Bulimia is a condition in which a person uncontrollably binge eats an enormous amount of food. They feel guilty and ashamed, often make themselves vomit, and may try to exercise hard & diet to extremes until it all happens again (at least weekly, usually more often). Patients express an abnormal concern about weight and body image. Half the time, Bulimia begins by age 18; it’s six times more common in women than men.
It’s unknown exactly why it occurs. There’s possibly a genetic component, but patients often have a history of childhood trauma, such as abuse or separation. Most patients have other mental health conditions such as Depression, Anxiety, or Post-Traumatic Stress Disorder (a form of anxiety). Alcohol problems, smoking, and drug use are common. Some may intentionally cut or pick at themselves, or attempt suicide.
As opposed to Anorexia Nervosa, patients with Bulimia are normal weight or overweight. Diagnosis is made by questionnaires, asking things like:
- Do you ever make yourself so full as to feel sick?
- Have you lost control over your eating?
- Does food dominate your life?
- Are you unhappy with the way you eat?
- Do you ever eat in secret?
Patients may conceal their feelings and behaviors, especially when it comes to making themselves vomit. Sometimes we may notice calluses or skin changes on the knuckles (from stomach acid). Friends and family may report that the patient often “goes to the bathroom” immediately after eating. Some patients exercise compulsively, even if they’ve injured themselves.
Treatment primarily involves psychotherapy, dealing with the root causes of their emotional stress. Many patients eventually recover, although up to 25% my relapse again.