Bulimia

The Bulimia is an eating disorder characterized by the occurrence of episodes of excessive and uncontrolled intake of food, recurrently.

The syndrome has two main components: the first, an uncontrollable urge to overeat, and the second, self-induced vomiting to prevent weight gain, which is sometimes accompanied by abuse of laxatives. Patients with this disease are generally of normal weight. Most are women and they often have normal periods.

The sick show overvalued ideas about shape and weight, along with a profound loss of control over overeating. They binge on food when they are alone. At first, they relieve tension, but this is soon followed by guilt and discomfort.

Causes of bulimia

A multitude of factors associated with an increased risk of suffering from this disorder have been described:

• Enzyme abnormalities
• Genetic predisposition, which will manifest itself under adverse conditions such as an inadequate diet or stress .
• Personality characteristics of the patients: immaturity, hypersensitivity, impulsivity, low tolerance for frustration, obsessive-compulsive tendencies, insecurity.
• Adolescence and puberty, where physical changes and internal conflicts take place, favors its development at this stage.
• Family dynamics seem to play an important role in the disease, but so far specific patterns of impaired family functioning have not been demonstrated in these patients.
• Sociocultural factors such as social pressure from the media, advertising, fashion, etc., by associating beauty with extreme thinness affect the youngest.

People with bulimia binge over and over again, accompanied by the fear of gaining weight. The reason for binge eating is usually hunger when we are underweight or are eating a restrictive diet. After the binge, they feel guilty and torment over the loss of control and apply purging methods such as vomiting, diuretics or laxatives. Little by little they lose control more and more, to the point of vomiting every time they eat.

What symptoms appear?

Psychics:

• They often have depressive symptoms and difficulty expressing their feelings.
• They also have an increase in impulsivity, with suicide attempts, aggressive behaviors towards others, kleptomania, alcohol and other substance abuse.

Physical:

Symptoms appear as a result of vomiting such as:

1. Erosions in the enamel of the teeth
2. Potassium depletion that can cause weakness, heart arrhythmia, and kidney damage. Urinary infections and seizures can occur.

Diagnosis of bulimia

It is very important to take a thorough medical history about eating behavior and concerns about body shape and weight. There are a number of criteria that must be met to make the diagnosis of bulimia nervosa:

1. Recurrent episodes of overeating
2. During overeating there is a sense of lack of control over eating behavior.
3. The individual tends to induce vomiting, uses laxatives, follows strict diets, fasts, or engages in vigorous exercise to avoid weight gain.
4. A minimum average of two binge-eating episodes per week for at least three months.
5. Persistent excessive preoccupation with body shape and weight.

An assessment of the physical condition of the patient must be made, and in the event of suspected abuse of purges or self-induction of vomiting, analytical determinations will be made, mainly of potassium in the blood.

An assessment of the mental state of the patient will be made, especially to detect depressive symptoms that could benefit from antidepressant treatment.

Treatment of bulimia

In general, hospital admission is not necessary, and hospitalization is indicated only in the event of severe depressive symptoms or physical complications or if home treatment fails.

Psychological treatment : The goal is to make the patient responsible for controlling their own eating. They attend these psychotherapies several times a week, keep records of their food ingestion and vomiting episodes, and try to identify and avoid any environmental stimuli or emotional changes that usually come from the urge to overeat.

Medical treatment : It is generally accepted that the only useful drugs for bulimia are antidepressants. However, antidepressant treatment should be associated with psychotherapy.

A doctor should be consulted when a continuous preoccupation with food appears with irresistible desires to eat, to which the patient succumbs, and the subsequent provocation of vomiting to counteract the weight gain due to an irrational fear of gaining weight.