Bulimia is an eating disorder that is less publicized and recognized by the media and general public than its counterpart, anorexia nervosa. Although they are both eating disorders that can be a danger to the sufferer, bulimia is much harder to identify and diagnose without the admission of the client or observation of the rituals by family or friends. Someone with bulimia will often have normal to average weight and seem to have a normal or above average appetite. There are signs to look for to determine if someone you know is battling bulimia.
Causes
The cause of bulimia is not known but there are conditions that may put one at risk for developing it. Someone who has a feeling of a lack of control in their life, social /family pressure to be thin, depression, high stress, emotional or physical trauma may be at risk. It may also develop while someone is attempting to diet by limiting food. The pangs of hunger may become unbearable and lead to binging, or excessive overeating. The pattern of starvation and binging may become habitualized and lead to strong feelings of guilt that begins the pattern of purging, or ridding the body of food. Not all people that suffer from bulimia will purge. Some will use excessive exercising or long term restrictions on eating to control weight instead of vomiting or using laxatives.
Signs
Someone with bulimia may eat normal size meals when in front of others but may binge eat or hoard food to eat all at once when alone. They may hide the trash from binging such as containers of food, ice cream tubs, pizza boxes, chip bags, and so on. There may also be many trashed boxes of laxatives, diuretics, diet pills, or emetics that induce vomiting. The behavior of binging and purging is often on a schedule and ritualistic. It may be observed that the person will eat a meal and then immediately go to the bathroom. There also may be instances in which the person goes to their room and locks the door or gets up late at night to go to the kitchen when everyone else is asleep. Often the sufferer is a young adolescent or young adult female, but bulimia can affect both males and females of all age groups. Due to the young age of some persons dealing with bulimia there may be instances of stealing money to buy food or stealing food from businesses.
Physical changes from bulimia can range from slight to drastic. A person with bulimia usually is obsessive about not gaining weight but feels a lack of control. The body weight may stay around average or the person may begin to rapidly lose or gain weight. The pattern of vomiting after eating will lead to tooth erosion and foul smelling breath but can lead to more serious complications such as esophageal rupture. You may notice that the eyes of the sufferer are red or blood shot after leaving the bathroom due to the strain involved from forced vomiting. The face may also show signs of swelling and a rash may develop. Long term medical conditions can occur but few are immediately life threatening and hospitalization is not always required. Sometimes anorexia occurs together with bulimia and the person fluctuates between starvation and binging behavior.
Treatment
Treatment for bulimia often includes an immediate intervention of group therapy, medical checkups, and nutritionist advice. Therapy is likely to work but only if the client is willing to change and has the appropriate support system to keep them accountable. The desired outcome of therapy is for the client to break the habit of the rituals around eating while also helping them maintain a healthy body weight. Inpatient treatment is not always required for someone with bulimia but a day treatment or outpatient program can be helpful.
