What is Bulimia
Bulimia thrives on silence and isolation
Helping people to realize that it’s a serious illness—and that there can be a path to recovery—is incredibly important to me. Combating prevalent misconceptions and chipping away at stigma are large parts of that.
So, here are the points I wish everyone understood about bulimia and those who struggle with it.
Not everyone with bulimia makes themselves vomit
Contrary to popular opinion, bulimia and vomiting aren’t inextricably linked, but this myth is so deeply ingrained that it can make it harder for people to realize when they or their loved ones need help.
In reality, bulimia (technically known as bulimia nervosa) is characterized by recurrent episodes of binge eating followed by trying to compensate in some way, like through purging (vomiting), fasting, using laxatives or enemas, or engaging in overly intense exercise.
Since exercise is often seen as purely healthy, many people don’t realize that working out too often and too intensely can be an emotionally and physically harrowing feature of disordered eating.
Bulimia isn’t really about vanity
Some people mistakenly assume that bulimia develops out of vanity or wanting to emulate thin celebrities. This dangerous way of thinking implies that a person can choose to stop having an eating disorder if they just quit caring so much about how they looked.
“The idea that bulimia is a lifestyle choice based on vanity perpetuates stigma, shame, and a reluctance to seek help,”.
“While a core eating disorder symptom is an overemphasis on weight, shape, and thinness, many patients additionally describe their behaviours as efforts to control their anxiety, shame, mood, and impulsivity.”
Willpower isn’t enough to overcome bulimia
“Bulimia is a complex ... disorder that usually requires outside assistance to disrupt and change,”
It’s incorrect to assume that willpower alone is adequate to change it or any other mental health problem. The more you will tried to stop, the more out of control you will feel. Once you accepted that you couldn’t force yourself to overcome this problem alone, and reached out for help. Only then you will be able to start building a healthy and intuitive relationship with food.
Bulimia can be harmful and even life-threatening
There’s a common (and incorrect) notion that anorexia is the only serious eating disorder. In reality, bulimia can lead to a host of health issues, like dental erosion, a sore throat from purging, anaemia, fainting, hormonal and menstrual irregularities that can cause fertility issues, and more.
It’s possible to recover from bulimia
Recovery looks different for each person with an eating disorder, just as the illness can manifest in myriad ways. While there’s always potential for relapse in eating disorder recovery, it’s not inevitable for everyone.
“It is important for patients and their families to know that effective treatments do exist,”
“All of these treatments require commitment and effort but can produce lasting change.” Reaching out for support is an integral part of this process.
Cognitive Behavioral Therapy (CBT)
CBT for bulimia nervosa directly targets the core features of this disorder, namely binge eating, inappropriate compensatory behaviours, and excessive concern with body shape and weight. This treatment focuses on how these symptoms cycle to perpetuate themselves in the present, as opposed to why they originally developed in the past. CBT for bulimia nervosa is conducted in approximately twenty weekly sessions, which encompass three phases.
The first phase includes psychoeducation regarding weight and the adverse physiological effects of binge eating, purging, and extreme dieting, and helps the patient establish a regular pattern of eating and an appropriate weight monitoring schedule.
In the second phase, the focus shifts to reducing shape and weight concerns and dieting behaviour and identifying precipitants to any remaining binge-purge episodes.
The third phase is devoted to maintenance planning and the prevention of relapse in the future.
In CBT, the therapist works collaboratively with the patient to disrupt the factors maintaining the cycle with the goal to achieve abstinence from these behaviours. This treatment is typically administered individually, but it can be delivered in a group format.
Signs and symptoms of bulimia
Bulimia is a mental health condition that causes people to engage in a repeating cycle of binge eating and then doing things to ‘cancel out’ or compensate for the eating binge. Not everyone who experiences bulimia will have the exact same profile of symptoms and different symptoms can emerge and change as the condition develops over time. Some of these symptoms affect your behaviour, while others affect how you think and how you feel. The behaviours associated with bulimia can also lead to physical health complications over time. Because some symptoms of bulimia don’t develop straight away, it’s important to keep in mind that you should still reach out for help and support, even if you aren’t experiencing physical symptoms or complications. Like all eating disorders, bulimia begins in the mind, affecting how you think and feel first and foremost. Mental distress and inner turmoil have a very real impact on wellbeing and they do not have to be accompanied by physical complications to justify care and support. Below is a list of signs and symptoms of bulimia. This list doesn’t capture all experiences associated with bulimia and each individual’s experience with bulimia is different and unique.
Behavioural symptoms when dealing with bulimia
Engaging in episodes of binge eating
Using control of food as a way to cope with emotional difficulties and stress
Engaging in purging behaviours (vomiting or taking laxatives), restricting your food intake or doing intense exercise to ‘compensate’ for eating binges
Psychological symptoms of bulimia
Being preoccupied with your body shape and weight
Feeling afraid of gaining weight
Feeling guilty after eating
Experiencing mood swings
Anxiety and low mood
Feeling out of control
Feeling afraid or uncomfortable when eating in public or around other people
Spending a large amount of time thinking about what you’re eating on a daily basis
Do I weigh and measure my body constantly?
