Eating disorders are a mental health condition that is said to affect around 5% of the global population. Some typical eating disorders are anorexia nervosa, bulimia nervosa, and restrictive food intake disorder.
In light of this, let us explore the symptoms, causes, and treatment of bulimia nervosa.
1. What are the Symptoms of Bulimia?
Knowing the symptoms of bulimia will definitely be the first step toward answering the question “Is bulimia a mental illness?”. Being aware of the signs and symptoms of bulimia nervosa can help you recognize if someone is afflicted with this eating disorder.
The main bulimia symptoms are:
1.1. Binge Eating
Binge eating (thus the name “binge eating disorder”) usually occurs in episodes wherein one’s food intake is much higher than their usual diet or what the situation calls for. Binge eating is characterized by a feeling of being out of control, one feels like they cannot stop themselves from eating.
Binge eating episodes can happen spontaneously, or they can be planned, like buying foods to binge on at a later time.
For binge eating to classify as a symptom of bulimia nervosa, the episodes must be recurrent over time.
Binge eating is usually followed by acts of purging. Purging involves trying to rid oneself of the excessive food eaten due to the fear of gaining weight. Methods to purge range from self-induced vomiting to taking too many laxatives.
Purging is a response to feelings of guilt, anger, and anxiousness that arise after binge eating. Although, it should be noted, that purging has little to no effect on the number of calories absorbed by the body after eating.
1.3. Intrusive Thoughts about Food
Intrusive thoughts are unwanted thoughts that can distract your brain even if you don’t want to think about them. People with bulimia tend to be preoccupied with thoughts of food and eating as they see comfort in it.
Feelings of distress cause one to seek comfort (food), but since people with bulimia are afraid of weight gain, these thoughts might cause further distress.
1.4. Self-Esteem and Body Image Issues
People with bulimia usually struggle with their self-esteem. This in turn causes them to be overly focused and critical of their body image, shape, and eating habits.
They set up unrealistic body weight and dieting goals for themselves, failing to achieve which they fall into another cycle of compensatory behaviors to comfort themselves from the feelings of guilt and anger.
2. What are the Long-Term Effects of Bulimia?
In time, the maladaptive behaviour patterns associated with bulimia nervosa can lead to a variety of serious health complications. These arise due to a lack of proper nutrients, self-induced vomiting, and excessive use of laxatives.
The long-term effects of bulimia might include:
2.1. Dental Problems
The tooth enamel can get damaged by the stomach acid which accompanies vomit. This can cause tooth decay in bulimic people.
2.2. Bad Breath & Sore Throat
The stomach acid from repeated vomiting bouts can also give rise to bad breath, and sore throat and might even harm the lining of the throat.
2.3. Dry Skin and Hair
The lack of proper nourishment of the body by nutrients can lead to dryness of the hair and skin. Nails can also get brittle due to this.
2.4. Swollen Glands
The salivary glands may get swollen because of recurring vomiting.
2.5. Chemical Imbalance
Vomiting often or using too many laxatives can lead to an imbalance of chemicals, especially electrolyte imbalance, in the body. This imbalance can cause feelings of tiredness, weakness, damage to the kidneys, or even include muscle spasms or convulsions.
Electrolyte deficiency in the body can also generate severe dehydration.
2.6. Bowel Troubles
Frequent usage of laxatives can harm the bowel muscles, leading to problems such as permanent constipation or irritable bowel syndrome.
2.7. Heart Problems
Bulimia nervosa also exposes people to an increased risk of heart problems.
Lack of proper nutrients might result in weak bones and low bone density.
2.9. Menstrual Cycle
Periods in people with bulimia become highly irregular or might stop altogether.
3. What are the Causes of Bulimia Nervosa?
The exact causes of any eating disorder are undefined. Research suggests that they may be caused due to a combination of many different factors.
3.1. Psychological Factors
Most people with bulimia nervosa exhibit certain common thoughts and behavioural patterns. These patterns often make them more vulnerable to eating disorders.
Psychological causes for bulimia nervosa might be:
A predisposition towards anxiety, having low self-esteem, depression, or an obsessive personality type.
