Bulimia Nervosa
Overview
Bulimia nervosa is a serious and potentially life-threatening eating disorder characterised by a cycle of binge eating followed by compensatory behaviours, often in the form of purging, fasting, excessive exercise, or the use of laxatives or diuretics.
According to the DSM-5, during a binge, a person with bulimia consumes a large amount of food within a short period and experiences a feeling of loss of control. The binge eating is followed by an intense fear of gaining weight, leading to the aforementioned compensatory behaviours.
Individuals with bulimia can be of average weight or overweight, making the disorder sometimes less noticeable. Bulimia nervosa affects all genders and may co-occur with other mental health disorders such as anxiety, depression, or substance abuse disorders.
Purging Type: Individuals with purging-type bulimia nervosa engage in compensatory behaviors such as self-induced vomiting, misuse of laxatives, diuretics, or enemas following binge eating episodes.
Non-Purging Type: Individuals with non-purging-type bulimia nervosa use other compensatory behaviors to prevent weight gain, such as fasting or excessive exercise, but do not engage in self-induced vomiting or misuse of laxatives or diuretics.
Key Features
Binge Eating Episodes: Individuals with bulimia nervosa engage in recurrent episodes of binge eating, characterised by consuming large amounts of food in a discrete period of time while feeling a lack of control overeating behavior.
Compensatory Behaviors: Following binge eating episodes, individuals engage in compensatory behaviors to prevent weight gain. These may include self-induced vomiting, misuse of laxatives, diuretics, or enemas, fasting, or excessive exercise.
Preoccupation with Body Weight and Shape: Individuals with bulimia nervosa have an intense fear of gaining weight or becoming fat. They are preoccupied with their body weight and shape, and their self-esteem is heavily influenced by their perceived attractiveness and weight.
Secrecy and Shame: Individuals with bulimia nervosa often engage in binge eating and compensatory behaviors in secret due to feelings of shame, embarrassment, and guilt.
Physical Consequences: Bulimia nervosa can lead to a range of physical consequences, including electrolyte imbalances, dehydration, gastrointestinal problems, dental issues (such as tooth decay and erosion of enamel), and irregular menstrual periods in females.
Psychological Distress: Individuals with bulimia nervosa may experience psychological distress, including anxiety, depression, low self-esteem, and feelings of worthlessness or shame related to their eating behaviors.
Interpersonal Difficulties: Bulimia nervosa can impact interpersonal relationships, leading to social withdrawal, isolation, and difficulties in maintaining close relationships.
Co-Occurring Mental Health Conditions: Bulimia nervosa commonly co-occurs with other mental health conditions, such as depression, anxiety disorders, substance abuse, and personality disorders.
How We Can Help
Psychotherapy: Psychotherapy, or talk therapy, is a primary treatment for bulimia nervosa. Cognitive-behavioral therapy (CBT) is the most well-established psychotherapeutic approach for bulimia nervosa. Psychologists use CBT techniques to help individuals challenge dysfunctional thoughts and beliefs about food, body image, and weight, develop healthier eating behaviors, and learn adaptive coping strategies to manage urges to binge and purge.
Dialectical Behavior Therapy (DBT): DBT is another effective therapy for bulimia nervosa, particularly for individuals with emotion dysregulation and impulsive behaviors. Psychologists use DBT techniques to help individuals develop skills for emotion regulation, distress tolerance, mindfulness, and interpersonal effectiveness, which can help reduce binge eating and purging behaviors.
Interpersonal Psychotherapy (IPT): IPT focuses on addressing interpersonal difficulties and relationship issues that may contribute to bulimia nervosa symptoms. Psychologists help individuals identify and resolve interpersonal conflicts, improve communication skills, and build stronger social support networks to reduce reliance on disordered eating behaviors.
Nutritional Counseling: Psychologists collaborate with registered dietitians or nutritionists to provide specialised nutritional counseling for individuals with bulimia nervosa. This may include meal planning, education on balanced nutrition, strategies for normalising eating patterns, and addressing fear foods or food-related anxiety.
Body Image Work: Psychologists help individuals address body image concerns and develop a more positive and accepting relationship with their bodies. Through body image work, individuals learn to challenge societal ideals of beauty, develop self-compassion, and focus on overall health and well-being rather than weight or appearance.
Coping Skills Training: Psychologists provide coping skills training to help individuals develop healthier coping strategies for managing stress, negative emotions, and triggers for binge eating and purging. This may include relaxation techniques, problem-solving skills, assertiveness training, and self-soothing strategies.
Relapse Prevention: Psychologists work with individuals to develop relapse prevention strategies to maintain progress and prevent recurrence of bulimia nervosa symptoms. This may involve identifying early warning signs of relapse, developing coping strategies for high-risk situations, and building a support network for ongoing recovery.
Group Therapy: Group therapy provides opportunities for individuals with bulimia nervosa to connect with others who share similar experiences, receive support and validation, and learn from each other's perspectives and coping strategies. Group therapy can enhance social support, reduce feelings of isolation, and promote accountability and motivation for recovery.
If you or a loved one is battling with bulimia nervosa, remember that there's hope and help is available. You don't have to face this alone. Our team of empathetic and skilled psychologists is here to assist you in breaking the cycle of bulimia. Reach out to us today, take the first step towards recovery, and start your journey to a healthier, happier you.