Do daily count the calories of everything I eat?
Do I eat normally in front of others but binge in secret?
Do I vomit or use laxatives to control my weight?
Do I keep on eating even though I’ve had enough?
Do I starve myself for fear that if I start eating I may never stop?
Do I use and abuse slimming pills or other meds to lose weight?
Do I exercise compulsively?
Thoughts & Cognitions
Do you think about food, eating and your body constantly?
Do you find yourself obsessively ruminating on everything you eat?
Do you have negative thoughts about your body and your eating habits?
Do you constantly compare your body shape and physique to others?
Do you have strict rules and rituals around what you eat and don’t eat?
Emotions & Feelings
Do you feel fat and disgusting even when others are worried that you are too thin?
Do you suffer from guilt and worthlessness when you eat something “bad”?
Do you feel self-hatred and loathing when you look in the mirror?
Are you scared to eat normally?
Do you feel out of control and anxious if you don’t stick to your diet rigidly?
Beat Compulsive Eating & Bingeing
The Effects of Bulimia on Your Body
Bulimia nervosa is an eating disorder that’s described as a destructive pattern of eating and purging to control weight. Two of the most prominent behaviours of bulimia are bingeing (eating a lot of food) and purging (self-induced vomiting), but bulimia encompasses so much more than that. It can also take a tremendous emotional toll and lead to severe, life-threatening conditions.
When you think of bulimia, you’re most likely to think of bingeing and purging. However, these aren’t the only symptoms of the disorder. Bulimia can present itself through the following symptoms:
Central nervous system (mental and emotional health)
While characterized as an eating disorder, bulimia is also a mental health disorder that causes a cycle of health concerns. You may experience depression, anxiety, or obsessive-compulsive behaviours. Moodiness and irritability may occur due to a lack of vitamins or behaviours that come along with bulimia. For example, constant monitoring of food and weight can become an obsession. Someone may also binge in secret and then hide evidence of food and laxatives. In order to achieve their ideal weight, people may also engage in substance abuse.
Compulsive exercising or preoccupation with appearance are also common symptoms. It’s not unusual for someone with bulimia to spend a lot of time thinking about food and how to control it. In fact, people with bulimia may become quite focused on eating to the exclusion of other activities that they used to enjoy.
Having to keep secrets contributes to the cycle of stress and anxiety. Over time, guilt can build up from keeping secrets from your friends and loved ones. This may also be accompanied by feelings of embarrassment and shame. Suicidal behavior may form as a culmination of stress and an extremely unhealthy body image.
The cycle of bingeing and purging eventually takes a toll on your digestive system. Not only is it physically demanding, but the effects of bulimia can bring on general weakness and fatigue.
A sore throat, stomach pain, or both may be the first obvious physical side effects of bulimia. As the disorder progresses, chronic self-induced vomiting can cause a variety of symptoms in the digestive tract, beginning at the mouth. Over time, the high acid content of vomit can damage teeth and cause enamel erosion, tooth sensitivity, and gum disease. Puffy cheeks or jaws may be noticed secondary to swollen salivary glands.
Acid can also:
irritate or tear your oesophagus
rupture your oesophagus and cause blood in vomit
irritate your stomach
cause stomach-aches, heartburn, and acid reflux
damage the intestines and cause bloating, diarrhoea, or constipation
Putting a finger down your own throat is one of the most common ways people with bulimia induce vomiting. Doing this over and over can cause callouses on the back of your hand (in the knuckle area) because of your knuckles coming in contact with your incisors. This phenomenon is known as Russell’s sign. The acidity scars the skin on your fingers and hands.
Another way that some people try to rid the body of excess calories from food is to use diuretics, diet pills, or laxatives. Overuse of these products can make it difficult to have a bowel movement without using them. Misdirected use of diuretics may also damage the kidneys. Overstrained bowel movements can also result in haemorrhoids.
Frequent purging can cause dehydration. This leads to weak muscles and extreme fatigue. It can also throw your electrolytes out of balance and put a strain on your heart. This can cause an irregular heartbeat (arrhythmia), and in some severe cases, a weakened heart muscle and heart failure. The electrolytes that tend to go missing from constant vomiting are potassium, magnesium, and sodium.
Bulimia can cause low blood pressure, a weak pulse, and anaemia. Vomiting can be a violent event. The sheer force of it can even cause the blood vessels in your eyes to rupture.
The nutritional deficiencies people with bulimia experience can cause a hormonal imbalance. The fatigue can kill your sex drive. Bulimia can interfere with your menstrual cycle or stop it altogether. If the ovaries no longer release eggs, it’s impossible for the sperm to fertilize the egg.
Pregnant women who continue to engage in bingeing and purging behaviors face additional complications for themselves and their babies. These include:
maternal high blood pressure
higher risk of cesarean delivery
low birth weight babies
The use of diuretics or laxatives during pregnancy may be harmful to your unborn baby.
