The bulimia (bulimia nervosa), making it a dining nervosa and one of the eating disorders. In contrast to anorexia , you can hardly tell that people with bulimia are suffering from an eating disorder, since they are usually of normal weight. Typical signs are high calorie food, vomiting, tooth decay and a lack of self-esteem.
What is bulimia?
According to DigoPaul, bulimia (Bulimia nervosa) is derived from the Greek and actually means “ox hunger”. In psychological and general usage, however, bulimia is synonymous with eating-vomiting addiction. This involves eating excessively (cravings), but vomiting again for fear of gaining weight.
In advanced cases, bulimia continues to eat after vomiting and the cycle begins again. In the meantime, however, there are also subspecies of bulimia in which there is no vomiting, but rather too much exercise is supposed to train what is eaten away (sport bulimia) or is removed with various means.
The causes of food cravings in bulimia have deep psychological reasons, while vomiting in bulimia can be fixed in relation to the ideal of beauty. Possible reasons for bulimia can be trauma experiences that the person concerned could not deal with psychologically. These include fear of loss, abuse, rape, neglect and / or other physical and psychological violence.
Co-dependency is often associated with bulimia. This is also known as addiction to relationships and includes unconditional care for someone close to you. For example, parents, siblings or closest friends who are alcoholic or drug addicts.
In addition, there is the fear of weight gain, which may be based on the ideal of beauty of the media and the general public. Many people with bulimia also work in professions in which a good figure is important (e.g. model industry). However, bulimia cannot be linked to work.
Symptoms, ailments & signs
People affected by bulimia are mostly of normal weight. Sometimes they are – according to the normal healthy population – also overweight or underweight. In this respect, bulimia does not express itself externally. Rather, the disease is characterized by more or less regular eating attacks that can occur several times a day, or even just every few days. The perceived control over eating behavior decreases. Large amounts of food and a fast eating pace play a role in binge eating.
The disease bulimia is defined by the fact that the person concerned tries to compensate for his or her eating behavior. Self-induced vomiting is particularly common for this. But also doing a lot of sport, starting extreme diets and using laxatives and emetics appear to be good measures for those affected. There are also combinations of these measures.
In the course of the disease, cravings are further promoted by the fact that the countermeasures taken against eating put a strain on the body’s energy balance. In this respect, a vicious circle of binge eating and exhausting countermeasures is initiated.
Possible long-term effects affect the teeth and esophagus (due to gastric acid), the stomach, the metabolism and intestines (due to laxatives) and much more. Head, neck and back pain are particularly common and unspecific symptoms that often occur in people with bulimia.
The disease often occurs around the age of 17 or 18 and is occasionally linked to a history of anorexia. The list of possible psychological comorbidities is long and includes, for example, substance abuse, feelings of inferiority and impulse control disorders.
Bulimia is a serious disease that must be treated by a doctor or psychologist. It is not uncommon for patients to be admitted to a clinic for treatment so that they can no longer harm themselves. If bulimia is not treated properly, it can cause severe health damage to the body and, in the worst case, lead to death.
Typically, bulimia has a variety of symptoms and complications. The affected person often exhibits aggressive behavior and social isolation. In addition, there are depression and feelings of inferiority, which are not further intensified by social exclusion.
Not infrequently, bulimia also occurs with the abuse of alcohol and other drugs and leads to the ingestion of drugs that lead to vomiting. These drugs are harmful to the body in high amounts and cause stomach problems. The teeth are permanently damaged by the rising stomach acid and have to be replaced by crowns.
Treatment takes place primarily on the psychological level. Then there is the treatment of the physical symptoms, as the body has to get used to normal food intake again. The treatment of bulimia is usually successful, but it does not rule out the possibility that the affected person will get the disease again.
When should you go to the doctor?
In any case, bulimia requires medical treatment. In the worst case, the disease can lead to death. In serious cases, those affected have to be treated in a closed clinic. Usually the patients do not admit the disease to themselves, so that parents and friends in particular have to initiate the treatment and diagnosis.
See a doctor if the person loses a lot of weight in a short period of time. Persistent vomiting or decreased self-esteem can also indicate the disease. Likewise, patients often suffer from tooth decay and eat high-calorie foods. In addition, a doctor should be consulted if the bulimia leads to psychological and social complaints.
An emergency doctor must be called in acute emergencies. Comprehensive treatment for bulimia should be done in a clinic. For this, however, those affected have to admit the disease. Treatment in self-help groups is also possible.
