Understanding Bulimia Nervosa: Signs, Symptoms, and Treatment Options

In this video, we're going to cover key things that you need to know about an eating disorder called bulimia nervosa, often just referred to as bulimia. Now, bulimia is a mental health condition, and while it can potentially be life-threatening, it can also be managed well if the right support is in place. I do hope that this video helps you.

We’ll cover what bulimia is, signs and symptoms, causes, complications, diagnosis, and finally, treatment options.

So, let's start by trying to better understand what bulimia nervosa is. There are two key patterns to bulimia. First, an individual will typically consume an unusually large amount of food in a short period of time. This is known as binge eating. This period of binge eating is then followed by getting rid of the food, which is called purging. Purging might involve vomiting or taking laxatives, which are medications that speed up the movement of food through your body to make you poo more often. Some people with bulimia also misuse water pills, known as diuretics, or diet pills. They might eat very little or sometimes not at all, and they may also exercise excessively.

It's important to note that people with bulimia are usually a normal, healthy weight. So, just by looking at someone, you might not be able to tell that they have bulimia. But they often judge themselves harshly based on their view of their body shape or weight and usually have self-esteem issues closely linked to their body image.

Who does bulimia nervosa affect? While bulimia nervosa typically affects women more than men, it's really important for you to know that men are affected, and it's a growing problem in men. It typically develops when someone is a teenager or a young adult, but it can affect people of all ages.

Now we know what it is and who it affects, let’s discuss some of the symptoms as well as the signs. Bulimia nervosa can be hard to spot because people with bulimia often binge and purge in private. But things like empty food wrappers and laxative packaging can be warning signs of the condition. Other signs might include frequent visits to the bathroom, particularly after meals, excessive exercising, a preoccupation with body image, an intense fear of gaining weight, depression or anxiety, substance abuse, feeling out of control, or feeling guilty or shameful about eating.

People with bulimia can sometimes also get physical symptoms and signs, including dental issues. That's because when they purge, they might try to make themselves vomit. The acid from the stomach can then cause erosion of your tooth enamel. They might also have something called Russell's sign, which are calluses on the knuckles caused by repeated self-induced vomiting over long periods. Other physical symptoms of bulimia nervosa can include swollen cheeks or a swollen jawline, problems with your gastrointestinal system like constipation and acid reflux, fainting, irregular periods, muscle weakness, bloodshot eyes, as well as dehydration.

Now, let’s briefly cover some potential complications associated with bulimia. Bulimia can cause health problems because it stops your body from getting the important nutrients that it needs from food. These health issues can include sores in the throat and stomach, tooth decay, inflammation and tears in the food pipe, harm to your intestines and stomach, unbalanced levels of body salts, an irregular heartbeat, heart problems, and a higher chance of thinking about or attempting suicide.

Let’s move on and discuss diagnosis as well as tests for bulimia nervosa. To diagnose bulimia nervosa, your healthcare provider will typically perform a physical examination. They'll ask you about your medical history as well as symptoms. It’s okay to be nervous when talking to your health provider, but try to remember that they want to help you get better, so it’s important to be honest with them about your eating habits. They’ll also ask you some questions like:

- Do you have repeated episodes of binge eating?
- Do you feel a lack of control over your eating during an episode?
- Do you engage in inappropriate purging behaviors, such as vomiting?
- Have you experienced binge eating at least once a week for 3 months?
- Does your body weight or shape have a strong influence on your self-image?

These questions help your health provider get a better understanding of what could be going on. While there aren’t any blood tests to specifically diagnose bulimia, they’re likely to order blood tests to see how bulimia has affected your health in general. These tests include blood tests, an analysis of your urine, as well as a trace of your heart known as an ECG or EKG.

Finally, how is bulimia nervosa treated? The first thing to mention is that there is no one treatment option, and often using a variety of techniques might be needed. The key thing is to work in partnership with your health provider to find the best option for you. They might refer you to a team of specialists, including dietitians as well as mental health professionals, such as a psychiatrist or a psychologist, to find the best treatment that works for you. This should be done in partnership with you, so try to be honest with your health provider about what you think will work for you.

It’s worth spending a little bit of time covering some of the options that might be available to you so that you’ve got some knowledge about them for an informed discussion. One way to treat this is through a kind of one-to-one counseling called cognitive behavioral therapy or CBT. The aim is to help change your thoughts and actions, especially about food and weight, and teach you some important management strategies. Another method is nutritional counseling, where you learn healthier eating habits. Sometimes doctors may also give you medication like antidepressants known as selective serotonin reuptake inhibitors or SSRIs. These can help reduce binge eating and vomiting, but it's not sure if they work in the long run. They’re also used for anxiety and depression, which are often found in people with bulimia. Lastly, joining a support group can be useful. This can be a place where you can meet, and sometimes your family can also meet, others experiencing similar challenges and share experiences. This is most helpful when combined with other treatment options. Again, it’s about finding what works for you.

What’s the outlook for people with bulimia nervosa? The good news is that many people with bulimia get better with treatment and go on to lead healthy lives. Some people improve at first but then unfortunately relapse and need treatment again. Statistics show about half of people with bulimia fully recover with appropriate treatment.

I’d like to finish this video by saying that if you’re suffering from bulimia or you have a family member or a loved one who’s suffering from this, try to seek the help you need. Your health professional is going to be there to support you or them in a non-judgmental manner, and seeking help is the first important step to recovery. Please consider making this challenging but really important step.

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