Bulimia Nervosa information and treatment

How do I know if I have Bulimia Nervosa?

A diagnosis of Bulimia Nervosa (BN) is usually made when a person has symptoms or behaviours which occur as frequently as every week. This may present as the person consuming an extraordinary amount of food; feeling they have lost control over what they eat, followed by behaviours designed to reduce the impact of this consumption on their weight and shape. Behaviours to reduce weight may include excessive exercise, self-induced purging or food restriction. Another symptom is that the person’s self-evaluation is heavily influenced by their perception of their own shape and weight.

What are the causes and effects of Bulimia?

Every person is different and it is likely that there is no single cause of bulimia, however researchers continue to investigate this. According to charity, Eating Disorder Hope, “bulimia nervosa is likely brought on by a complex interplay of factors which can include emotional and personality disorders, family stress, possible genetic or biologic susceptibilities, and a culture that is obsessed with body image and thinness.” In a book entitled Eating Disorders and the Brain edited by Ellern Mede founder, Professor Bryan Lask, regular feelings of ‘hunger’ are more marked for people with bulimia than people with other eating disorders. US Psychiatrist, Dr Walter Kaye has conducted several research studies into bulimia. His 2002 research linked an area of chromosome 10p to families with a history of bulimia nervosa, providing strong evidence that genes play a determining role in who is susceptible to developing the eating disorder. Earlier research in 1998 by Dr Kaye reported that women with bulimia nervosa experience alterations of serotonin level, a neurotransmitter that helps regulate mood. Altered levels could affect the control of appetite and thus contribute to a vulnerability to develop bulimia nervosa. The effects of bulimia, which worsen the longer the condition persists, include mental disorders such as depression and anxiety, but also physical damage to the heart, kidneys, digestive system and teeth.

Bulimia treatment

Ellern Mede follows NICE guidelines in treating Bulimia, the treatment of choice being cognitive behavioural therapy (CBT). Outpatient Care Plans are patient-centred to suit the lifestyle circumstances of the patient.

A strong focus of the treatment is on the particular causes of the bulimic behaviour in each patient. This could be linked to underlying psychological issues and so psychological therapy explores the thoughts that trigger the behaviour. The cycle of bingeing and purging can be similar to an addiction; breaking the cycle is essential to begin to restore normal eating patterns. The patient should eat regularly, to help avoid feelings of hunger and food craving. Thinking styles are challenged to improve self-esteem and change the belief that weight is key to personal value. Some patients may be recommended antidepressant medication.

Ellern Mede outpatient treatment consultations for psychiatry, psychology and dietetics may be found to help post discharge from other providers’ inpatient care. Maintaining therapy this way supports the person to make their new coping strategies part of every day life and by returning to work and family they maintain their career and social commitments while dealing with their health needs.

Bulimia recovery

Research reported in UK statistics portal ‘Statista’ indicates that 45% of people who experience bulimia will make a full recovery and 27% a partial recovery. Incidence is most likely to occur from age 18 to 40 and is very unusual in children. Once a ‘secret’ illness, awareness of the condition is now high as a result of well-known people such as Princess Diana and many others discussing their own experiences publically. Patients report feeling less alone in their recovery journey as a result of this public recognition.

Dr Gregg Jantz, an author on eating disorders, writes: “staying connected to you is the key to bulimia recovery” and offers five tips for maintaining your recovery after treatment:

• express how you feel and remember you have a right to feel that way
• relate to people that do trigger positive feelings in you, not negative ones
• overcome old ‘fears’ that prevented you from engaging with loved ones
• you have a new level of self control now so use this to mindfully respond to situations rather than ‘react’
• accept the hurts that are inevitably part of life and where possible, forgive

Finally Dr Jantz says: “It is okay if you stumble. It is okay if you fall. What matters most is that you get back up and stay on the road to recovery that belongs to you and you alone.”