Bulimia nervosa
In bulimia nervosa, the patient binge eats and then tries to compensate for this by restricting her food intake or using other compensatory behaviours such as vomiting, laxative misuse or excessive exercise.
What is defined as a binge? We all over-eat and comfort eat, particularly at particular times of the year such as Christmas. Binge eating means eating an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances.
The key difference between a pattern of binge eating and over-indulgence is the regularity with which the binges take place. The binges are also likely to be triggered by difficult feelings, such as feeling down or anxious. Overall, the feeling towards food is an overwhelming loss of control over behaviour towards food and intense guilt about bingeing.
The guilt and fears about weight gain results in compensatory behaviours to rid the body of this excessive intake of food. This takes the form of vomiting, laxative misuse or excessive exercise.
People with bulimia tend to be of a fairly normal weight range, although there tends to be a slight, steady weight gain over time if the condition is left untreated.
How common is bulimia?
Bulimia nervosa is more common than anorexia nervosa and often begins slightly later in life from late teens, to twenties and can occur at an older age. Prevalence rates in young women vary between 0.5 per cent and 2 per cent but the prevalence of atypical forms may be considerably higher.
What causes bulimia?
Like all eating disorders, bulimia develops when an individual is unable to cope with difficult feelings and expresses this struggle through their behaviour towards food, becoming trapped in a cycle of bingeing and purging. The underlying causes can be some of the following but will vary for every individual:
- Childhood trauma and abuse
- Family difficulties
- Stressful life events
- Personality factors
- Low self esteem
How is bulimia treated?
Unlike people who have anorexia, who often feel ambivalent or resistant to treatment, people with bulimia usually want to change and overcome their eating disorder. The difficulty is usually around coming forward to seek treatment because there is normally a deep-seating sense of shame about their food behaviour. However on the more positive side, it is clear that bulimia responds very well to treatment once a diagnosis is made. Treatment is almost always undertaken on an outpatient basis; admission is normally only required when other are other very serious complications involved.
Outpatient treatment involves going to see a specialist once or twice a week for therapy sessions lasting one hour or ninety minutes. The specialist may be a consultant psychiatrist or a psychologist.
Cognitive behavioural therapy has been proven to be very effective in the treatment of eating disorders and there is form of CBT which has been specifically developed for the treatment of eating disorders, called CBT-E. At Newbridge House we also use an approach called Mindfulness-Based CBT-E which is very helpful in the treatment of bulimia and Motivational Enhancement Therapy which helps people to consider the benefits of overcoming an eating disorder and harnessing that motivation within their treatment programme. As a specialist centre for the treatment of eating disorders, we offer outpatients specialist support from our dietetic service run by a dietitian specialising in the treatment of eating disorders.
