4 Symptoms of Bulimia Nervosa
Reviewed By: Nicole Cauchois, LCPC, LADC
Written By: Daniel Mark Hipp
What is Bulimia Nervosa?
Bulimia nervosa is “an eating disorder involving recurrent episodes of uncontrolled excessive (binge) eating followed by compensatory actions to remove the food (for example, deliberate vomiting, laxative abuse, and excessive exercise)” (Durand & Barlow, 2016).
Bulimia nervosa literally translates into “nervous ravenous hunger” from Greek to English. Bulimia nervosa is sadly one of the most common psychiatric disorders on college campuses. (Durand & Barlow, 2016).
Cycles of Bulimia Nervosa
In order to qualify for a bulimia nervosa diagnosis, there should be a distinctly out of control phase where the patient is incapable of regulating how much food they are eating (Sysko & Wilson, 2011).
These binge eating sessions will often consist of eating exorbitant amounts of junk food rather than something substantial like fruits and vegetables. In order to compensate for the out of control binge eating phase full of junk food, there will be a distinct purging phase.
As mentioned before, purging can take many different forms. Patients can use primarily one form of purging, or a combination of methods. Although purging is not particularly effective, bulimia nervosa patients will engage in extreme behaviors to compensate for the previous binge eating session.
4 Core Features of Bulimia Nervosa
The 5th text revision edition of the Diagnostic and Statistical Manual of Mental Disorders identifies 4 core features of bulimia nervosa.
*If you or a loved one are experiencing these symptoms, you should consult The Healing Center or a qualified mental health professional immediately.
**If you require higher levels of care beyond individual counseling, you should enroll in an eating disorder treatment clinic. Here is a link for Las Vegas Eating Disorder Clinics.
https://www.psychologytoday.com/us/treatment-rehab/nv/las-vegas?category=eating-disorders
“Features of bulimia nervosa include the following:
1. Recurrent episodes of binge eating, characterized by an abnormally large intake of food within a discrete period of time combined with a sense of lack of control over eating during the episode.
2. Recurrent, inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting, misuse of laxatives or diuretics, fasting, or excessive exercise.
3. On average, the binge eating and inappropriate compensatory behaviors both occur at least once a week for 3 months.
4. Self-evaluation in unduly influenced by body shape and weight” (American Psychiatric Association, 2022).
Origins of Bulimia Nervosa
Bulimia nervosa had been documented for millennia, but it was not formally recognized as a psychiatric disorder until the 1970s. The “overwhelming majority” of patients are women (90 to 95% of cases) (Durand & Barlow, 2016).
Eating disorders such as anorexia nervosa and bulimia nervosa appear to be an unintended consequence of widespread western media. There is research which suggests that countries began developing eating disorders after the normalization of the television being in every household.
Western beauty ideals have placed an emphasis in the past half century on being thin. All over television, advertisements, and instagram are models photoshopped and filtered to achieve the image of a body most people are not capable of replicating in a healthy manner.
Effects of Repeated Cycles of Binging and Purging
Medical Risks From Binging and Purging
There is a significant medical risk posed to patients with bulimia nervosa due to their potential electrolyte imbalance from repeated cycles of binging and purging. Serious medical problems such as “cardiac arrhythmia (disrupted heartbeat), seizures, and renal (kidney) failure, all of which can be fatal” (Durand & Barlow, 2016). This can be treated by establishing a regular eating pattern free of binging and purging.
Russell Sign Scars on Hands
Many individuals choose to induce vomiting as their preferred method of purging. Doing this action repeatedly over time develops a scar on the back of their hand called a Russell Sign. The Russell Sign comes from the back of the hand scraping against their teeth over and over again. This is named after Gerald Russell, a psychiatrist who was a pioneer in bulimia nervosa research.
Esophagus Damage and Tooth Decay
Induced vomiting is hard on the body. It especially strains the esophagus. It can wear away at the patient’s teeth due to high acidity levels.
Most Common Co-Occurring Disorders for Bulimia Nervosa
It is quite common for one psychiatric disorder to be accompanied by another when left untreated throughout life. Research found that of those with bulimia nervosa, 80.6% of patients also qualified for an anxiety disorder diagnosis at some point in their lives (Hudson et al., 2007).
Anxiety, mood, and substance use disorders are particularly common in patients presenting with bulimia nervosa. Patients being diagnosed with bulimia qualify for mood disorder diagnosis 20% of the time at the diagnostic interview (Hudson et al., 2007).
There is a shocking estimated 50 to 70% of bulimic patients qualifying for a mood disorder diagnosis at some point in their lifetime (Hudson et al., 2007).
Hudson even reported that bulimia patients present with a substance use disorder 36.8% of the time, with a disturbingly high lifetime occurrence (2007).
Treatment Options for Bulimia Nervosa
Unlike anorexia nervosa, bulimia seems to respond well to drug treatments. Antidepressants are shown to be effective with managing binging and purging episodes (Broft, Berner, & Walsh, 2010). These are the very same drugs which are prescribed for treating both anxiety and mood disorders.
Research suggests that antidepressants alone are not an adequate treatment in the long term for bulimia patients (Wilson & Fairburn, 2007).
Patients with bulimia have an intense preoccupation with how they look. Cognitive Behavioral Therapy-Enhanced (CBT-E) should be utilized to to address issues at the root of the patient’s preoccupation and disordered binging and purging habits.
In CBT-E, patients are taught the detrimental long term effects of living a lifestyle full of extreme binging and purging. They are immediately put onto a daily regimen of small meals every few hours in order to avoid setting off binging or purging behaviors (Durand & Barlow, 2016).
They are taught to cope in healthy manners with the stressors of life to avoid cycling. Family therapy may be beneficial for adolescents with bulimia who have conflict in the household.
The traditional course of action for bulimia nervosa treatment is antidepressants and CBT-E. They work synergistically together.
The Healing Center
The Healing Center in Las Vegas provides tailored mental health services facilitated by a team proficient in addressing diverse cultural backgrounds. Certified therapists deliver in-person or remote sessions, aiming to reduce stigma and foster a mentally healthy community. Our Boutique Psychotherapy Center employs spiritually attuned counselors, employing various techniques to reconnect individuals with their inner selves and foster self-worth.
With holistic approaches, these therapists equip patients with strategies to navigate life's crises effectively.
For further information on their therapies or to schedule a consultation, please visit The Healing Center's website at https://www.thehealingcentervegas.com/.
Contact The Healing Center via phone (702)505-1280 or email TheHealingCenterOperations@gmail.com.
References
[1] American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th. ed., text rev. ). Washington, DC. https://doi.org/10.1176/appi.books.9780890425787