I have heard of bulimia nervosa, the eating disorder. But at that time, I didn’t know how it could negatively affect a person’s physical and mental health until I saw one suffering from it. My poor daughter is suffering from bulimia nervosa, and as a mother, I thought that I had failed her. I should have seen this coming, and I should have been more focused on her. What kind of a mother am I if I could not see how my children were doing? At first, I blamed it on myself, and I felt very guilty.
Ever since the child psychologist confirmed that my 14-year-old daughter was suffering from bulimia nervosa, my emotions had been a mess. I felt angry at myself for not paying attention to the signs soon. I pitied my child for developing an eating disorder—an experience that might stay etched in her mind forever.
When I had a heart-to-heart conversation with my daughter after the diagnosis, she crumbled in front of me. She said, “Mom, the kids at school have been bullying me for years, calling me Juggernaut or Miss Piggy. I feel ashamed for eating a lot every mealtime, so I end up forcing myself to bring the foods back out.”
Despite the twisted reasoning that I just heard, I could not get angry at my child. She’s going through something that even adults could not handle level-headedly. How could anyone expect her to know what to do from the start?
Still, after that conversation, I encouraged my daughter to seek help. I allowed her to choose her therapist and what type of therapy she would do to ensure that she wasn’t doing it to appease me. The first sessions went great; they took place once a week a few blocks away from home. However, due to the COVID-19 pandemic, my daughter had to get therapy online. The child psychologist then tasked me to monitor her behavior closely and text her about it almost daily to see her progress.
I am not saying it because I love my child, but I have not seen any worrying activity from her. It’s as if the quarantine is very suitable for my daughter’s healing process.
These are the upsides that I have noticed:
Lack Of Social Pressure Makes A Child Worry-Free
My child is visibly more relaxed now than ever. She stays in her pajamas all day long and jokes around with us. It seems natural for her not to talk about being fat or give any body-related comment.
I believe that this change is all thanks to the lack of social pressure that my daughter experiences now. When she attends a class via the school’s online portal, I would see that everyone else—even the teacher—is not dressed to impress. I also saw one student snoring on top of his books, thus proving that no one cared about their appearance for once. So, my kid does not feel any pressure to follow the social norms or entertain distorted thoughts about body image.
Hard Work Lessens Food Consumption
When the lockdown started, I informed the entire family that we would not be ordering food from restaurants for a while. The reason was that I wanted to lessen our social interaction with other people and reduce the chances of getting the coronavirus. They could tell me what they wanted to eat so that I could order the groceries online and have the salesperson drop them in my trunk. However, we would have to make the dish together.
Eating too much and then vomiting it later was perhaps easy-peasy for my 14-year-old kid before the lockdown. However, since my daughter’s expected to chop the vegetables or man the stovetop these days, she appears to eat until she’s full. Hence, there are no more long, suspicious bathroom trips after mealtimes.
I don’t have any idea how much longer this quarantine will last. It can happen next week or in the next two months. What I can only pray for, though, is that my daughter will continue to let go of her bulimic habits until she does not feel the need to do it anymore. If that happens, I will be the happiest and most fulfilled mother on the planet.
The role of nutrition in promoting good health among teens was emphasized during the 2018 Boston Annual Nutrition & Health Conference. The conference discussed the importance of having a balanced diet and proper food nutrition in preventing illnesses, which includes eating disorders.
Eating disorders can significantly affect the health and well-being of teens, especially among girls. As a parent, you need to protect them from it.
With this in mind, here are some tips and advice to help you protect your teen from developing bulimia:
Know The Symptoms Of Bulimia
Prevention is better than cure, so you have to be wary of the symptoms of bulimia to prevent it before your child shows signs. The most common symptoms are:
- Usually having an average or low body weight but perceive themselves as overweight
- Constant binge eating, often in secret
- Self-induced throwing up
- Excessive exercise or fasting
- Strange eating habits that appear abruptly
Promote Healthy Eating Habits
Proper nutrition is critical to our health, appearance, and energy level. It would be best if you encourage your teen to eat whenever he or she feels hungry. It would also be helpful to explain why they shouldn’t deprive themselves of eating correctly.
One way to boost their appetite is to prepare meals that they like but are nutritious at the same time. You should also eat together as a family more frequently to model good eating habits and encourage them.
