The bulimia nervosa is an eating disorder behavior is a lack of control over eating, with an intake of large amounts of food in a short period of time (bingeing), accompanied by compensatory behaviors such as excessive use of laxatives or vomiting self-induced, differentiating it from other eating disorders such as anorexia nervosa . The patient keeps these behaviors secret, so it is sometimes difficult for people around him to detect the problem.

Bulimia, with anorexia nervosa are the eating disorder (TCA) faster growth in young people, characterized by a set of behaviors directed to achieving or maintaining what he considers patient acceptable weight, following a totally irrational diets and with a distressing fear of gaining weight .

Bulimia does not necessarily entail an alteration of the weight and generates a feeling of guilt and shame.

It occurs in 90% of cases in women; Men can also suffer it, although its proportion is about ten times less, with rising figures in recent decades. It is common in adolescents and early adulthood, although some cases may appear in childhood and in women over 40 years of age. Its prevalence is estimated at around 1-3% of the population, although with figures that are probably not entirely real since it is usually kept hidden, with a clear evolution to chronicity. Some social groups such as models, athletes or dancers, have a higher prevalence of this problem.

Causes of bulimia

Although an organic cause for this eating disorder (ACT) has not been found, it is believed that there are several factors that can trigger bulimia nervosa . On the one hand, numerous scientific studies genetically locate the disorder on chromosome 10 of affected people, with an alteration in the levels or in the activity of neurotransmitter substances in them (serotonin, norepinephrine, dopamine). On the other hand, there is usually a susceptibility in these patients that is surely demonstrated through other family cases or specific circumstances in their personal environment.

A low self – esteem can lead to an excessive concern for physical appearance , leading to perform restrictive diets, which do not always produce the desired results, alternating with episodes of uncontrolled consumption of food, which cause metabolic imbalance . The patient has feelings of guilt as a result of the binge, and his concern about gaining weight generates other behaviors such as self-induced vomiting and laxative abuse.

The patient may also feel pressured by beauty patterns considered leading by society, and by the need to be slim and attractive to feel accepted. Experiences of social rejection or emotional failure can make you believe that losing weight is a prerequisite for success.

Another cause, also present in anorexia disorder , is a false perception of body image: the patient looks fat even though his weight is normal for his age and constitution.

Symptoms of the person with bulimia

• The person with bulimin has a continuous concern for food , and has an uncontrollable desire to eat, especially foods with a high caloric value (carbohydrates, sweets …). Consume large amounts of food in short periods of time (every two hours or even less).
• To counteract weight gain, the patient may vomit , abuse laxatives (purgative form), use appetite-reducing drugs, or diuretics. Other times he resorts to physical exercise to compensate (non-purging forms). Therefore, it is necessary to suspect when a person locks himself in the bathroom as soon as he finishes eating.
• It is characteristic of this disorder that the patient suffers from a feeling of guilt , shame or self-reproach for this behavior.

• In the same way, other symptoms of bulimia can be fasting for long periods of time, following very restrictive diets and doing intense exercise.
• The subject manifests a strong fear of gaining weight, setting a goal of less than his optimal weight.
• Bulimia generally occurs in patients with a prior history of anorexia nervosa , and with an interval between the two disorders of several months or years.
• Patients with bulimia manifest apathy, fatigue, irritability and changes in the rhythm of sleep, which generates a loss of work or school performance, and the abandonment of personal care.
• Other symptoms that can be seen in a medical examination are: a slight abdominal distension with the presence of constipation , hypertrophy of the parotid glands, loss of dental enamel, throat injuries, electrolyte imbalance, edema in extremities and abrasions on the back of hands; all this due to induction of vomiting. The use of laxatives and diuretics also produces fluid and electrolyte imbalance.
• In bulimics, there are also endocrine changes; In women, the appearance of irregularities in the menstrual cycle or amenorrhea is frequent .