What is bulimia?

Bulimic people are unable to control the impulses that lead them to eat, but the feeling of guilt and shame after eating many foods leads them to fast, use purgatives (laxatives, diuretics, diets, diet pills, etc.) and provoke vomiting to prevent weight gain.

Bulimics have about 15 episodes of binging and vomiting per week and, in general, their weight is normal, making it difficult to detect the disease. In a single binge they can consume from 10,000 to 40,000 calories.

This disease affects young people and, like anorexia, occurs more frequently in women. The average age of onset is 19 years old and people who have suffered anorexia or have carried out uncontrolled diets have a higher risk of suffering this pathology. The number of patients with bulimia has surpassed in recent years those with anorexia.

In this disease, two subtypes can be distinguished:

Purgative: The patient uses vomiting or other purgative methods to avoid weight gain.

Non-purgative:Use non-purgative methods such as fasting or compulsive physical exercise, but do not resort to vomiting, diuretics or laxatives

. What is its origin?

The factors involved in the onset of bulimia are numerous and sometimes difficult to determine. Biological, psychological and social factors intervene in the origin of this disease that distort the patient’s vision of himself and respond to a great fear of gaining weight. The patient always looks fat, even when his weight is normal, but he cannot suppress his desire to eat.

Bulimia usually manifests itself after having carried out numerous harmful diets without medical supervision. 50 percent of anorexia cases lead to bulimia. The limitation of food imposed by the patient himself leads to a strong state of anxiety and the pathological need to eat large amounts of food.

Until now, the biological vulnerability involved in the development of the disease is unknown, and some triggers related to the social environment, diets, and fear of ridicule about the physicist are better known. Many of the factors coincide with those of anorexia, such as affective disorders arising in the family, drug abuse, obesity, diabetes mellitus, certain personality traits and distorted ideas of the body itself.

Symptoms

Generally, people with bulimia have been obese or have followed numerous diets without medical supervision. They try to hide vomiting and purging, so the disease often goes unnoticed for a long time. The typical symptoms of a bulimia condition are the following:

• Binging or food binge eating: The patient eats a large quantity of food in a very short space of time. He has no control over his intake and his anxiety is such that he believes he cannot stop eating.
• To prevent weight gain and compensate for binge eating or overeating, you vomit, use laxatives, diuretics, drugs, or resort to other means that allow you to control your weight, such as abusive sports activities.
• Binge-eating and vomiting cycles occur at least twice a week.
• The patient’s self-esteem is low and identifies it with his body.

  Likewise, other physical and emotional changes (depression, anxiety) occur that manifest the development of the disease. Bulimics look fat, even when their weight is normal; they are ashamed of their body and reject it, so they try to diet at all times. Despite everything, compulsive ingestion on the sly or at night is one of the main characteristics of this pathology.

  They may end up spending a large amount of money on food or turning to what is already at home, which mysteriously begins to disappear from the pantry. They do not feel any pleasure when eating or preferences regarding the type of food, they only seek to be satisfied. They try to avoid places where there is food and try to eat alone. Their behavior is usually asocial, they tend to isolate themselves, and food is their only topic of conversation.

  Also, the lack of control over food produces great feelings of guilt and shame. As for the physical signs that show the disease are weakness, headaches; swelling of the face due to the increase in the salivary and parotid glands, problems with the teeth, dizziness, hair loss, menstrual irregularities, and sudden increases and decreases in weight, although they generally do not suffer from a weight swing as important as that manifested in anorexia. Bulimia can be accompanied by other disorders such as kleptomania, alcoholism, or sexual promiscuity.

  Diagnosis and treatment

  The diagnosis of bulimia is complicated since episodes of voracity and vomiting are easily concealed. In addition, some symptoms can be confused with those of other pathologies. For a proper diagnosis, a psychiatric interview is needed to reveal the patient’s perception of his own body and the relationship he has with food.

  Likewise, a complete physical examination is necessary to detect the disorders resulting from their eating behavior. The goals of treatment are to correct the eating and psychological disorders of the disease. Due to the severity, outpatient treatment or hospitalization may be used.

  In the first place, it is a matter of avoiding vomiting, normalizing the metabolic function of the patient, a balanced diet and new eating habits. Along with this treatment, aimed at physical recovery, psychological treatment is developed in order to restructure rational ideas and correct the patient’s mistaken perception of his own body.

  Treatment also involves the collaboration of the family, since sometimes the factor that triggers the disease is in their womb. The cure of bulimia is achieved in 40 percent of cases, although it is an intermittent disease that tends to become chronic. Mortality in this disease exceeds that of anorexia due to complications derived from vomiting and the use of purgatives.

  How it differs from Anorexia

  Anorexia involves weight loss caused by the patient himself, but at no time is overfeeding used and, consequently, compensatory behaviors (vomiting) that try to remedy binge eating disappear. The patient begins to gradually reduce food intake, the diet is restrictive and this process leads to a state of starvation. Weight loss is evident, whereas in bulimia the weight variations are usually not as great.