Bullimia

 

Bulimia nervosa is a serious, potentially life-threatening eating disorder characterized by a cycle of binge eating followed by compensatory behaviors to prevent weight gain.

 It is defined by recurrent episodes of binge eating, which involve consuming a significantly larger amount of food in a short period (typically less than two hours) compared to what most people would eat under similar circumstances, accompanied by a sense of lack of control over eating.

 These binge episodes are followed by inappropriate compensatory behaviors such as self-induced vomiting, misuse of laxatives, diuretics, or other medications, fasting, or excessive exercise.

The disorder is distinct from binge eating disorder (BED), where binge eating occurs without consistent compensatory behaviors, and from anorexia nervosa (AN), where individuals are typically underweight.

 People with bulimia nervosa are usually within the normal weight range, although they often experience significant dissatisfaction with their body shape and weight, and their self-esteem is heavily influenced by their perceived body image.

 The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), requires that these binge eating and compensatory behaviors occur, on average, at least once a week for a period of three months to establish a diagnosis.

Bulimia nervosa most commonly begins in adolescence or young adulthood and disproportionately affects females, though it can affect individuals of any gender.

 The precise causes are multifactorial, involving biological, psychological, and environmental factors, with research suggesting abnormalities in brain function, particularly in areas related to interoception and reward sensitivity, may contribute to the disorder.

 Individuals with bulimia nervosa are at increased risk for various medical complications, including dental erosion, electrolyte imbalances (such as hypokalemia), dehydration, metabolic alkalosis, cardiac arrhythmias, and gastrointestinal issues.

 They also face a higher risk of comorbid psychiatric conditions, including depression, anxiety, and substance use disorders.

Treatment is available and effective, with cognitive behavioral therapy (CBT) being a primary therapeutic approach.

 Selective serotonin reuptake inhibitors (SSRIs), particularly fluoxetine, are the only medications approved by the FDA for treating bulimia nervosa and have been shown to reduce the frequency of binge and purge episodes.

 Recovery is possible, with studies indicating that about half of individuals recover over a 10-year period with appropriate treatment.