Develop Open Communication With Your Teen
Teenagers are exposed to different media that may influence their behavior, confidence, and personality. Television programs, movies, and social media platforms may send a wrong message to your teen. Talk to them about the media they consume.
Encourage A Healthy Body Image
To protect your child from bulimia, you have to convince him or her about the importance of proper eating habits in having a healthy body. It might not be easy, but it is essential to talk to your teen about self-image and reassure them that body shapes vary.
Seeking advice or a second opinion from other experts may help you detect if your child is at risk of having bulimia. Moreover, consulting with your teen’s doctor is vital for proper diagnosis and treatment. If necessary, he or she can refer your teen to a mental health provider.
Bulimia nervosa is a severe mental health disorder that if left untreated can become life-threatening. It involves the intake of excessive amounts of food and then engaging in compensatory behaviors to counteract this intake. There can be purging bulimia where the person uses self-induced vomiting or laxatives, enemas or diuretics to rid the body of the food. In contrast, there can be non-purging bulimia where they use other compensatory methods such as strict dieting or engaging in excessive exercise. These two types of bulimia are not necessarily exclusive and often overlap. Despite this focus on food, truly bulimia is not about food, but anxiety. People experiencing bulimia are often worried about their weight or body shape. They are likely to have high expectations for themselves and a tendency to focus on their self-perceived flaws. As bulimia goes deeper than simply a concern about food or weight and is rather due to deeper seeded low self-esteem, it can be very difficult to recover from. However, with good support and the right treatment, it can certainly be overcome.
Bulimia nervosa is not just an eating disorder but a grave psychological disorder that can become life-threatening under some circumstances. This eating disorder is typically characterized by recurring phases of binge eating and purging where the patient first stuffs as much food as possible and thereafter, retires to the bathroom to vomit out the food. The bulimic initially tries to refrain from bingeing as he is apprehensive of gaining weight, but is unable to control his cravings in the end.
Historically, across cultures, humans (and other animals) are known to engage in ritualized behaviors of purging and regurgitation as methods of altering states of consciousness. — Leslie E. Korn Ph.D., MPH, LMHC, ACS, NTP
In order to compensate for having consumed too much, a patient of bulimia attempts to disgorge the excessive food through self-induced regurgitation through the use of diuretics, emetics, and laxatives. Many bulimics do intensive workouts, starve, and go through a rigorous dietary plan to burn the calories. Bulimia nervosa often takes a tremendous toll on the physical and mental health of the patients resulting in their suffering from heart attacks, hypertension, and damaged kidneys.
A great majority of bulimics often report symptoms of depression, and anxiety disorder and several other mental disorders.
Following are some of the most common symptoms of bulimia nervosa:
- A round of bingeing where the patient consumes upwards of 2,000 calories of food at one sitting lasting for a short period
- The bingeing is followed by spells of vomiting to disgorge the excess amount of food consumed or embarking on strenuous exercises, fasting or following rigorous dietary regimens in order to burn calories
- Large scale misuse of laxatives, diuretics, and emetics with the ultimate aim of preventing weight gain. However, rampant abuse of such medications can prove to be fatalistic in the long run.
- Torn between feelings of uncontrollable urge to eat on one hand and the attendant guilt that comes with overindulgence and the apprehension of putting on weight
- Preoccupation with overeating, dieting, purging, and body weight keeps the bulimic from performing routine tasks and leading a normal life
- Having a sense of worth oriented around weight and physique
Perhaps sociology could offer answers as to why these so-called ‘gurgitators’ would inhale everything from hot dogs to mayonnaise under the pressure of time and before live screaming audiences…of thousands. — Lawrence Rubin Ph.D, ABPP, LMHC, RPT-S
Besides the above prevalent and widespread symptoms, a bulimic may exhibit the following signs as well:
- Stowing food items in the most unlikeliest of places, especially areas that the patient may be easily able to access without being found out
- Prefers to eat alone rather than in the company of other people
- Female bulimics may experience irregularity in their menstrual cycles
- The patient might lose or gain considerable weight on a recurrent basis, and in a short time period
- Conversations and discussions will mostly revolve around dieting, foods, figure, and body weight
- Will appear ashen or pale owing to deficiency and/or imbalances of vital electrolytes including sodium, potassium, and calcium and loss of fluids owing to frequent purging leading to dehydration
- Will be obsessed with workouts and overuse laxatives/diuretics
Physical signs and symptoms:
- Flaky, dry, and wrinkled skin
- Thin, dry and frizzy hair
- Mouth ulcers and sores
- Decaying teeth, tooth enamel, and bleeding gums
- Inflamed salivary glands
- Abdominal pain and cramps
- Successive bouts of diarrhea and constipation
- Feeling tired most of the time
- Restlessness and anxiety owing to lack of sleep
- Calluses or bite marks on knuckles resulting from frequent regurgitation brought upon by oneself
- Wreaked by feelings of guilt, depression, and anxiety
- Substance abuse, alcoholism, and resorting to intake of banned medications or drugs
Ample research shows that people can be healthy and confident at a whole range of shapes and sizes. — Alexis Conason Psy.D.
