What are the symptoms of Bulimia?
Bulimia nervosa is a serious eating disorder causing an individual to become trapped in a binge-purge cycle. A binge means consuming a large number of calories in a short period of time, normally in secret, accompanied by feeling a loss of control. The binge is followed by overwhelming feelings of guilt and shame, triggering the purge, which often involves self-induced vomiting, but can also include over-exercising and the use of laxatives.
Bulimia nervosa is the second most common eating disorder. The national eating disorders charity Beat states there are approximately 1.25 million people in the UK who have an eating disorder. Of these, around ten per cent have anorexia nervosa, 40 per cent have bulimia nervosa and the remaining 50 per cent have binge eating disorders or EDNOS (eating disorders not otherwise specified).
Individuals with bulimia tend to be within a normal weight range. Equally, people may wait many years before seeking bulimia treatment due to feelings of guilt and shame about their condition. It is important to note that the effects of bulimia are serious. We consider the physical effects of bulimia, together with impacts on well being which include chronic fatigue, depression and low self-esteem.
Signs and symptoms of bulimia
The binge is one of the symptoms of bulimia which is perhaps not straightforward to define. What is the difference between ‘overdoing it’ or ‘comfort eating’ and the sort of binge that might be considered one of the signs of bulimia? In quantitative terms, a binge is an amount of food which is significantly larger than a person would be expected to eat during a single episode.
Often, a binge involves the consumption of food that is ‘forbidden’ or ordinarily avoided (for example high calorie, high carbohydrate content). An important component of bulimia symptoms are the feelings of guilt which follow the binge. This is far more intense than regret at eating ‘too much’. Feelings are painful and overwhelming, driving the purge which follows.
Understanding bulimia symptoms
In common with all eating disorders, the effects of bulimia tell us a person is struggling to cope with very difficult and painful feelings. Bulimia treatment focuses on emotions and feelings that trigger a binge: what are the things that have made a binge more likely to occur?
Individuals are often encouraged to keep a diary and precisely record the circumstances, their feelings and emotions that precede each binge, so a full picture can be seen and understood.
Common causal factors for bulimia nervosa, like other eating disorders, includes: genetic predisposition, childhood trauma, family difficulties, stressful life events, personality factors and low self-esteem. There is always more than one factor involved and the exact pattern contributing to the development of an eating disorder will vary for each individual.
Treatment and support
The positive message is that many studies have shown established bulimia treatment approaches are effective and recovery rates are good, especially when therapy commences at an early stage. The main treatment approach for bulimia nervosa is Cognitive Behavioural Therapy (CBT) using a programme adapted for eating disorders. Studies have shown this is an effective way of treating bulimia, providing a practical, solutions-based focus on the thoughts and emotions occurring before a person binges and how that pattern of responses can be altered.
This type of bulimia treatment is usually delivered by a psychologist specialising in Cognitive Behavioural Therapy, seeing patients once a week for an individual session lasting about one hour for up to 20 sessions, depending on needs. Some people also find patient support groups are helpful to bulimia recovery, providing an opportunity to meet other people who are coping with the effects of bulimia and sharing experiences.