Summary about Disease
Bulimia nervosa is a serious, potentially life-threatening eating disorder characterized by a cycle of binge eating followed by compensatory behaviors, such as self-induced vomiting, misuse of laxatives, diuretics, or other medications, fasting, or excessive exercise, to prevent weight gain. These behaviors are often driven by an intense fear of gaining weight, a distorted body image, and an overvaluation of body shape and weight.
Symptoms
Behavioral: Binge eating (consuming large amounts of food in a short period), self-induced vomiting, misuse of laxatives, diuretics, or enemas, fasting or severe restriction of food intake, excessive exercise, using the bathroom frequently after meals, preoccupation with food, weight, and body shape, hiding food or evidence of binge eating.
Physical: Chronically inflamed and sore throat, swollen salivary glands in the neck and jaw area, worn tooth enamel and increasingly sensitive and decaying teeth (due to exposure to stomach acid), acid reflux disorder and other gastrointestinal problems, intestinal distress and irritation from laxative abuse, severe dehydration, electrolyte imbalance (which can lead to heart problems, including cardiac arrest), irregular heartbeat, menstrual irregularities or absence of menstruation, anxiety, depression.
Causes
The exact cause of bulimia nervosa is unknown, but it is likely a combination of genetic, psychological, environmental, and social factors.
Genetics: There may be a genetic predisposition to developing eating disorders.
Psychological: Low self-esteem, perfectionism, impulsivity, difficulty managing emotions, anxiety, depression, and a history of trauma can contribute.
Environmental: Societal pressures to be thin, media portrayals of ideal body types, and cultural norms surrounding food and weight can play a role.
Social: Family history of eating disorders, teasing or bullying about weight, and pressure from peers can contribute.
Medicine Used
Antidepressants: Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac), are often prescribed to help reduce binge-purge cycles and improve mood. Fluoxetine is the only medication specifically FDA-approved for the treatment of bulimia nervosa.
Other medications: Depending on individual needs and co-occurring conditions, other medications, such as mood stabilizers or anti-anxiety medications, may be prescribed.
Nutritional Supplements: Electrolyte imbalances might require supplements.
Is Communicable
No, bulimia nervosa is not a communicable disease. It is a mental health disorder, not an infectious illness.
Precautions
Early intervention: Seeking professional help at the first signs of an eating disorder can improve outcomes.
Therapy: Participating in individual, group, or family therapy can help address underlying psychological issues and develop healthy coping mechanisms.
Nutritional counseling: Working with a registered dietitian can help re-establish healthy eating patterns and address nutritional deficiencies.
Support system: Building a strong support system of family, friends, and support groups can provide encouragement and accountability.
Self-care: Practicing self-care activities, such as exercise, relaxation techniques, and hobbies, can help manage stress and improve overall well-being.
Be aware of triggers: Identify and avoid situations, people, or thoughts that trigger binge eating or purging behaviors.
Promote positive body image: Challenge negative thoughts about body shape and weight and focus on self-acceptance and self-compassion.
How long does an outbreak last?
Bulimia nervosa is not an "outbreak" in the infectious disease sense. It is a chronic mental health condition. Without treatment, bulimia can persist for many years, with cycles of remission and relapse. With consistent treatment, individuals can manage their symptoms and achieve long-term recovery, but there is no set time frame for "outbreak" resolution.
How is it diagnosed?
Bulimia nervosa is diagnosed based on criteria established in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Diagnosis typically involves:
Clinical interview: A healthcare professional will ask about eating habits, body image, and mental health history.
Physical examination: A physical exam can help identify physical signs of bulimia, such as dental problems, swollen salivary glands, or electrolyte imbalances.
Psychological evaluation: A psychologist or psychiatrist will assess for underlying mental health conditions, such as depression or anxiety.
Diagnostic criteria: Meeting the specific criteria for bulimia nervosa as defined in the DSM, which includes recurrent episodes of binge eating followed by inappropriate compensatory behaviors to prevent weight gain, occurring at least once a week for three months, and self-evaluation being unduly influenced by body shape and weight.
Timeline of Symptoms
The development of bulimia nervosa can vary, but a general timeline of symptom progression might look like this:
Early stages: Increased concern about weight and body shape, dieting or restrictive eating, occasional episodes of overeating.
Middle stages: Development of binge eating episodes, followed by compensatory behaviors like self-induced vomiting or laxative abuse, increasing secrecy about eating habits, growing anxiety and shame.
Later stages: More frequent binge-purge cycles, significant distress and impairment in daily life, physical health problems (e.g., dental issues, electrolyte imbalances), social withdrawal, and potential for co-occurring mental health conditions (e.g., depression, anxiety). Note: This is a general timeline, and individual experiences may vary.
Important Considerations
Co-occurring conditions: Bulimia nervosa often occurs with other mental health conditions, such as depression, anxiety, substance use disorders, and personality disorders. These conditions should be addressed as part of the treatment plan.
Medical complications: The physical consequences of bulimia can be serious and life-threatening. Medical monitoring is essential to address electrolyte imbalances, cardiac problems, and other health issues.
Relapse: Relapse is common in eating disorder recovery. Ongoing support and maintenance therapy are important to prevent relapse and promote long-term recovery.
Individualized treatment: Treatment for bulimia should be tailored to the individual's specific needs and circumstances.
Stigma: Eating disorders are often stigmatized, which can make it difficult for people to seek help. Raising awareness and reducing stigma is important to encourage people to get the treatment they need.
Family Involvement: Including family members in therapy can be beneficial, as they can provide support and learn how to help their loved one recover.