Most of the common signs or symptoms associated with bulimia nervosa are not palpable, making it difficult to diagnose the eating disorder as the patients are fearful of expressing the same. Bulimics can go to extreme lengths to prove that they are perfectly normal and healthy. If you are a bulimic yourself or know somebody who may be suffering from the eating disorder, then you seek medical intervention right away.
Bulimia nervosa or simply bulimia is a grave eating disorder that affects a significant proportion of the population, particularly young women, and can sometimes get fatal. An individual with bulimia tends to binge or eat gluttonously during a sitting, much more than what one would consume normally. Majority of bulimics also resort to purging or regurgitating after a round of gorging.
At a larger social level are the influences of pressure and advertisements on children and adults of what constitutes a perfect body and the ways that food, or lack thereof, may achieve that. — Leslie E. Korn Ph.D., MPH, LMHC, ACS, NTP
Bulimic individuals usually follow the cycle of bingeing and vomiting with the sole objective of staying as slim as possible and checking weight gain. Bulimics find themselves torn apart by an irrepressible urge to eat on one hand, and on the other, an irresistible desire to purge or vomit the excess food consumed. However, there is a proportion of bulimics who exploit other ways in order to shed the excessive intake of calories, instead of purging, like dieting, starvation, and intensive workouts.
It is estimated that 0.1-0.5% of males and 1.1-4.6% of females in the US may have or have had bulimia at some point in their life.
Symptoms and Signs of Bulimia
Unlike anorexics, bulimics tend to be have a normal weight and a very few bulimic persons are obese or overweight. Bulimics, on the other hand are also more likely to indulge in substance abuse, including narcotics, banned prescription drugs, tranquilizers, and alcohol. A typical bulimic might be difficult to identify as the usual signs or symptoms associated with the eating disorder are barely noticeable.
Physical signs generally include:
- Fluctuating body weight
- Acute dehydration
- Malnutrition causing one to remain in poor health
- GERD (gastro esophageal reflux disease)
- Irregularity in menstruation
- Teeth damage and sore throat owing to acid refluxes
And the behavioral symptoms entail:
- Eating all by oneself
- Stashing food in unlikely places
- Visiting the bathroom right after bingeing
- Being finicky about gaining weight
- Starving or dieting intensively followed by binge eating and vice versa
Bulimics are in the habit of taking emetics and laxatives that stimulate purging urges and usually keep such medications hidden. These persons also are adversely affected by sudden mood swings, and often diagnosed with depression or anxiety disorder. A bulimic might feel inhibited to talk about his or her eating disorder despite being acutely aware of the same.
Newsflash: purging food was discovered eons ago by patients suffering from eating disorders—no surgical procedure required. — Alexis Conason Psy.D.
Causes of Bulimia
The causes behind bulimia nervosa that have not yet been traced may help diagnosticians and medical scientists to work out an effective treatment plan. However, most dieticians, nutritionists, and medical professionals are of the opinion that a combination of genetic, environmental, and behavioral or temperamental factors are responsible for causing bulimia. Bulimics subjecting themselves to bingeing followed by a phase of purging is usually a means of dealing with emotional and psychological stress.
Bulimia patients are constantly troubled by feelings, usually bordering on irrationality that they are putting on undue weight and becoming obese. Consequently, they develop a sort of love-hate relationship with everything related to obesity including food. What starts as a simple way for managing emotional stress soon burgeons into an infatuation that bulimics find difficult to control.
