It is an eating disorder characterized by repeated episodes of excessive food intake in a short period of time.
Bulimia is coupled with an excessive preoccupation with controlling body weight, which can lead you to use methods to control weight gain. The person suffering from bulimia looks fat, has a distorted idea of his own body, although he has a normal weight and has permanent feelings of body dissatisfaction, fear of gaining weight, he is not able to control his impulses with food and cannot resist the desire to binge.
Two therapeutic approaches are contemplated
The pharmacological and the psychotherapeutic. Cognitive behavioral therapy has been very successful. It is very important that parents go to the doctor because patients often deny the symptoms and try to hide the seriousness of the problem.
Clinical diagnosis
Medical causes of loss of food control and vomiting should be ruled out in bulimia.
- Diagnostic interview.
- Rule out organic disease through: magnetic resonance imaging, general and specific tests and assessment by other specialists (endocrinologists).
- Psychodiagnostic tests.
- Carrying out the diagnosis following the ICD-10 and DSM-IV-TR criteria.
Treatment of bulimia nervosa
- The disappearance of binge eating and purgative behaviors.
- The development of standard eating patterns.
- The modification of dysfunctional attitudes and ideas regarding weight and body image.
- The disappearance of the associated symptoms (mainly anxiety and depression).
- Learning guidelines to create and maintain stable social relationships.
- Relapse prevention.
- In a team with different specialists, which is usually led by a psychiatrist or child psychiatrist, a plan for weight recovery and dietary and nutritional re-education should be made.
- A very close follow-up is done so that the recovery of the weight is gradual, with frequent controls.
- Diet problems that affect the patient are studied and improved, as well as factors that influence binge eating and vomiting (anxiety about school, problems with parents or friends).
- In addition to the physical improvement of weight, diet and eating habits, a psychiatric treatment is carried out, which combines psychoeducation, individual psychotherapy, group psychotherapy and family therapy.
- It can be helped with medications such as antidepressants, which improve binge eating, vomiting, depressed mood and treat other associated problems.
Cause
- This disease is multifactorial and the clinical symptoms represent the end of the interaction of three types of factors.
- Predisposing factors: individual, family and cultural.
- Precipitating factors: crisis situations, such as loss of affection or the start of a strict diet due to personal or bodily dissatisfaction.
- Perpetuating factors: malnutrition clinic and associated affective clinic (anxiety, depression …)
It is believed that there may be a problem in the regulation of serotonin, as serotonin reuptake inhibitor (SSRI) antidepressants improve the levels of this neurotransmitter and are useful in the treatment of bulimia.
The symptoms that indicate that a person may have bulimia are binge eating and excessive food intake in a short time.
- Loss of control over food, which in turn creates a lot of anxiety.
- The patient can use compensatory mechanisms to control weight gain (use of diuretics, laxatives, excessive exercise, hypocaloric diet, fasting periods, etc.)
- In addition to the psychological symptoms that it may present (anxiety, depression, low self-esteem …), there may be physical symptoms such as headaches, dental problems, a swollen face, hair loss, irregular menstruation, dehydration, arrhythmias, etc.
Most common symptoms
- Distortion of body image.
- Malnutrition
- Digestive disorders
- Biochemical alterations in blood.
- Lack of calcium
Medical complications and physical risks
Severe malnutrition, such as digestive disorders (due to binge eating, vomiting, use of laxatives), heart problems (due to malnutrition), biochemical changes in the blood (low potassium or sodium), endocrine or hormonal changes and lack of calcium in the bone. Patients with bulimia frequently have depression, anxiety and addiction problems or impulse control disorders (compulsive shopping, kleptomania – stealing things that are not needed – self-mutilation and promiscuity). The person with bulimia is aware that their way of eating is not normal.