Getting treatment for bulimia
Thinking that you might be experiencing bulimia can be a scary thought. No matter how hard it may seem, it is possible to make a recovery. Recovery is not always linear. It can be one step forward and one step back sometimes, and what recovery means to you might be different to what it means for someone else. Everyone’s recovery journey is different and it may take time, but recovery from bulimia is always possible at any stage.
If you think you may have bulimia, going to your GP as soon as you can and letting them know what’s going on is an important first step. They will be able to point you in the right direction to get treatment. Sometimes the idea of speaking to your therapist about concerns around eating habits can be daunting. If you feel like you’re not ready to take that step just yet, you could call counselling therapy. Eden therapy clinic
If you are worried about a friend or family member, talk to them about it and encourage them to go see their GP. You can also offer to go with them if they don’t want to go alone.
The types of treatment you receive can depend on your situation, but in general, the aim of treatment is to help you gain control over the bulimia symptoms so that you can return to eating regular meals without engaging in purging or bingeing. The treatment will also help you work on the thoughts, feelings and experiences that are underlying the behavioural symptoms. Getting treatment that is evidence-based and specialised for eating disorders makes a substantial difference to a person’s recovery and quality of life. Trying to recover from bulimia, or any eating disorder, by yourself can be really isolating and hard. Reaching out for support from professionals, family, and friends can make all the difference and help to get you through.
Talking therapy and family therapy
Talking therapy is usually a part of treatment for bulimia. Some people will take part in individual talking therapy or group therapy, while others (especially young people) might do family-based treatment with members of their family. The aim of talking therapy is to help you understand the root causes of your eating disorder, and to work towards feeling more comfortable with food.
A form of Cognitive behavioural therapy (CBT) called CBT is often used to support recovery from bulimia. CBT has been enhanced in certain areas, and particular strategies have been added to specifically address eating disorders and their core symptoms. CBT looks at the ways that our thoughts affect our behaviours and feelings. Through CBT you can develop strategies to help you build self-awareness and identify triggers, create helpful routines, and manage compulsive thoughts and unhelpful behaviours. All of these are important steps towards a future free from bulimia.
How to Cope With an Eating Disorder Treatment
Feelings of shame, guilt, and discrimination for having a mental condition hinder many people from receiving life-saving treatment. Due to this, people who have already entered rehab often end up relapsing in early recovery. However, with the right form of treatment, support, and motivation a full recovery and improved quality of life are possible.
The good news is that there are many treatment options available for people with eating disorders such as anorexia and bulimia, as well as substance use disorders.
Eating disorders are treated most effectively when diagnosed and intervened with as early as possible. The earlier a person receives treatment, the greater the probability that they will make a full recovery, and be able to live a more fulfilling life.
Psychotherapy, Counselling and Nutritional Counselling
Individual, group, and family therapy sessions help individuals with eating disorders specifically understand their thoughts, emotions, and behaviours that trigger their unhealthy episodes.
Lastly, due to the serious physical problems caused by these mental conditions, it is important that our comprehensive treatment plans for a person with anorexia nervosa, bulimia nervosa or binge eating disorder include medical care in conjunction with nutritional therapy.
This helps individuals engage in healthy eating habits to rebuild their overall well-being, mentally and physically. It is important to note, that the exact form of treatment to tend to the needs of each individual will vary.
How to Cope With An Eating Disorder
It is important for individuals struggling with an eating disorder to find a health professional they trust to help coordinate and oversee their care. At Eden therapy clinic we can help with :
Keeping a food and mood diary: Writing things out can help identify and keep track of personal triggers and control binge eating impulses.
Practice mindfulness: Increase awareness of triggers and practice self-control and self-acceptance through holistic approaches such as meditation and yoga.
Support: Support is the key to any successful recovery. Finding someone to talk, to at a support group, a friend, family member, or significant other can help you feel more connected and motivated to keep going.
Exercise: Moderate exercise approved by your doctor can help improve your body image, boost mood through the release of endorphins, reduce stress and anxiety, etc.
Sleep: Lack of sleep is known to be associated with irregular eating patterns. It is suggested to get 7-8 hours of sleep per night to help reduce triggers.
Counselling for Bulimia
Is eating dominating your thoughts and do you struggle constantly to control your weight? Maybe you obsess about your shape and find yourself hating your own body, or you have strict rules around what you should and should not eat. Then you may be harming your body and well-being on many levels.
Eating disorders are embedded in the person’s sense of self, with the individual demonstrating a pathological need to control in order to feel safe and secure in their lives. Eating disorders are progressive and the more sufferers find the need to control, the more they are trying to feel safe and create a secure base within themselves. Repressing emotions and dealing with life’s difficulties through food contractually means that we miss out on emotionally processing our lives.
The work of counselling therapy or Psychotherapy is to process the underlying painful emotions within the context of a secure base in the psychotherapeutic setting.
Recovery involves supporting the sufferer to understand why the eating disorder emerged in the first place; facilitating new ways of coping and ultimately nourishing the self.
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