Treatment & Therapy
Bulimia is a disease that can only be treated with the help of a doctor who specializes in bulimia. This doctor is usually a therapist or a psychologist. Treatment for bulimia can usually only begin once the person concerned realizes that they need help.
Afterwards, a week-long psychosomatic spa stay is the best cornerstone to find your way back to a healthy life. This therapy tries to find out the causes of bulimia in order to work through them. Those with bulimia must learn to use alternative options instead of overeating.
A person with bulimia will have to watch out for their eating habits for the rest of their lives, just as a dry alcoholic has to watch out for not drinking alcohol. However, the bulimic has the disadvantage that he has to eat in order to survive and cannot be abstinent.
The correct handling of food is just as important a point in bulimia therapy as various methods of dealing with the causes. After intensive therapy, outpatient, regular talk therapy should be continued in order to be able to survive in everyday life and to learn to deal with relapses without falling back into bulimia.
Outlook & forecast
The eating disorder can be cured with the right therapy and substantial cooperation from the patient. Approximately half of all patients are free of symptoms after a course of several years. In about 30% an improvement of the clinical picture is only partially observed and 20% of all patients show no healing of the existing complaints.
The earlier the disease is diagnosed, the better the overall prospect of a cure. At the same time, the age of the patient when starting treatment plays an important role in the prognosis. Younger teenage patients have a significantly better chance of recovery than adults.
With the use of a therapy, the chances of recovery improve considerably than without the help of a doctor or therapist. Many patients often suffer one or more relapses during the recovery process, despite medical care. Young patients are particularly affected. In addition, there is a risk that the disease will develop into a chronic course and persist for many years.
At the same time, this increases the likelihood of a secondary illness breaking out. Bulimic patients often experience depression, obsessive-compulsive disorder, addiction, or impulse control disorder. Patients who also suffer from borderline disease have a significantly poorer prognosis. They have a significantly higher suicide rate and the likelihood of alcohol abuse.
Preventing bulimia is very difficult, as the causes of bulimia are usually subconsciously established. Before the person concerned realizes that he is stuck in a bulimic spiral of thought, he is usually no longer able to recognize himself that he needs help. It is important to have good self-reflection and a healthy self-esteem in order to be able to approximate prevention.
Bulimia, like all addictions, is the expression of a mental ailment that is unprocessed. Anyone who has had bad experiences should therefore always seek therapeutic help, even if they think they don’t need it. Awareness of this is vital because bulimia, like other addictions, can be fatal.
As a rule, intensive follow-up care is necessary for bulimia. Especially after inpatient therapy, it is advisable to see an outpatient psychotherapist and continue the treatment. This can help those affected find their way back to everyday life and prevent any relapses. In addition, visiting self-help groups can be helpful in most cases.
In most clinics, individual aftercare concepts are agreed upon with the attending physicians before discharge. Patients should strictly adhere to such instructions. In individual serious cases, after inpatient therapy, those affected can move into special supervised residential groups for former bulimia patients for the period of follow-up care.
In addition, many medical facilities offer online follow-up care for patients with eating disorders. Outpatient psychotherapy is particularly recommended for those affected who have not previously been treated in a clinic. This should be continued in any case, even if those affected perceive a significant improvement in the disease. Family members and relatives should be involved in the process throughout the follow-up period. If a relapse occurs, patients should always see a doctor.
You can do that yourself
Bulimia is a serious eating disorder that can cause considerable physical and psychological damage if it is not recognized in time and treated professionally. It is therefore imperative to refrain from self-therapy. However, those affected can help support the recovery process.
The earlier the disease is recognized, the lower the risk that those affected will suffer long-term damage. That is why a doctor should be consulted at the first signs of an addiction to eating / vomiting. In addition to drug treatment, patients should definitely make use of accompanying psychotherapy.
If the attending physician does not suggest this on his own, the therapy must be actively requested by those affected. Cognitive behavioral therapies, in particular, are very often successful in bulimia.
It is also important that those affected are not ashamed of their suffering and that they at least inform their social circle such as parents, roommates and, if necessary, colleagues or their superiors about their illness. Many patients also find it helpful to join a self-help group or to chat with other sufferers in online forums for bulimics.
A bulimia diary is also recommended. Such records can help keep track of eating habits and identify the triggers of the disease. Eating attacks, which mainly occur at night, can also be controlled by consumer behavior. Instead of storing food for the whole week, only the daily needs should be bought.