient’s life.
Historically, bulimics were often hospitalized to end the pattern and then released as soon as the symptoms had been relieved. But this is now infrequently used, as this only addresses the surface of the problem, and soon after discharge the symptoms often reappeared as severe, if not worse.
Several residential treatment centers offer long term support, counseling, and symptom interruption. The most popular form of treatment involves therapy, often group psychotherapy or cognitive behavioral therapy. Anorexics and bulimics typically go through the same types of treatment and are members of these same treatment groups. This is because anorexia and bulimia often go hand in hand, and often patients have at some point suffered from both. Some refer to this as "symptom swapping". These forms of therapy address both the underlying issues which cause the patient to engage in these behaviors, and the food symptoms. Sadly, most people with eating disorders will never have the chance to receive treatment from a facility that specializes in eating disorders. The Hollywood Anorexic type checking in and out of rehab is the minority. Usually, eating disordered people are professionally, socially and financially devastated by their illness. Most insurance companies will only cover brief inpatient stays in general hospital psych wards. This ultimately leaves the eating disordered person more confused, more desperate and sicker than before. Specialized treatment is necessary for recovery. Few can afford it and few receive it. Consequently, many continue to die from these mental illnesses.
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