Bulimia

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Bulimia
Bulimia
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Bulimia: what is it?

With bulimia nervosa (BN, bulimia), eating attacks occur. Those affected eat large amounts of food in a short period of time. Various measures are then used to "reverse" the consequences of the phases of hunger (= weight gain).

Bulimia nervosa patients are very busy with eating, shopping and preparation. Figure, body weight and appearance are central issues. People with bulimia can be of normal weight.

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  • Binge eating & compensatory behavior
  • Preoccupation with food and body weight
  • Different shapes
  • Consequences of bulimia nervosa

Binge eating & compensatory behavior

The compensatory behaviors include:

  • self-induced (induced) vomiting,
  • Temporary periods of hunger (diets, fasting), avoidance of high-calorie foods,
  • Abuse of laxatives (laxatives), use of diuretics, appetite suppressants and thyroid supplements as well
  • excessive physical activity.

Those affected are often very afraid (pathological fear) of gaining weight. During the binge eating, there is no control over how much and what is eaten. Bulimic sufferers feel during attacks that they cannot stop eating.

Binge eating and weight loss measures occur several times - according to the DSM-V of the American Psychiatric Association, one binge eating per week over a period of three months is given for a diagnosis. (Objectively) large amounts are amounts that are significantly larger than the amounts that other people would eat in a similar situation in the same period of time. Hunger and satiety are not perceived by those affected or are no longer perceived as "normal".

Preoccupation with food and body weight

Bulimia nervosa patients are very busy with eating as well as with the purchase and preparation of food. Figure, body weight and appearance are central issues. In many cases, people are of normal weight or have a weight that is slightly below the normal range - but they can also be overweight. Those affected set a very strict weight limit, which is far below the age-appropriate ("healthy") body weight.

Different shapes

Not all criteria of bulimia are always pronounced. For example, one speaks of “atypical bulimia”. Bulimia is often preceded by anorexia. Symptoms can also overlap with those of other eating disorders.

Consequences of bulimia nervosa

Bulimia is not only physically stressful, but also psychologically, socially and financially. The consequences depend on the severity and duration of the illness, the number of binge eating and the compensatory measures.

Teeth, stomach & intestines

Vomiting can cause a sore throat and chronic hoarseness. Heartburn as well as reflux disease and inflammation of the lining of the esophagus (esophagitis) occur. Stomach acid that gets into the mouth as a result of vomiting can attack tooth enamel and promote tooth decay. There is also swelling of the salivary glands. In addition, chronic laxative use can lead to constipation. Those affected also experience disturbances in the feeling of hunger and satiety.

Minerals, Metabolism & Cardiovascular System

Fasting, one-sided diets, vomiting, and the abuse of diuretic drugs and laxatives can all lead to a lack of electrolytes. However, these are vital. A deficiency affects the metabolism and the organs connected to it and can, for example, lead to muscle cramps, but also to severe cardiac arrhythmias.

Especially in combination with too little fluid intake (drinking too little), the kidneys can be heavily stressed. With chronic deficiency there is a risk of severe damage to the kidney tissue, which can lead to kidney failure. Bulimia also has hormonal disorders that affect kidney and adrenal function, as well as the body's water balance. Most of those affected show water retention in the tissue (edema) as a result of bulimia.

Disorders of the hormonal balance are expressed, for example, by cycle irregularities. If the weight fluctuates significantly or if the weight is very low, menstruation may stop.

Due to insufficient supply of nutrients and disorders in the hormonal balance, the disease can lead to bone softening and, as a result, osteoporosis. Deficiency symptoms are also noticeable on the skin - similar to anorexia nervosa, for example in the form of atrophic, dry skin. In addition to a lack of electrolytes, other deficiencies (e.g. vitamins) can occur. Fatigue, decreased ability to concentrate and dizziness also occur as a result of the disease.

Mental Problems & Addictions

In the course of a BN disease, mood swings, depressive tendencies, lack of joie de vivre and lack of interest can appear. In addition, the ability to concentrate and perform decreases. Depressive moods can also be present before the illness.

Bulimia nervosa is sometimes associated with severe mental disorders. In addition to depressive disorders, there are, for example, anxiety disorders, affective disorders and post-traumatic stress disorders. Obsessive-compulsive disorder and social phobias can also be present before BN. Personality disorders (e.g. borderline personality disorder or anxious avoidance personality disorders) as well as self-harming behaviors occur.

Substance abuse and dependence (e.g. alcohol abuse and dependence, drug consumption) are also associated with BN.

For more information, see

  • psyche
  • Dependence, addiction

Social & Financial Problems

Financial problems can arise from the high cost of purchasing foods that are consumed during the cravings. The disease can also lead to social withdrawal. For more information see about debt etc. see Financial Problems & Health.

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