A bulimic often indulges in self-destructive behavior leading to chronic psychological issues including anxiety disorder, bipolar disorder, and depression.
Oftentimes, symptoms and behaviors are rationalized and minimized by the person who engages in them. — Lisa Ferentz LCSW-C, DAPA
Researchers and scientists are yet to pin down a single, palpable risk factor that might cause an outbreak of bulimia. It is generally alleged that there could be a set of environmental, psychological, biological, behavioral, and genetic factors working in coordination. Women are more prone to exhibiting symptoms of bulimia, compared to men, mostly during puberty when they experience physical and mental changes as a result of increased hormonal secretions.
More often, an obsession to emulate the dietary styles of celebrities, results in the young female being diagnosed with bulimia.
The treatment procedure or plan for breaking the destructive cycle of binging and purging is protracted, lasting for nothing less than 4-6 months. A judicious blend of nutritional counseling, cognitive and behavioral therapy, medications, interpersonal therapy and the support of near and dear ones are instrumental for remitting symptoms of bulimia.
It seems counterintuitive to think about how many people are willing to put their emotional and physical health at risk in order to lose weight when one of the main reasons that people state for wanting to lose weight is to improve their health and feel better about themselves. — Alexis Conason Psy.D.
Bulimia nervosa is regarded as a serious eating disorder where the patient indulges in successive phases of bingeing, gorging on food, and purging or regurgitating with the aim of keeping self extremely lean. Though bulimia apparently is associated with recurring cycles of eating excessively and then dieting or starving, there’s much more to the eating disorder than you might think. Bulimia can play havoc with one’s physical and mental well-being, and in the worst case scenario, lead to the patient’s death.
This eating disorder takes a tremendous toll not only on the patient’s physical well being but also on his mental health. Bulimics, are more often than not, diagnosed with OCD (obsessive compulsive disorder), anxiety disorder, and depression. They are subjected to extreme irritability and mood swings owing to malnutrition, lack of sleep, dehydration caused by electrolyte imbalance, IBS, and other issues.
Physical Side Effects
Following are some of the adverse side effects arising out of Bulimia
Electrolyte Imbalances and Abnormalities
As a bulimic patient usually escapes to the bathroom to vomit after a round of bingeing, he or she loses a high amount of fluids leading to electrolyte imbalance. Owing to electrolyte imbalance, the patient’s body becomes deficient of vital minerals including sodium, calcium, potassium, and magnesium. Abnormal decreases in the levels of these minerals or electrolytes can lead to chemical imbalances ultimately causing a heart attack or malfunctioning of other bodily organs.
Eating disorders are highly comorbid with obsessive-compulsive disorder, and the functional nutritional treatment for both is very similar. — Leslie E. Korn Ph.D., MPH, LMHC, ACS, NTP
Digestive and intestinal issues
Both binge eating and purging causes a heavy strain on the digestive system and metabolism of the bulimic individual. All organs associated with digestion and ingestion starting from the teeth, tongue, esophagus, and stomach to liver, kidney, and intestines are overworked as abnormal amounts of food have to be broken down for assimilation. Additionally, self-induced regurgitation leads to further straining of these organs.
Initially, the patient will experience abdominal pains, heartburns, bloating, and stomach cramps. In the long run, it is not unusual for the bulimic to be diagnosed with peptic or gastric ulcers, tooth decay, enamel erosion, and gingivitis. Long-term laxative and emetic abuse leads to diarrhea, constipation, and rupturing of the esophageal wall. GERD or acid reflux also has the potential of damaging the small and large intestines, trigger blood vomiting, and cause distended salivary glands.
Unfavorable effects on the circulatory system
Purging on a recurrent basis results in undue loss of fluids and electrolytes like potassium, sodium, and calcium eventually causing dehydration. Dehydration and electrolyte imbalance causes the muscles, ligaments, tendons, and tissues to become weak leading to muscle cramps. All these issues have a bearing on the normal functioning of the heart making the blood pumping and purifying organ to miss regular heartbeats-a medical condition termed arrhythmia.
