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Many people ask us, “what are the characteristics of bulimia?” Adults and adolescents struggling with bulimia nervosa may often consume unusually large amounts of food (binge-eating), followed by a behavior that compensates for the binge, such as purging (vomiting, excessive use of laxatives or diuretics), fasting and/or excessive exercise. This bulimic binge-and-purge cycle may be repeated several times a week or, in more serious cases, several times a day. People with bulimia often suffer from these symptoms:
- Chronic gastric reflux after eating, peptic ulcers
- Cuts and injuries to the throat and lining of the mouth as a result of insert objects into the mouth to induce vomiting.
- Inflammation of the esophagus or a rupture in the wall of the esophagus wall due to self-induced vomiting
- Swollen salivary and neck glands
- Dehydration, constipation, hypokalemia, gastroparesis (delayed emptying)
- Electrolyte imbalance, which can cause cardiac arrest, arrhythmia, and death
- Erosion of enamel on teeth due to frequent exposure of teeth to gastric acid
People struggling with bulimia often experience negative emotions like anger and fear, shame and anxiety that become attached to their behavior. Many can’t figure out why they keep binging and purging despite the toll it takes on their physical, emotional and spiritual health. As a result, they often feel helpless—even if they’ve enjoyed success and accomplishments in other areas of life.
Bulimia Nervosa is a disease that doesn’t have a single cause, so there’s no single way to cure it. Bulimia can be caused by the intersection of a wide range of factors. None of these factors, by itself, causes someone to develop bulimia. Yet research points toward several issues that might work together or separately to cause someone to develop an eating disorder like bulimia nervosa. These include:
- Behavior: Certain behaviors, such as dieting or over-exercising, can contribute to the development of bulimia nervosa by encouraging someone to develop rigid rules about food.
- Genetics: A person’s unique genetic makeup, especially if a parent or sibling has had an eating disorder, may influence someone to develop it. Serotonin (a chemical found naturally in the brain) may also cause abnormal eating behavior.
- Emotional health: Low self-esteem, perfectionism, impulsive behavior, anger management issues, past trauma, family conflicts and/or troubled relationships can all contribute to a mindset that’s conducive to developing bulimia. Difficulty controlling impulsive behaviors, expressing anger and managing mood swings can also become factors in developing the disorder.
- Social factors: Our culture promotes thinness, which is associated with beauty, success and worth. Peer pressure based on these associations may fuel this desire to be thin. When someone receives a compliment for losing weight, for example, it could fuel an eating disorder in an effort to generate more compliments. This is especially important in a person whose self-esteem or self-worth is dependent on approval from others.
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The effects of bulimia nervosa range from those that are mental and emotional, to a series of physical effects. Below are the most common effects of bulimia on the body that can even be life-threatening.
Mental and Emotional Effects
Because bulimia nervosa is a mental health disorder, some of the most common side effects of bulimia nervosa are mental and emotional. Such common effects include anxiety, depression, and obsessive-compulsive disorders. Further, individuals with bulimia are particularly at risk for substance abuse issues and even suicidal behavior. People with bulimia will typically attempt to binge and purge the food they’ve consumed in secret, which can add to their feelings of anxiety and stress and reinforce a feeling of shame.
Not only are the effects of bulimia psychological in nature, but there are also a variety of physical side effects of the eating disorder. Bulimia can affect the circulatory system in several ways. Purging on a regular basis can cause dehydration in the body, which can subsequently result in extreme fatigue, weak muscles, and dry skin. Further, when vomiting is used as the purging method, the body’s electrolytes will be thrown out of balance resulting in low levels of sodium, magnesium, and potassium. This is extremely dangerous, and can lead to an irregular heart beat and even heart failure. Further circulatory side effects of bulimia include low blood pressure, anemia, and a weak pulse. Bulimia can also impact the digestive system. Initial side effects include a sore throat and stomach pain. However, as an individual continues down the dangerous cycle of the eating disorder, additional side effects will be present in the digestive system. Vomiting on a regular basis is dangerous, as the high acid content in vomit has the ability to damage teeth, increase tooth sensitivity, and lead to gum disease and enamel erosion. Someone with bulimia may also exhibit puffy cheeks and jaws, which are both side effects indicating swollen salivary glands. While some with bulimia will use vomiting as a way to purge, others turn to diuretics, laxatives, or diet pills. Overuse of such medications can lead to a reliance on the products to have a bowel movement. Further, misuse of a diuretic can cause problems with the kidneys, as well as bloating, constipation, and diarrhea.
What are the Risk Factors for Bulimia?
Here are several factors that correlate with, but do not specifically cause, a higher risk of developing bulimia:
- Age: Bulimia often begins in late adolescence or early adulthood. It’s more common in college-age students than in younger teens.
- Dieting: People who lose weight are often reinforced by positive comments from others and by their changing appearance. This may cause some people to take dieting too far, leading to bulimia.
- Emotional Disorders: People with co-occurring disorders such as depression, anxiety, and obsessive-compulsive disorders are more likely to have bulimia nervosa.
- Family History: Eating disorders, such as bulimia, are more likely to occur in people who have parents or siblings who have had an eating disorder.
- Family Influences: People who feel less secure in their families, whose parents and siblings may be overly critical, or whose families tease them about their appearance are at higher risk of bulimia and other eating disorders.
- Gender: Females are more at risk for bulimia than males, but people of all genders are susceptible. Males may be less likely to seek bulimia treatment. While girls and women are more likely to have bulimia than boys and men are, roughly 10-15% of males do suffer from bulimia nervosa. This may be an under represented number due to the fact that males may be less likely to seek treatment. We seek to help men feel comfortable in getting help for bulimia.
- Occupation: Eating disorders, including bulimia nervosa, are most common among people whose jobs place them in the public spotlight, including athletes, actors, television personalities, dancers, and models