Bulimia Nervosa: The “purging “ Disorder?
Bulimia Nervosa: Is it really that
different from anorexia?
Nervosa is characterized by frequent binge eating and compensatory behaviors to
avoid gaining weight. Bulimia nervosa differs from anorexia nervosa in that
individuals with this eating disorder are not usually significantly underweight,
and may actually be of normal weight, or may be even slightly overweight. Like
anorexia, bulimia nervosa is a disorder relatively specific to girls of late
adolescence to early adulthood, and is rarely found in men. Because of the
overlapping symptoms between anorexia and bulimia, there have been challenges to
the distinction between the two. The fact that many individuals may move from
one diagnosis to the other depending upon fluctuations in body weight and the
presence or absence of menses, suggests to some
experts that both disorders may
be more accurately defined as a subtype of a more inclusively defined eating
disorder. While binging and purging may be present in both, some individuals
have pure cases of anorexia (without binging in purging) and pure cases of
bulimia nervosa, in which their body weight never falls below the normal level.
What are the signs and symptoms
of bulimia nervosa?
The DSM-IV, which is used to define emotional
disorders by mental health clinicians, has concluded that bulimia nervosa is
present under the following circumstances: There must be recurrent episodes of
binge eating in which an individual eats a large amount of food within a very
short period of time, and has a definite sense of lack of control over eating
during this episode. They also have recurrent, inappropriate compensatory
behaviors, such as the misuse of laxatives, self-induced vomiting, diuretics,
enemas, inappropriate use of medications, fasting or excessive exercise to keep
from gaining weight. Both the binge eating and inappropriate compensatory
behaviors must occur on an average of at least twice a week for three months.
Their body weight must remain at a normal level or above, in order for them not
to receive a diagnosis of anorexia. Finally, they must have a self-evaluation
which is unduly influenced by their body shape and weight.
If I have these symptoms, what do
If you recognize that you have the symptoms of
bulimia nervosa, you have already taken the first step. The next thing that you
would do would be to consult your physician or a mental health clinician, to
find a psychologist, psychiatrist or other mental health clinician who
specializes in these disorders. They will do an assessment to help decide
whether you truly have an eating disorder. They will help you to discuss your
attitudes about your self-image, eating behaviors and various other subjects,
and may even consult with members to your family. Sometimes they may ask you to
take a blood test. Frequently, bulimia nervosa may be treated on an outpatient
basis rather than requiring hospitalization. The emphasis will be in getting
back to a regular routine of eating three meals a day, reestablishing a “normal”
pattern of eating, and re-establishing a sense of control. The goal will be to
maintain steady weight control without starving or vomiting. Dietary information
is usually given along with psychotherapy to assist with meeting goals and
providing support. Also, you will probably want to deal with problems which may
underlie your eating disorder. You may also get additional assistance by joining
support groups and reading. The longer you let this problem go, the more severe
it may become. Help is available today.
Information and webpage by
Paul Susic Ph.D. Licensed Psychologist (Health
Diagnosis - DSM-IV
Diagnosis and Codes: In Alphabetical Order