Bulimia Nervosa
What is bulimia nervosa?
Bulimia nervosa, usually referred to as bulimia, is defined as uncontrolled episodes of overeating (binge eating) in addition to purging through misuse of laxatives, enemas, medications that cause increased production of urine, self-induced vomiting, fasting, or excessive exercise. Binge eating, in this situation, is defined as eating much larger amounts of food than would normally be consumed within a short period of time (usually less than two hours). Eating binges occur at least twice a week for three months and may occur as often as several times a day and is accompanied by unhappiness with an individual's body shape and weight.
What causes bulimia?
The cause of bulimia is not known. Factors believed to contribute to the development of bulimia include cultural ideals and social attitudes toward body appearance, self-valuation based on body weight and shape, and family problems. People who develop bulimia are more likely to come from families with a history of eating disorders and other mental health problems, such as mood disorders or substance abuse. Mood disorders and substance abuse are also commonly found in teens with bulimia nervosa.
Who is affected by bulimia?
The majority of people with bulimia are female of adolescent or young adult age, but males can develop bulimia too. All westernized industrial countries have reported cases of bulimia. An estimated 3 percent of people in the United States have bulimia.
What are the different types of bulimia?
There are two subgroups of behavior aimed at controlling one's weight:
- Purging type
- Regularly engages in self-induced vomiting or misuse of laxatives, diuretics, or enemas.
- Non-purging type
- Uses other unhealthy behaviors, such as fasting or excessive exercise, to prevent weight gain after binge eating.
What are the symptoms of bulimia?
The following are the most common symptoms of bulimia. However, each child may experience signs differently. Symptoms may include:
- food mysteriously disappearing from cabinets
- peculiar eating habits or rituals
- frequent trips to the bathroom, especially immediately after meals
- excessive exercise
- negative talk about their weight or appearance
- anxiety
- withdrawing from friends and family activities
- low energy level and fatigue
- muscle cramps
- chest pain or heartburn
- irregular or absent menstrual periods
- fainting spells
- decreased athletic ability, poor performance
The symptoms of bulimia may resemble other medical problems or psychiatric conditions. Always consult your child's physician for a diagnosis.
How is bulimia diagnosed?
Parents, teachers, coaches, or instructors may be able to identify the person with bulimia, although many persons with the disorder initially keep their illness very private and hidden. However, a pediatrician, family physician, an adolescent medicine physician, or mental health professional usually diagnoses bulimia in children and adolescents. A detailed history of the child's behavior from parents and teachers, clinical observations of the child's behavior, and, sometimes, psychological testing contribute to the diagnosis. Parents who note symptoms of bulimia in their child or teen can help by seeking an evaluation and treatment early. Early treatment can often prevent future problems.
How is bulimia treated?
Specific treatment for bulimia will be determined by your child's physician based on:
- the person's age, overall health, and medical history
- extent of the symptoms
- tolerance for specific medications, procedures, or therapies
- expectations for the course of the condition
Bulimia is treated with counseling that usually involves a combination of individual therapy, family therapy, behavior modification and nutritional rehabilitation. Treatment should always be based on a comprehensive evaluation of the adolescent and family. Several different medications have been proven helpful in decreasing the frequency of the binge / purge episodes. The occurrence of medical complications during the course of rehabilitative treatment requires both your child's physician and a nutritionist to be active members of the management team. Parents play a vital supportive role in any treatment process.
How is bulimia prevented?
Specific preventive measures to reduce the incidence of bulimia are not known at this time. Role modeling healthy eating habits and realistic attitudes toward weight may be helpful. Early detection and treatment of an eating disorder can reduce the severity of symptoms, enhance the process of normal growth and development, and improve the quality of life experienced by adolescents with bulimia nervosa.
Contact us
For additional information on this or any Health Topic, please call the Family Resource Center, 513-636-7606, or your pediatrician.
Rev. 8/04, 6/05, 7/07
