BULIMIA NERVOSA

ELMEIDA EFFENDY
 EATING DISORDERS
An eating disorder is to eat, or avoid
eating, which negatively affects both
one's physical and mental health.
It is present when a person experiences
severe disturbances in eating behavior,
such as extreme reduction of food
intake or extreme overeating, or
feelings of extreme distress or concern
about body weight or shape.
 The two main types of eating disorders
are anorexia nervosa and bulimia
nervosa. A third category is "eating
disorders not otherwise specified
(EDNOS) ," which includes several
variations of eating disorders.
Binge-eating disorder - This is a chronic
condition that occurs when an
individual consumes huge amounts of
food during a brief period of time and
feels totally out of control and unable
to stop their eating morbid obesity,
diabetes, hypertension, and
cardiovascular disease.
 BULIMIA NERVOSA
DEFINITION - episodes of secretive
excessive eating (bingeing) followed by
inappropriate methods of weight
control, such as self-induced vomiting
(purging) , abuse of laxatives and
diuretics, or excessive exercise.
Often, the individual will feel an
impairment or loss of control during
the binge eating and the purging
becomes a way of regaining control.
 THE BINGE &
PURGING CYCLE

They obsess over

what, when, and how
much to eat, what
they shouldnt eat,
and how to avoid
eating.
At the same time,
their calorie
restriction triggers
physical cravings
the bodys way of
asking for the
nutrition it needs.
 DIAGNOSIS DSM IV
1. Recurrent episodes of binge eating. An episode of binge
eating is characterized by the of the following :
Eating, in discrete period of time (e.g., within any 2-
hour period), an amount of food that is definitely larger
than most people would eat during a similar period and
under similar circumstances.
A sense of lack of control over eating the period (e.g., a
feeling that one cannot stop eating or control what or
how much one is eating).
2. Recurrent inappropriate compensatory behavior in order
to prevent weight gain, such as self-induced vomiting,
misuse of laxatives, diuretics, enemas, or other
medications, fasting, or excessive exercise.
3. Both the binge eating and the compensatory behaviors
must occur at least two times per week for three months.
4. There is dissatisfaction with body shape and/or weight.
5. The disturbance does not occur exclusively during
episodes of Anorexia Nervosa.
 SUBTYPES OF BULIMIA
NERVOSA

Purging type Non-purging type

bulimics bulimics

self-induce vomiting (usually by

exercise or fast excessively after a
triggering the gag reflex or
binge to offset the caloric intake
ingesting emetics such as syrup
after eating. Purging-type
of ipecac) to rapidly remove food
bulimics may also exercise or fast,
from the body before it can be
but as a secondary form of weight
digested, such as laxatives,
control
diuretics, and enemas
 CAUSES & RISK FACTOR
1. Poor body image (distorted image) - body
dissatisfaction
2. Low self-esteem - depression, perfectionism,
childhood abuse, and a critical home
environment
3. Dieting
4. Appearance-oriented professions or
activities
5. Major life changes - stressful changes or
transitions
6. Biological factors - Eating disorders run in
families
7. Low levels of serotonin play a role in bulimia
 SIGNS & SYMPTOMS
BINGE
PURGING PHYSICAL
EATING
Lack of control Going to the Calluses or scars
over eating bathroom after on the knuckles
Secrecy meals or hands
surrounding Using laxatives, Puffy
eating diuretics, or chipmunk
Eating enemas cheeks
unusually large Smell of vomit Discolored teeth
amounts of food Excessive Frequent
Disappearance exercising fluctuations in
of food weight
Alternating Swollen glands
between in neck and face
overeating and Constipation
fasting Irregular period
Weakness
AFFECTS BULIMIA TO YOUR BODY
 COMPLICATIONS
Weight gain

Abdominal pain, bloating

Swelling of the hands and feet

Chronic sore throat, hoarseness

Swollen cheeks and salivary glands

Weakness and dizziness

Acid reflux or ulcers

Ruptured stomach or esophagus

 Cognitive-
TREATMENT Pharmacological behavioral
therapy (CBT)
FOR BULIMIA
Tricyclic Breaking the
antidepressants binge-and-purge
(TCA) cycle
trazodone,
mianserin
Changing
unhealthy
thoughts and
SSRI fluoxetine patterns
(Prozac)

Interpersonal
psychotherapy
Mood stabilizer -
lithium carbonate

Group therapy
Anti-anxiety -
buspirone
(Buspar)
 The long-term prognosis for bulimics is
slightly better than for anorexics

The recovery rate is felt to be higher

However, many bulimics continue to retain

slightly abnormal eating and dieting
behaviors even after the recovery period
THANK YOU