Recognizing The Signs Of Bulimia

What is Bulimia?

Bulimia is an eating disorder characterized by bouts of extreme overeating (binging) followed by use of laxatives and self-induced vomiting (purging). Bulimia generally begins as an attempt to avoid weight gain, however the binge/purge cycle gets out of control and the individual finds herself unable to stop.

What are the Signs and Symptoms of Bulimia?

Bulimia, like many eating disorders, can go unrecognized for quite some time before symptoms become obvious. Often the actions and habits of someone with Bulimia, though considered somewhat odd, are not thought to be anything to worry about. Another difficulty in recognizing Bulimia arises from the fact that, as a general rule, those suffering from Bulimia look healthy. Unlike a person suffering from Anorexia, bulimics are often normal weight and may even be overweight. There are, however, signs a concerned parent or friend can look for to assess whether or not a loved one is suffering from bulimic tendencies. An obvious habit is going to the restroom immediately following a meal. This is not a definitive sign, however, as there are many people who excuse themselves shortly after a meal with very legitimate reasons! That said, an odor of vomit or acidic breath can signify purging of calories through self-induced vomiting. Additionally, bulimics will often have callouses on their fingers or the back of their hands from their teeth rubbing on their knuckles as they induce vomiting. Tooth decay from excessive contact with stomach acid can become problematic for bulimics. A trip to the dentist may be one method of determining whether or not your child is vomiting after meals. There may be jaw discomfort, bleeding gums or other oral discomfort.

Abdominal distention and discomfort, bloating and excessive gas may also signal Bulimia. Overuse of laxatives can cause irritation of the gastrointestinal tract and possibly even permanent damage. Diarrhea and constipation can be linked to abuse of laxatives. Long term laxative abuse can lead to poor colon function and, consequently, the inability to have a bowel movement without a laxative (constipation). Diarrhea causes excessive fluid loss, dehydration and mal-absorption of essential nutrients. Electrolyte imbalances can result.

Often an individual who seems to eat 'whatever she wants' and never gain weight is envied, however this can be a sign of Bulimia. Concerned parents may notice that large amounts of food seem to disappear from the kitchen. Additionally an over abundance of food wrappers and trash in the garbage could be cause for concern. Bulimics tend to be very secretive with their eating habits, often hiding out in their rooms or sneaking into the kitchen late at night. Bulimics can inhale huge amounts of food before purging, eating an entire cake or a full carton of ice-cream in one sitting. They may horde food and, although they eat huge amounts when they are by themselves, they will generally be very delicate and even picky eaters when others are present.

Strange eating habits such as cutting food into very small bites, only eating foods in certain combinations, eliminating various types of food, and pushing food around on the plate can all be signs of an eating disorder. Bulimics may also drink large amounts of water and/or diet soda. This can help make vomiting easier.

Excessive or rigid exercise routines can also be a characteristic of Bulimia. Not all bulimics purge through laxatives and vomiting. Some will eat huge amounts of food and then attempt to undo the 'damage' they have caused by imposing strict exercise and diet restrictions on themselves. It can often be difficult to differentiate between a serious athlete and a bulimic because both may exercise more than average and eat very small amounts. Generally, however, the serious athlete will eat enough for their needs while the bulimic will restrict caloric intake to a dangerous level.

What are the consequences of Bulimia?

Bulimia, left undiagnosed, can be a life-threatening illness. Binging can lead to obesity and the plethora of health complications associated with obesity. These include, but are not limited to, heart disease, osteoarthritis, type II diabetes, and hypertension. More alarming, however, are the effects of constant purging. Purging through vomiting can lead to periodontal disease, inflammation of the jaw, salivary glands, and esophagus. In some instances gastric rupture can also occur during purging. Electrolyte imbalances, vitamin and mineral deficiencies, and dehydration are directly related to purging. Sufferers also experience bowel irregularities, chronic diarrhea, constipation, and flatulence. In addition to the above, chronic fatigue, muscle aches and weakness, depression, self-loathing, anxiety and other mental or emotional problems can arise.

