Bulimia

What is bulimia?

Bulimia, also called bulimia nervosa, is a disorder in the eating disorder spectrum. Bulimia is characterized by episodes of secretive excessive eating (bingeing) followed by inappropriate methods of weight control, such as self-induced vomiting (purging), abuse of laxatives and diuretics, or excessive exercise. Like anorexia, bulimia is a psychological disorder. It is another condition that goes beyond out-of-control dieting. The cycle of overeating and purging can quickly become an obsession similar to an addiction to drugs or other substances. The disorder generally occurs after a variety of unsuccessful attempts at dieting.

Bulimia is estimated to affect between 3% of all women in the U.S. at some point in their lifetime. About 6% of teen girls and 5% of college-aged females are believed to suffer from bulimia. These numbers are somewhat lower than earlier estimates of the prevalence of bulimia due to the precise criteria now established for the diagnosis (see below). Approximately 10% of identified bulimic patients are men. Bulimics are also susceptible to other compulsions, affective disorders, or addictions. Unlike anorexics, bulimics experience significant weight fluctuations, but their weight loss is usually not as severe or obvious as anorexics. The long-term prognosis for bulimics is slightly better than for anorexics, and the recovery rate is felt to be higher. However, many bulimics continue to retain slightly abnormal eating and dieting behaviors even after the recovery period. For further information on anorexia, please read the Anorexia Nervosa article.
The secrecy of bulimia stems from the shame that bulimics often attach to the disorder. Binge eating is not triggered by intense hunger. It is a response to depression, stress, or other feelings related to body weight, shape, or food. Binge eating often brings on a feeling of calm or happiness (euphoria), but the self-loathing because of the overeating soon replaces the short-lived euphoria.

Often, the individual will feel an impairment or loss of control during the binge eating and the purging becomes a way of regaining control. Not all bulimics engage in self-induced vomiting or the misuse of laxatives, diuretics, or enemas during the current episode. Some may fast for days following a binge episode. Others may resort to excessive exercise as a method to regain their control and rid their body of the possible weight gained during the binge. Excessive exercise is that which interferes with normal daily activities or when it occurs at inappropriate times or in inappropriate settings, or when it continues despite illness or injury.