What is Bulimia?

First diagnosed in the 1980s, initially experts believed that bulimia was an eating disorder caused by an individual’s reaction to stress and/or depression. However, later studies indicate that bulimia may be caused by some biological and hereditary conditions as well as emotional and psychological factors.

Results of a 1999 study, published by the American Medical Association's Archives of General Psychiatry, indicated that bulimia could be the result of a chemical imbalance in the brain. When deprived of the amino acid tryptophan, recovered bulimic women reported mood swings, a return to pre-occupation with body image, and anxiety over their ability to retain control over their eating habits. Tryptophan, a natural part of many foods helps the brain produce serotonin, which is a mood and appetite-regulating chemical. In an unrelated study, Dr. Walter H. Kaye of the University of Pittsburgh also reported finding abnormal levels of a serotonin-related chemical in the spinal fluid of actively bulimic women.

Today bulimia is separated into three types and is generally diagnosed as bulimia nervosa:

1. Simple bulimia nervosa
2. Anorexic bulimia nervosa
3. Multi-impulsive bulimia nervosa

Although the types of bulimia have been split into the above three categories, each type shares some common characteristics and successful recovery from each type increases with early diagnosis and treatment.

Common Characteristics

Bulimia is binge eating followed by purging. The binge is a period of compulsively eating large amounts of food in a short period of time. Purging, although most often thought as self-induced vomiting may also be accomplished by over-use of laxatives, diuretics, fasting between binges, restrictive dieting, and excessive exercise.

Bulimia is life-threatening. Current estimates suggest that 10% of all those who suffer from bulimia die from physical complications caused by the disease. It is difficult to tell if a friend or loved-one suffers from bulimia. Both binge eating and purging are typically done in private. In addition, those with bulimia may appear to be of average weight, underweight, or overweight. The most noticeable symptom of bulimia is an over-preoccupation with weight and/or body image.

Simple Bulimia Nervosa

Simple Bulimia Nervosa most commonly occurs in young adult women and frequently begins after a period of stress or unhappiness. In an effort to improve self-esteem, the individual focuses on appearance and diet. However, unlike the anorexic individual, the bulimic is unable to control their eating habits and resorts to purging. Eventually the body’s systems of appetite control are over ridden. Although weight may stay the same, the individual’s eating patterns deteriorate into a self-destructive cycle of binging and purging. Although simple bulimia nervosa is the least severe form of the illness, it is still a very serious disorder. Early diagnosis and treatment are necessary for recovery to be successful.

Anorexic Bulimia Nervosa

Although the term anorexic bulimia nervosa suggests an anorexic individual who purges, that suggestion is a misconception. Those who suffer anorexic bulimia nervosa are typically those who have recovered from a short-term battle with anorexia, often without undergoing treatment. As weight stabilizes and their life returns to normal, they are unable to control their eating habits and begin purging, mostly by vomiting after meals. Frequent vomiting adds to their problems of appetite control and at that point, binging begins and they enter the binge-purge cycle.

The seriousness of anorexic bulimia stems mainly from two factors, the first being that the individual may revert to restrictive dietary measures and relapse into anorexia. The second most serious element of anorexic bulimia nervosa is on the toll repeated vomiting takes on the digestive system. Among the many physical problems faced are those such as stomach ulcers and ruptures of the stomach and esophagus.

Those who suffer from anorexic bulimia nervosa are likely to need hospitalization especially if weight loss becomes a factor in their illness. Restoration of normal weight is essential to appetite control.

Multi-impulsive Bulimia Nervosa

Multi-impulsive bulimia nervosa is the most severe variant of bulimia and usually begins in a similar way to simple bulimia. In addition to the binge-purge cycle, this group often also suffers from a variety of impulsive and self-destructive behaviors. However, those with this variant of the illness generally refuse help until the illness causes secondary problems that may include, drug and/or alcohol abuse, self-mutilation, theft and promiscuity.

This is the most difficult of the types of bulimia to treat and helping patients to change their patterns and modify their behaviors can take prolonged treatment. They frequently need inpatient care in a highly structured environment to prevent them from acting out in self-destructive ways and to teach them successful methods to control their impulses and cope with other emotional and social problems.

Although bulimia is categorized into three types, symptoms overlap from one type to the next. The best way to treat bulimia is to begin with a comprehensive diagnosis from an experienced medical professional.

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