Arrhythmic pulsations put a heavy stress on the heart, and in the worst case scenario, lead to a heart attack because of fatigued cardiac muscles. On the other hand if the patient is severely dehydrated, he or she might lose consciousness or faint, may suffer falls, feel dizzy, and over time, the kidneys might get damaged permanently. Bulimia nervosa may cause optic blood vessels to rupture, lead to hypertension and anemia.
Integumentary system takes a beating as well
The side effects of bulimia are across-the-board and does not even spare the organs categorized under integumentary system, like the nails, skin, and the hairs. Dehydration resulting from periodic spells of regurgitation leads to a decreased level of water in the body which implies that all bodily organs including the nails and the hairs have to make do with less water. Consequently, hairs dry up and turn frizzy, the skin wrinkles, and the nails become brittle.
And the reproductive system also
Bulimic individuals deprive their bodies of essential nutrients, causing hormonal imbalance eventually leading to decreased appetite for coitus. Pregnant and lactating women continuing with their binging and purging behaviors also face several complications.
Anyone who is has an eating disorder is very invested in maintaining the thoughts and behaviors that fuel it, so when a loved one expresses concern they may be met with anger or defensiveness. — Lisa Ferentz LCSW-C, DAPA
Bulimia nervosa, despite its severity, is very much treatable. However, bulimics need to be very patient as the treatment process is long drawn, spread over a period of 3-6 months. A combination of treatment plans including behavioral and cognitive therapies, medications, and interpersonal therapies needs to be resorted to for healing.
People generally use carbohydrates as their food of choice in bulimia, though they may choose fatty foods as well. These are mood altering by way of the serotonergic system, and they also lead to a sense of fullness by filling the stomach and putting pressure on the diapgragm. — Leslie E. Korn Ph.D., MPH, LMHC, ACS, NTP
If you are a bulimic, you’d have an irrepressible and unmanageable urge to gorge followed by a relentless impulse to spew out the large quantity of food consumed. Almost all bulimics follow a similar pattern like yours, of first bingeing and thereafter purging, all with the sole objective of staying as slim as possible. Bulimia nervosa, like anorexia, is more of a psychological disorder that is brought about by the interaction of an array of risk factors, including genetic, environmental, societal, and behavioral.
Bulimia as an eating disorder usually predominates in women compared to men, particularly when they are in their teens, twenties, and thirties. However bulimics can expect a full recovery, thanks to the availability of advanced inpatient and outpatient treatment options. Following are some startling facts about bulimia nervosa:
- Bulimia nervosa is idiopathic, i.e. there is no single cause which can be held responsible for triggering the outbreak or development of the disorder in an individual
- The eating disorder could be genetic-You’re at greater or higher risk of developing the disorder if someone in your immediate family or a close relative has any type of eating disorder
Bulimia nervosa afflicts approximately 4% of women and 0.5% of men in the US. Nearly 4% of those suffering from bulimia will die from the disease and nearly all struggling with the illness experience serious medical and/ or emotional effects. — Alexis Conason Psy.D.
- It is the society, you stupid-Western societies tend to be obsessed with slimness and always urge individuals to keep weight as low as possible. Obesity is considered a taboo. Therefore people, mostly women are fixated with maintaining a reed thin figure in order to make selves more appealing, and often end up developing detrimental eating habits.
- The disorderliness exists more in the mind-Apparently, bulimia is an eating disorder but in reality, the disorderliness is mental. Bulimics find bingeing as a means of escapement from feelings of shame, guilt, or suicide that cause emotional turmoil. Bulimia is often co-morbid or in other words, bulimia patients often suffer from an additional health issue or issues that could be physical or mental or both.
If the statistic published by ‘National Association of Anorexia Nervosa and Associated Disorders’ is to be believed, then bulimia along with anorexia and binge-eating disorder are amongst the most fatalistic mental disorders in the US.
- Bulimics find themselves trapped in a web of obsessive habits-As a bulimic you’d find yourself struggling hard to contain your food cravings. You’d be storing food items in the unlikeliest of places (apart from the regular ones) so that you can access the same whenever you wish to. At the same time, you’ll be continually stocking up on laxatives, diuretics, and emetics-medicines that induce regurgitation.
You’d also have the compulsive need to exercising strenuously in order to burn calories. To accelerate the calorie torching process, you may also resort to starving, doing without big meals and surviving on tidbits.
