Bulimia

This page was reviewed or revised on Saturday, October 26, 2002.

Although many people believe that eating disorders are rare, health professionals say that their frequency is rising at an alarming rate. Not all eating disorders lead to obesity. Two serious conditions at the underweight end of the scale - anorexia nervosa and bulimia - are affecting many teens and young adults.

Our awareness of anorexia nervosa has grown as more and more celebrities have gone public with their fights against this disease. This complex eating disorder causes young, intelligent people to enter into self-imposed starvation. Their distorted body image shows a picture of an overweight person instead of the wasted skeleton they are. Although this disease affects a very small number of people, less than half of the anorectics completely recover. Many anorectics are in real danger of dying.

Until recently anorexia nervosa completely overshadowed bulimia. While bulimia does not have the severe health effects of anorexia nervosa, it affects more women and causes a lot of pain.

What does this strange word "Bulimia" mean?

It's literal translation is "hunger like an ox". Today we use bulimia to mean uncontrollable eating (binging) followed by an attempt to purge. The diagram below shows this vicious circle. The typical bulimic is a female, in her late teens or early twenties. Bulimics tend to be introverted, achievement-oriented and do well in school. Most bulimics are not severely overweight or obese. Rather, their weight varies. They have an intense fear of gaining weight and are willing to do almost anything to avoid an extra pound. Almost all bulimia is preceded by at least one attempt at weight loss through crash dieting. Since studies have shown that 80 percent of all young women have been on a diet by age 18, the potential number of bulimics is vast.

Why do people overindulge in food only to force themselves to vomit?

In our society, thinness is a desired state; to be beautiful implies being thin. Fashion, entertainment, and advertising all center around slender models with hollow cheekbones. Since society has set such a thin image as the desirable image, dieting has also become a cultural norm. We expect people to be disappointed with their body weight and we reward them with praise and attention when they lose weight. Unfortunately, the pressure from society to be thin has hastened the dramatic increase in bulimia.

In direct conflict with the bulimic's fear of the weigh scale, is their preoccupation with food. They tend to be compulsive eaters who fantasize about forbidden foods on their diet. Finally, they give in to their urgent need to eat in a last ditch attempt to get all of what they want before starting a diet. During a binge, large quantities of food can be ingested in a very short period of time (whole pies, cakes, packages of cookies, cartons of ice cream, etc. -- often more than 10,000 calories per binge).

For most bulimics, the worst part of the eating disorder is the anxiety and guilt feelings which occur immediately after a binge. Guilt over lying to friends and family, guilt over food and money wasted, guilt over their lack of control. They become depressed and often isolate themselves from social situations for fear of being embarrassed by their eating impulses. Purging becomes a means of punishing themselves in response to their guilt as well as a seemingly fool-proof method of weight control.

Is Purging dangerous?

Purging short-circuits the body's absorption of nutrients, and can cause serious health risks. The most dangerous of these is low potassium (hypo) which can cause serious, sometimes fatal, heart problems. Other complications of bulimia include: hand and foot tingling, decay of tooth enamel (due to acidic vomit), swelling of salivary glands, chronic indigestion and stomach pain. Bulimics often use laxatives and diuretics in large quantities on the false premise that they reduce calorie absorption. Instead, they remove the remains of digested food and body water, leading to dehydration.

What can be done?

Eating disorders are rarely overcome on their own. The first step requires the bulimic to recognize that she has become a "slave" to the vomiting or purging. With proper counselling and nutritional guidelines, most bulimics can learn to control their eating behaviour. Often, once the bulimic is able to pin point determine what causes binging, - love, boredom, loneliness, stress - they are able to develop more appropriate coping strategies for these situations. Maintaining a steady weight, rather than losing weight is the treatment goal. Gaining control over eating habits is difficult, involving patience, persistence and pain. Friends, family and health professionals must offer support and understanding as well as encourage bulimics to seek the help they so desperately need

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