A B C D E F G H I J K L M N O P R S T U V W

BULIMIA NERVOSA

What is Bulimia Nervosa ?

Anorexia nervosa is a condition where there is an intense fear of becoming fat. This fear leads the sufferer to pursue a programme which will ensure that they lose weight. Apart from not eating, this may include the taking of laxatives, self-induced vomiting and excessive exercise. The loss of weight can be considerable. The fear is so intense that there is a distortion of body image so that patients believe they are fat even when this is not the case. As a result of the loss of weight and starvation, the sufferer will become physically and psychologically ill, leading to loss of periods, anxiety, tiredness, loss of hair and poor skin. Bulimia nervosa tends to occur at a later age than anorexia. It too is characterized by a compulsion to being thin and a concern over body image. Weight loss is not such a feature. The sufferer has repeated episodes of binge eating (bulimia) during which she feels out of control. This is followed by feelings of guilt and worthlessness which lead to episodes of self-induced vomiting, diarrhoea brought on by laxatives or extreme dieting. The sufferer may also be depressed and feel ashamed and guilty.

Why does Bulimia Nervosa occur ?

The cause of these eating disturbances is not known. A number of factors are considered to be important. In anorexia but not in bulimia, there is a suggestion that there may be an inherited tendency. Both the personality of the sufferer as well as family relationships may be important. Some consider that cultural issues are relevant: Western fashion tends to pressurize women to be thin.

Why does Bulimia Nervosa occur ?

The above factors may have been present for many years. These illnesses may be triggered off by a virus infection, an episode of depression or embarking on a slimming diet. They are considerably more common in women.

Treatment Involved for Bulimia Nervosa

In anorexia, weight loss can be very severe and it may be necessary for the sufferer to be admitted to hospital: sometimes it is possible to manage the problem without this. The object of treatment is to restore the sufferer to their normal weight. A high calorie diet is therefore encouraged. It is important to help the sufferer to accept that this is necessary. The main treatment consists of psychotherapy (or talking treatment) and behavioural therapy (which attempts to change behaviour patterns). Drugs are not often used unless there is an underlying depression. Family therapy is sometimes used for the younger patient. Psychotherapy is also known as talking therapy . This is undertaken either with the individual, in groups or with the other members of the family (family therapy). It seeks to give the sufferer an opportunity to discuss and explore some of her feelings. By so doing, it allows an insight into the sufferer's personality and perhaps an understanding of the reasons behind her illness. Behaviour therapy is a form of psychological treatment that involves a planned programme which aims to change the individual's behaviour. Attempts are made to deal with any underlying anxiety or depression. A weight target may be set and a programme of regular meals may be planned, to bring about a gradual weight gain.

During Treatment of Bulimia Nervosa

Treatment is principally supportive and is therefore without any serious side-effect. During treatment, it is not unusual for the sufferer to cheat by self-induced vomiting or diarrhoea. Alternatively, she may lie and pretend to have eaten a meal. It will be necessary to attend a clinic regularly, not only for psychotherapy, but also to have weight checked to ensure that it is increasing. If attempts to manage the problem at home fail, then hospital admission may be required.

If Bulimia Nervosa is Left Untreated

It is important for both these conditions to be treated. Untreated, they will lead to serious ill health, causing problems such as pneumonia, mineral and vitamin deficiencies, kidney and heart disorders. It is important to realize that these are both serious conditions which carry a risk of death. However, treatment can be successful and is more likely to be so if started early on in the condition.

Effects on Family of Bulimia Nervosa

These are both distressing conditions. The behaviour of the patient can be difficult to understand and the loss of weight can be very worrying. It is not unusual for the patient to lie and manipulate their family and friends. It is important, however, that family and friends work together with the doctor to provide the patient with sympathetic support, encouragement and understanding. Especially in the younger sufferer, the family become more actively involved in treatment by taking part in family therapy.