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Bulimia Nervosa
By Allison Jackson

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Bulimia nervosa is an eating disorder consisting of binge eating followed by self-induced

vomiting or the use of laxatives (Matthews 2001 p.59). It is classified by binging and purging on
average of at least twice a week for three months (Kittleson & Kramer 2005 p. 21). It is a mental
disorder that can cause a lot of damage to your body. There are various medical complications,
physical damages in your appearance, and mental problems that accompany this disease. Bulimia
is a dangerous eating disorder that causes many problems.
There is a big list of medical complications ranging from minor to life-threatening. This
list includes binge eating, gastric rupture, nausea, abdominal pain and distention, prolonged
digestion, weight gain, purging, dental erosion, enlarged salivary glands, oral/hand trauma,
esophageal/pharyngeal damage, heartburn, sore throat, upper gastrointestinal tears, perforation of
upper GI tract, excessive blood in vomit, gastric pain, electrolyte imbalances, hypokalemia,
tetany, seizures, and cardiac arrhythmias (Matthews 2001 p.66). There are also physical effects
of repeated regular vomiting. The teeth will become sensitive to temperatures from erosion of
enamel from the stomach acid, blood potassium could drop significantly due to the vomit which
could disturb the hearts rhythm and even produce sudden death, salivary glands could swell
resulting in infection, stomach ulcers and bleeding, and constipation. (Wardlaw Smith Collene
2015 p.520).
Since bulimia nervosa has so many medical complications, a complete physical
examination is imperative in patients with the disorder. The examination should include vital
signs and an evaluation of height and weight relative to age. The physician should look for
general hair loss, lanugo, abdominal tenderness, acrocyanosis, jaundice, edema, parotid gland
tenderness or enlargement, and scars on the dorsum of the hand. Also, patients who engage in

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self-induced vomiting should be referred for a complete dental examination (Matthews 2001 p.

Bulimia nervosa is commonly diagnosed by a dentist or family doctor by seeing the

eroded teeth or performing a physical examination (How is bulimia nervosa diagnosed?, n.d.).
Diagnosis happens from recurrent episodes of binge eating, a sense of lack of control over eating
during the episode, feeling that one cannot stop eating or control what or how much an
individual is eating, recurrent inappropriate compensatory behavior in order to prevent weight
gain (such as self-induced vomiting), and binge eating and inappropriate compensatory behaviors
both occur on average twice a week for three months. These people also have low body weight.
The long term outcome is still not known. Research shows that 30 percent of patients with
bulimia rapidly relapse and up to 40 percent remain chronically symptomatic (Medina 2003
p.12). Some warning signs to look for include a preoccupation with food, overeating as a reaction
to emotional stress, the consumption of huge amounts of food without gaining weight, frequent
use of the restroom after meals, compulsive exercise, swollen cheeks, and broken blood vessels
in the eyes. They also often feel helpless, depressed, or anxious (Kramer & Kittleson 2005 p.21,
People with bulimia nervosa have low self-esteem and often see themselves as fat and
that is why they purge Because they are afraid of gaining weight. There is a cycle of obsession
that goes like this: binging, fear of fat gain, purging, loss of fear of fat, guilt, anxiety, binging,
etc. (Wardlaw, Smith, & Collene 2015 p.520). These individuals are very vulnerable and channel
it into a number of mechanisms such as rapid weight changes, assault on body image, and stress
on psychological functions like self-esteem and control of the body (Kaplan & Garfinkel 1993 p.

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There are some psychiatric conditions that coexist with bulimia nervosa. They are mood
disorders, major depression, dysthymic disorder, bipolar disorder, substance related disorders,
alcohol abuse, stimulant abuse, polysubstance abuse, anxiety disorders, panic disorder,
obsessive-compulsive disorder, generalized anxiety disorder, post-traumatic stress disorder,
personality disorders, borderline personality disorder, histrionic personality disorder, narcissistic
personality disorder, and antisocial personality disorder (Matthews 2001 p. 65).
Bulimia nervosa mostly affects teenage girls although there are some boys who have it.
It has become more popular in the last 30 years. The disorder is 10 times more common in
females than males and affects 1 to 3 percent of female adolescents and young adults of 13 to 20
years of
age (Medina2003p. 11).

("bulimianervosastatistics GoogleSearch,"n.d.)

One form of treatment is therapy. Therapy for bulimia nervosa requires a team of
experienced clinicians. Bulimic individuals are less likely than those with anorexia to enter
treatment in a state of semi starvation. However, if a bulimic person has lost significant weight,
this must be treated before psychological treatment begins. Treatment should last at least 16

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weeks. Hospitalizations may be indicated in cases of extreme laxative abuse, regular vomiting,
substance abuse, and depression, especially if physical harm is evident. There are three types of
therapy that they can use, nutritional therapy, psychological therapy, and pharmacological
therapy. Nutritional therapy helps with reestablishing regular eating habits and correcting
misconceptions about food. Psychological therapy helps to improve a persons self-acceptance
and help them not be so concerned about body weight. Pharmacological therapy can help with
increasing feelings of satiety after eating and reduce frequency of binging (Wardlaw, Smith, &
Collene 2015 p. 521, 522).

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Works Cited
Matthews, D. D. (2001). Eating disorders sourcebook: Basic consumer health information about
eating disorders, including information about anorexia nervosa . Detroit, MI: Omnigraphics.

Kramer, G. F., & Kittleson, M. J. (2005). The truth about eating disorders . New York: Facts On

Wardlaw, G. M., Smith, A. M., & Collene, A. L. (2015). Eating disorders. In Foundations of
nutrition (4th ed.). OH: McGraw Hill Education.

How is bulimia nervosa diagnosed? (n.d.). Retrieved from


Medina, L. M. (2003). Bulimia . San Diego, CA: Greenhaven Press.

Kaplan, A. S., & Garfinkel, P. E. (1993). Medical issues and the eating disorders: The interface .
New York: Brunner/Mazel.

bulimia nervosa statistics Google Search. (n.d.). Retrieved from


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bulimia nervosa statistics Google Search. (n.d.). Retrieved from