Bulimia nervosa, also known as simply bulimia, is an eating disorder characterized by binge eating followed by purging. Binge eating refers to eating a large amount of food in a short amount of time. Purging refers to attempts to rid oneself of the food consumed. This may be done by vomiting or taking a laxative. Other efforts to lose weight may include the use of diuretics, stimulants, fasting, or excessive exercise. Most people with bulimia have a normal weight. The forcing of vomiting may result in thickened skin on the knuckles and breakdown of the teeth. Bulimia is frequently associated with other mental disorders such as depression, anxiety, and problems with drugs or alcohol. There is also a higher risk of suicide and self-harm.
Bulimia is more common among those who have a close relative with the condition. The percentage risk that is estimated to be due to genetics is between 30% and 80%. Other risk factors for the disease include psychological stress, cultural pressure for a certain body type, poor self-esteem, and obesity. Living in a culture that promotes dieting and having parents that worry about weight are also risks. Diagnosis is based on a person's medical history, however this is difficult as people are usually secretive about their binge eating and purging habits. Furthermore, the diagnosis of anorexia nervosa takes precedence over that of bulimia. Other similar disorders include binge eating disorder, Kleine-Levin syndrome, and borderline personality disorder
Bulimia typically involves rapid and out-of-control eating, which may stop when the bulimic is interrupted by another person or the stomach hurts from over-extension, followed by self-induced vomiting or other forms of purging. This cycle may be repeated several times a week or, in more serious cases, several times a day and may directly cause. Chronic gastric reflux after eating, Dehydration and hypokalemia caused by frequent vomiting, Electrolyte imbalance, which can lead to abnormal heart rhythms, cardiac arrest, and even death, Esophagitis, or inflammation of the esophagus, Mallory-Weiss tears, Boerhaave syndrome, a rupture in the esophageal wall due to vomiting.
Cognitive behavioural therapy is the primary treatment for bulimia. It works to solve current problems and change unhelpful thinking and behaviour. The name refers to behaviour therapy, cognitive therapy, and therapy based upon a combination of basic behavioural and cognitive principles. Most therapists working with patients dealing with anxiety and depression use a blend of cognitive and behavioural therapy. This technique acknowledges that there may be behaviours that cannot be controlled through rational thought, but rather emerge based on prior conditioning from the environment and other external and/or internal stimuli. CBT is "problem focused" (undertaken for specific problems) and "action oriented" (therapist tries to assist the client in selecting specific strategies to help address those problems, or directive in its therapeutic approach. It is different from the more traditional, psychoanalytical approach, where therapists look for the unconscious meaning behind the behaviours and then diagnose the patient. Instead, behaviourists believe that disorders, such as depression, have to do with the relationship between a feared stimulus and an avoidance response, resulting in a conditioned fear, much like Ivan Pavlov.