Difficulty in handling stress and/or previous experience of a traumatic or stressful situation.
Often feeling apprehensive and anxious about the future.
Being a perfectionist, setting very high ideals and standards for oneself which are not realistically achievable.
Too much focus on and being highly critical of one’s body weight and body image.
Difficulty in expressing feelings and emotions.
Frequent occurrence of negative intrusive thoughts.
3.2. Environmental Factors
Environmental factors constitute the factors in one’s surroundings that contribute to detrimental mental health. These can be anything ranging from one’s socio-economic status to the behaviour of one’s family members towards them.
Environmental factors for bulimia nervosa can include:
Bodily changes due to puberty. Rapid changes in the body during puberty accompanied by hormonal changes can cause feelings of anxiousness and shame, resulting in low self-esteem and distorted body image.
Big life changes, like moving to a new city or the death of a family member, can cause immense amounts of stress.
The negative effect of media, especially social media, wherein idealistic standards of body shape and weight are portrayed as normal. This gives rise to feelings of insecurity and shame among young people about their bodies.
Bullying or pressure at school/workplace.
Having family members that give great importance to being slim and thin and overly criticize weight gain or eating habits.
3.3. Biological & Genetic Factors
Biological and genetic factors have also been found to play an important role in the prevalence of eating disorders in people. These can be:
A family history of mental disorders such as eating disorders, depression, or addictions to drugs and/or alcohol.
Already have other mental health conditions such as depression or obsessive-compulsive disorder.
4. What are the Treaments for Bulimia?
There are a range of treatments available for eating disorders as they are for other mental illnesses. The treatment plans can be altered to suit your support needs and situational factors. Treating bulimia includes holistic care for your mental health along with your physical well-being.
Ways to treat bulimia nervosa are:
4.1. Psychological Treatment
Psychological treatments for bulimia nervosa involve talk therapy with psychologists who provide support, and treatment and help you navigate through your recovery journey in an effective way.
4.1.1. Cognitive Behavioral Therapy (CBT)
CBT is one of the main talking therapies that are used in treating bulimia. CBT is based on the view that our affective (feelings and emotions), behavioural, and cognitive (thoughts) patterns are interlinked and influence each other.
CBT for bulimia nervosa primarily focuses on helping patients change the way they think about food, eating, and their body image. In this way, it aims to change the behavioural aspects of this eating disorder and facilitate recovery.
4.1.2. Interpersonal Therapy (IPT)
Interpersonal psychotherapy or IPT was developed on the idea that our interpersonal relationships (relationships with family, friends, romantic partners, etc.) and the external world in general exercise a lot of influence on our mental health.
IPT for treating bulimia nervosa basically evaluates these interpersonal relationships and how they might be affecting one’s perception of food, eating, and body image. Therapy aims to help people improve these malfunctioning relationships as a way to recover from this eating disorder.
4.1.3. Other Psychological Treatments
Family therapy and support groups, usually governed by healthcare professionals, also prove useful in providing a good support system in a treatment plan for bulimia.
4.2. Guided Self-Help
Guided self-help is a form of treatment for bulimia wherein one undertakes to do most of the activities themselves after getting equipped with all the necessary information. Regular support sessions are scheduled with a healthcare professional (usually a psychologist) to provide guidance and helpful suggestions for the recovery journey.
Activities in a guided self-help plan can include journaling, maintaining a food diary or a self-help book, prepping meal plans, and filling out worksheets.
Antidepressants can also be used to treat bulimia nervosa. Selective serotonin reuptake inhibitors (SSRIs) are antidepressants that have been used as an effective treatment for bulimia.
The SSRI that is most commonly prescribed for bulimia nervosa is called fluoxetine (Prozac). This medication works to inhibit the impulse to binge and/or vomit. It should be remembered that antidepressants might take several weeks before they start to work and help you feel better.
Recovery from bulimia nervosa can be quicker if it is diagnosed in the early stages. Therefore, if you or anyone around you experiences the aforementioned symptoms of bulimia, then it would be a good idea to consult a healthcare professional and seek help.