Bulimia
Bulimia, also called bulimia nervosa is a psychological eating disorder. Bulimia was diagnosed as its own eating disorder in the 1980s. It is an illness that is most commonly found in girls of later adolescence and early adulthood. It is very rarely found in men. Bulimia is characterised by episodes of binge eating; eating large amounts of food in a short time. This behaviour may be severe with enormous quantities of food, most typically carbohydrates being consumed. Sometimes up to 20, 000 calories at a time. The foods on which they binge are usually foods labelled as “comfort foods”, sweet foods, high in calories, or smooth, soft foods like ice cream, cake and pastry. To prevent otherwise inevitable consequence of weight gain there are periods of food restriction and often vomiting, fasting, enemas, excessive use of laxatives and diuretics, or excessive exercising. When vomiting is used then the binges may become multiple with repeating cycles over several hours in which the sufferer eats until full. Then vomits again and eats. Binge eating is not a response to intense hunger. It is usually a response to depression, stress of low self-esteem. During the binge episode, the individual experiences loss of control. With increasing severity the girls’ lives become more chaotic with the focus increasingly on the bulimic behaviour. They generally find their own behaviour disgusting and are deeply ashamed of it so that it almost always occurs in secret. The cycle of overeating and purging usually becomes an obsession and is repeated often.
The causes of bulimia nervosa remain unknown although there is probably a small genetic contribution. In the sub-clinical form bulimic behaviour is very common in our society. The incidence of bulimia nervosa is usually given as 3% of young women but true incidence is likely o be much greater. The pressure to be thin and to look good and resulting abnormal eating patterns that are regarded as normal are probably partly to blame. Certainly the desire to be thin and attempts to restrict weight are the triggers that provoke the illness. Once established bulimia influences the way that emotions are felt. It protects the sufferer from experiencing feelings that may be to them unbearable. It is paradoxical that bulimia causes then to become increasingly out of control in a wide variety of ways and yet it is the one thing that enables them to feel in control. Their fear of being without this protection maintains and increases the severity of the illness which comes to dominate all emotional experience.
