The eating disorder bulimia nervosa is thought to affect from 1% to 4% of women at some time during their lifetime. It is found in men too, but at a rate of around 10% of that of women.
Bulimia is a compulsive behaviour by which sufferers seek to control their weight through binge eating and subsequent purging.
Bulimia is typified by bouts of bingeing and purging. Commonly, sufferers will quickly consume large amounts of food, whether or not they are hungry, until they feel discomfort. They then purge themselves by self-induced vomiting or the use of laxatives. It is a cycle they go through several times a week. There are also types of bulimia that purge using exercise or other means.
Bulimia and anorexia compared
Bulimia and anorexia are often mentioned in the same breath but they are distinct disorders. While both are eating disorders characterised by a desire to avoid weight gain and a dissatisfaction with body shape, bulimics will eat and purge while anorexics avoid food. Bulimia does not necessarily lead to low body weight while anorexia results in emaciation.
The causes of bulimia
What causes the onset of bulimia is not clear. Several factors appear to be involved:
- Trauma is a common trigger for bulimia - the loss of a loved one, a history of abuse or other traumatic experiences are often involved.
- Stress – as with many disorders, stress from any cause is frequently a factor behind the onset of bulimia.
- Psychological problems – bulimia sufferers often have other psychological problems, including depression, anxiety disorders and obsessive-compulsive disorder. The bingeing and purging practised by sufferers may also be their way of dealing with emotional difficulties.
- Social pressure – the fashion and film industries and the media promote the concept of thin is beautiful, which may pressure susceptible individuals to seek to lose weight through bulimia.
- Genetics – someone who has a relative with bulimia is four times more likely to suffer from bulimia than someone without.
Complications associated with bulimia
The constant rounds of bingeing and purging associated with bulimia can lead to a number of physical and mental problems. These include:
- Swelling - caused by the disturbances to the body’s fluids.
- Tooth decay - frequent vomiting means that the teeth are exposed to stomach acids that cause erosion of the enamel, so exposing the teeth to decay.
- Psychological problems – bulimia sometimes leads to depression and mood swings, as well as low self-esteem and feelings of guilt.
- Bowel problems – laxatives, which bulimics sometimes takes to excess, can damage both the bowel muscle and nerve endings, sometimes resulting in abdominal pain and permanent constipation.
- Electrolyte imbalance – frequent vomiting and excessive use of laxatives affects the body’s chemical balance. Reduced calcium levels can cause muscle spasms, while other deficiencies can cause kidney damage, abnormal heart rhythms, fatigue and weakness.
- Irregular menstrual periods – the poor diet associated with bulimia can affect hormone levels that can cause irregular periods, the cessation of periods or, in the case of younger sufferers, impede the onset of periods at puberty.
- Throat problems – bulimics often experience throat irritation and damage to the oesophagus.
- Internal problems – ulcers, inflammation of the pancreas and even rupturing of the stomach can occur as a result of bulimia.
Bulimia is treatable but it is difficult to cure completely. Treatment usually begins with a visit to a GP who will normally refer the patient to a specialist. It is a lengthy process and commonly involves advice on diet and eating habits, cognitive behavioural therapy and, sometimes, medication. Early intervention is crucial if the medical problems associated with bulimia are to be minimised.