Electrolyte imbalance, caused by chronic diarrhea and vomiting in a bulimic, can have uncomfortable and often fatal consequences. Common signs and symptoms of electrolyte imbalance include:
● Weakness
● Irritability
● Muscle cramps
● Thirst
● Tissue swelling
● Confusion
● Agitation
● Depression
● Change in heart rate or blood pressure
● Loss of coordination

Symptoms of dehydration include:
● Dry mucous membranes in the nose and mouth
● Reduced amounts of urine
● Urine that is dark yellow in color
● Dizziness, particularly when standing
● Low blood pressure
● Dry, warm skin
● Irritability

Any of the above signs are cause for concern and, as a parent or friend of a suspected bulimic sufferer, should not be ignored.

What are the best treatment options for Bulimia?

Eating disorders are serious, often fatal diseases. They should not be ignored, particularly since the chance for full recovery decreases significantly the longer the behaviors are left untreated. Treatment for Bulimia involves a comprehensive, multi-faceted approach. This involves psychotherapists, nutristionists, doctors, counselors, and other medical professionals. There are options for out-patient treatment, however treatment at a clinic which specializes in recovery from eating disorders is often the most successful option. Treatment usually involves cognitive behavioral therapy with a psychotherapist. This is to help replace negative body image and damaging attitudes and thought processes with positive, more realistic ideals. Along with this, dance therapy, animal therapy and other 'hands on' types of approaches may be used. The patient will receive a medical evaluation to assess what damage may have been done by the starvation, binging, purging, and excessive exercise. A nutritionist will be consulted to provide a well rounded, nutritional plan and teach proper eating habits. A healthier relationship with food will be taught. The patient may be asked to keep a food diary or journal detailing not only what is eaten and when, but her emotional state at the time. Family therapy is often incorporated in the treatment process to help those around the Bulimic patient understand the processes of the illness and what they can do to help facilitate recovery. Finally, medications such as antidepressants and/or anti-anxiety medications may be prescribed to help stabilize the emotional upheaval surrounding an eating disorder and recovery.

Group therapy and support groups are generally encouraged during treatment for Bulimia. It can be very helpful for Bulimia patient's to realize that they are not alone in their struggles. It is also a good way to draw the patient out and discourage a lot of the secrecy that usually surrounds the patient's actions. It is very important, when choosing a treatment facility, that you ask about the methodology used in their group therapy. Sitting with a group of patient's who struggle with Bulimia and discussing methods of purging or ways that they hide their illness is counter-productive to healing.

Where can I find organizations with more information regarding Bulimia?

There are many organizations geared toward helping those with eating disorders. Caution should be used, when searching for help, to make sure that the organizations and web sites are providing up to date, accurate information. Some organizations you may utilize are:

● National Eating Disorders Association
• www.nationaleatingdisorders.org

● Eating Disorder Referral and Information Center
• www.edreferral.com

● Pale Reflections Eating Disorders Community Treatment Finder
• www.pale-reflections.com

● Something Fishy Website on Eating Disorders
• www.something-fishy.org

What can I do if I feel my child or friend has Bulimia?

The first thing to remember is that you cannot force your child/friend to change her behavior. Trying to persuade, force, or 'guilt' the child in to changing will not work! Generally they already feel guilty for their behavior, and adding to that is not beneficial. If your friend or child is over 18, there is nothing you can do to make them stop. Your best option is to be a good listener. Provide them with a list of resources should they choose to seek help. Remember that eating disorders are generally not about the food. The underlying emotional issues are what need to be addressed. Express love and concern for the individual and a desire to help if you are able. Provide them with support if and when they decide to seek professional help.

If your child is under the age of 18, you have more options. Understand, however, that it is not an easy choice to make! Your child may beg, plead, promise to change, etc. to avoid being put in in-patient treatment. Keep in mind that the ultimate goal is full recovery and that the sooner the eating disorder is addressed, the greater the chance of a full recovery. It is rare for an individual to be able to quit these self-destructive behaviors on her own. It is not uncommon for a child to promise to change and then just work harder to hide the habits while continuing the behaviors. There are many options for recovery and help. Research these and decide which option is best for your situation. In the words of one individual suffering from an eating disorder "Research the disease before you talk to your child, hear her out, love her and support her. This is a complex problem that shouldn't be taken lightly..."