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Reviewed by Dr John Powell, specialist registrar in public health medicine and Dr Michael Sharp, senior lecturer in psychological medicine
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What is bulimia nervosa?
Bulimia is an eating disorder characterised by repeated episodes
of overeating and a preoccupation with the control of body weight.
Studies have shown that up to 1 per cent of the population is
suffering from bulimia nervosa at any one time, and this may well be an
underestimate.
Other studies show that up to 7 per cent of young women
consulting their GP have the symptoms of bulimia nervosa.
What are the symptoms?
According to the World Health Organisation, the criteria for a
diagnosis of bulimia nervosa include the following:
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persistent preoccupation with eating and an irresistible
craving for food.
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episodes of overeating in which large amounts of food are
consumed in short periods of time.
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excessive exercise, induced vomiting after eating, starving for
periods of time or taking medicines such as
laxatives or
diuretics to counteract the
bingeing.
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fear of obesity, which is also seen in people with
anorexia nervosa, and
there is some overlap in the symptoms of these two diseases.
What is the cause of the disease?
The cause of bulimia nervosa is unknown. Factors in the
patient's social environment are important, including the cultural
pressure for women in the Western world to aspire to an unnaturally slim body
weight. However, most people with bulimia nervosa maintain a normal body
weight. Patients with bulimia nervosa often suffer from low
self-esteem.
What are the symptoms of bulimia nervosa?
Often the person feels too fat and generally dissatisfied with
their physical appearance.
They may decide to eat less and avoid fattening foods. The
patient with bulimia nervosa becomes preoccupied with food and eating.
They will have episodes of craving for food and bingeing, which
may take place in secret. After bingeing, sufferers feel guilty, and may make
themselves sick.
What can people with bulimia nervosa do to help
themselves?
Recognise that you are suffering from bulimia nervosa and seek
help from your family doctor. There are also several good self-help books
available.
What is the course of the disease?
While some cases of bulimia nervosa are short-lived, usually the
symptoms will be present for some months or years before a sufferer seeks help.
The disease can persist for years, and in some people the symptoms may be
present all their lives.
Bingeing and vomiting can cause physical problems including
damage to teeth from stomach acid, and heart problems due to the body being
depleted of salts.
How is bulimia nervosa treated?
Treatment is aimed at the bulimia nervosa and any associated
problems such as low self-esteem or
depression.
Research suggests that cognitive behavioural therapy, a form of
psychological therapy, is an effective treatment for many patients. Further
research is being carried out into other forms of psychological therapy that
may also be helpful.
Antidepressant
medication can also be effective at treating the symptoms of bulimia
nervosa. Sometimes a combination of psychological therapy and drug therapy is
used.
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References
Hay PJ, Bacaltchuk J. Psychotherapy for bulimia nervosa
and bingeing (Cochrane Review) In: The Cochrane Library, Issue 1, 2000. Oxford:
Update Software.
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Based on a text by Dr René Støvring and Dr Kirsten Hørder
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Last updated 02.05.2005
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