Bulimia nervosa is a serious and sometimes life-threatening eating disorder affecting mainly young women. People with bulimia, known as bulimics, consume large amounts of food (binge) and then try to rid themselves of the food and calories (purge) by fasting, excessive exercise, vomiting, or using laxatives. The behavior often serves to reduce stress and relieve anxiety. Because bulimia results from an excessive concern with weight control and self-image, and is often accompanied by depression, it is also considered a psychiatric illness.
The cause of bulimia is unknown. Researchers believe that it may be caused by a combination of genetic and environmental factors. Bulimia tends to run in families. Research shows that certain brain chemicals, known as neurotransmitters, may function abnormally inacutely ill bulimia patients. Scientists also believe there may be a link between bulimia and other psychiatric problems, such as depression and OCD. Environmental influences include participation in work or sports that emphasize thinness, such as modeling, dancing, or gymnastics. Family pressures also may play a role. One study found that mothers who are extremely concerned about their daughters' physical attractiveness and weight may help to cause bulimia. In addition, girls with eating disorders tend to have fathers and brothers who criticize their weight.
According to the American Anorexia/Bulimia Association, Inc., warning signs of bulimia include, eating large amounts of food uncontrollably (bingeing), vomiting, abusing laxatives or diuretics, or engaging in fasting, dieting, or vigorous exercise (purging), preoccupation with body weight, using the bathroom frequently after meals, depression or mood swings, irregular menstrual periods, onset of dental problems, swollen cheeks or glands, heartburn or bloating.
Early treatment is important otherwise bulimia may become chronic, with serious health consequences. A comprehensive treatment planis called for in order to address the complex interaction of physical and psychological problems in bulimia. A combination of drug and behavioral therapies is commonly used. Behavioral approaches include individual psychotherapy, group therapy, and family therapy. Cognitive-behavioral therapy, which teachespatients how to change abnormal thoughts and behavior, is also used. Nutrition counseling and self-help groups are often helpful. Antidepressants commonly used to treat bulimia include desipramine (Norpramin), imipramine (Tofranil), and fluoxetine (Prozac). These medications also may treat any co-existing depression. In addition to professional treatment, family support plays an important role in helping the bulimic person. Encouragement and caring can provide the support needed to convince the sick person to get help, stay with treatment, or try again after a failure. Family members can help locate resources, such as eating disorder clinics in local hospitals or treatment programs in colleges designed for students.
Light therapy—exposure to bright, artificial light—may be useful in reducing bulimic episodes, especially during the dark winter months. Some feel that massage may prove helpful, putting people in touch with the reality of their own bodies and correcting misconceptions of body image. Hypnotherapy may help resolve unconscious issues that contribute to bulimic behavior.
According to the Health Service Executive's Child and Adolescent Mental Health Service (CAMHS), in 2012: Children aged 15 years were the most likely to be attending community CAMHS, followed by the 16/17 year old age group and children in the 10 to 14 year age group. Eating disorders accounted for 12% of all admissions to Irish child and adolescent units. Females accounted for 85% of all admissions with eating disorders. Eating disorders increased with age accounted for 4.5% of the primary presentations of the 15 years and older age group. Concerning primary presentation by gender - eating disorders/problems: including pre-school eating problems, anorexia nervosa, and bulimia nervosa: 17.4% were male and 82.6% female. Lifetime prevalence estimates of anorexia nervosa, bulimia nervosa, and binge eating disorder are .9%, 1.5%, and 3.5% among women, and .3% .5%, and 2.0% among men.Hudson et al. (2007). Eating disorders are most prevalent in females in the 15-40 age groups, where up to 0.5% may develop anorexia and up to 2% may develop bulimia. Rosenvinge & Götestam (2002). An estimated 20.8% of anorexia nervosa patients (Steinhausen, 2002) and 23% of bulimia nervosa patients do not recover or improve, but develop a long term or chronic form of the eating disorder. Steinhausen & Weber (2009). An Austrian study with 715 middle-aged women found that 4.6% reported symptoms matching diagnostic criteria for an eating disorder. Mangweth-Matzek et al. (2014).