Bulimia nervosa, or more commonly known as bulimia, is an eating and psychiatric disorder characterized by binge eating followed by intentional purging. The latter is usually done in order to compensate for the excessive intake of food and to prevent weight gain. Purging can take the form of vomiting, inappropriate use of laxatives, enemas, diuretics or other medication; or excessive physical exercise. This disease was first described by Dr. Gerald Russel in 1977 when he was working at the Royal Free Hospital in London.
In contrast to common belief, bulimia is usually not (only) about food and body image but a reflection of deeper psychological issues. While the exact causes of the malady are not clear, some factors are known to contribute to disease:
- Biological: Some people are genetically predisposed to the disease;
- Social environment: frequent criticism by parents for example;
- Life changes, stress, trauma;
- Personality traits such as low self-esteem and hopelessness. Bulimics are also often high achievers and perfectionists;
- Cultural and media influences.
Bulimia is an extremely complex disease and long term care is generally required. People suffering from bulimia should be followed both by a psychiatrist and a therapist specializing in eating disorders.
The antidepressant fluoxetine (Prozac) has been the most promising in treating bulimia and the depression that comes with it. A daily dose of 60 mg has been shown to reduce symptoms by more than 50%. Sometimes a psychiatrist may also prescribe an antipsychotic but at a lower dose than for schizophrenics. People suffering from bulimia have a somewhat distorted view of reality and cannot judge what an appropriate amount of food is, therefore antipsychotics may help.
However, full recovery is rarely obtained without pairing medical intervention with psychotherapy. One type of therapy seems to be more effective than the others: Cognitive behavioral therapy (CBT). It focuses on modifying everyday thoughts and behaviors and educates patients on how to cope with stress or negative emotions differently than they are used to. People with bulimia and anorexia both benefit from CBT and often follow the same treatment pattern as these two diseases frequently go hand in hand. It is not uncommon that a person at some point has participated in both. Another reason therapy is crucial is that a therapist can help investigate and deal with the underlying causes 鈥� the roots 鈥� of bulimia. Group therapy has also been recommended for bulimia, albeit with some controversy, because it may just serve as an opportunity for bulimics to swap ideas on how to purge.
Bulimia is not a disease to be taken lightly. It can lead to a slew of other conditions, including dehydration, electrolyte imbalance, eroded gum and teeth, infertility鈥� in severe cases it can cause heart attack and organ failure resulting in death. If you suffer from bulimia or think that you do, seek help immediately. The sooner you face the problem, the better chance you have to conquer it. And you don鈥檛 have to fight the disease alone. There are treatment centers that offer long term support, counseling and symptom interruption. They may also propose a meal plan that you will have to follow strictly. It helps to constantly keep in mind what your healthy weight is. Avoid looking into the mirror too often and stay away from websites and magazines that portray skinny women as beautiful. The recovery process is long and sometimes/often painful but definitely possible. Determination, perseverance and a desire to get better are essential in reaching full recovery.
Again, I cannot stress enough the importance of an adequate combination of psychiatric and psychological care. And don鈥檛 be discouraged if you don鈥檛 feel better right away; this kind of things take time, patience and effort. And if after a couple of sessions you find that you and your therapist don鈥檛 click, it鈥檚 okay to request someone else. Just remember that there is always hope.
Melody Ko is a Critical Care Physician and a 9I制作厂免费 alumnus.