- Bulimia can prove to be very damaging for women-Female bulimics will experience problems with menstrual cycles often missing periods. Pregnant women could be at risk of suffering miscarriages, giving birth to stillborns or giving birth to babies with congenital defects, and so on
The person restricting calories, bingeing, purging, or excessively exercising may become anxious about getting caught or irritable when accusing a loved one of being unfairly suspicious or “controlling.” — Lisa Ferentz LCSW-C, DAPA
- Bulimia can play havoc with the well-being of the affected person-Individuals with bulimia will have weakened digestive and metabolic systems. Electrolyte imbalance, anemia, dehydration, dry skin, ulcers, kidney failure, gastrointestinal issues, and esophageal ruptures are some common problems that bulimics face.
- A good proportion of bulimics happen to be men-Though members of the opposite sex are more vulnerable to bulimia nervosa, men are equally at risk of developing the eating disorder. 15% of individuals undergoing treatment for various eating disorders happen to be men, as per reports released by ANAD.
- The road to recovery is a long one and can be challenging-It might take months, if not years for a bulimic to recuperate fully and get back to living a healthy life.
Patients of bulimia need to realize that a combination of effective treatment plans that integrate supervised dietary regimen, scientific workout schedule, psychotherapy sessions, and an appropriate medication system will help them to recover.
Nowadays, the increasing pressure to have this hourglass, model-like body is very observable. Even little kids already know what is physically attractive and what is not. This unrealistic notion influences the youth to pursue these outrageous standards. Hence, several problems such as eating disorders, depression, and obsession arise.
Someone who is struggling with an eating disorder may attempt to eat “normally” in the presence of others, and then look for opportunities to be alone to find ways to binge or purge. — Lisa Ferentz LCSW-C, DAPA
It is totally fine to be physically fit and healthy, but if you are overdoing it, that’s a different discussion. One of the most common problems that this specific standard of having an hourglass figure creates is an eating disorder.
Different Types of Eating Disorder
There are three major types of eating disorders. Anorexia nervosa is the condition wherein the individual restricts the intake of food to avoid being fat when in reality, the person is already thin. The second one is called binge eating disorder which is characterized by an uncontrollable urge to eat despite being full or not being hungry. Lastly, bulimia nervosa is characterized by purging, vomiting, or exercising excessively after binge eating.
Let’s Focus on Bulimia Nervosa
Apparently, you should know that there are two common types of bulimia nervosa. The first one is the purging type which is characterized by self-induced vomiting or abuse of laxatives to compensate after a binging episode. The second type is the non-purging bulimia nervosa. This form does not engage in self-induced vomiting. Rather, the individual who has this condition compensates by exercising excessively or fasting for extended periods of time.
Opposing and competitive opinions and theoretical perspectives in conjunction with discrepancies and inconclusive outcomes in quantitative and qualitative research continue to make it difficult to understanding causation and therefore establish solid treatment protocols. — Judy Scheel Ph.D., L.C.S.W., CEDS
The typical causes of bulimia are usually stress, negative body image, low self-esteem, history of abuse or trauma, and/or other related factors. Despite these known factors, the specific cause of bulimia nervosa is not yet identified.
What can we do to treat Bulimia Nervosa?
Given the knowledge that you already know about bulimia nervosa, you probably have an idea what you can do to prevent it. Since one of the underlying factors for this condition is low self-esteem and the need to be thin just to be accepted by the society, it is understandable that doing activities to boost your morale can help. These activities, such as playing sports, joining a club, and others can help in increasing self-esteem, therefore lowering the risk for bulimia nervosa.
Another helpful treatment would be to discontinue the binge-purge cycle and to improve your negative thoughts so you won’t feel guilty about yourself and end up purging or over-exercising again. Re-establishing the way that you view yourself can help you erase the irrational beliefs about your weight or your body shape. As long as you are healthy, you are perfect the way you are.
The truth is: weight is a lousy indication of health. — Alexis Conason Psy.D.
The most important treatment is to seek out a professional that can help you through the process of dealing with bulimia nervosa. This kind of disorder can lead to serious medical complications. Delaying to seek out for help is a really bad idea.
If you know anyone who is having a hard time dealing with their eating habits, he or she might be at risk of developing bulimia nervosa. Don’t hesitate to reach out and ask for help.