Bulimia Nervosa

If you or someone you know eats/drinks to excess and then vomits that food back up, on a regular basis, then it’s possible that you have an eating disorder.

Definition of Eating Disorder

Firstly though, let’s define an Eating Disorder:

“a persistent disturbance of eating or eating-related behaviour that results in the altered consumption or absorption of food and that significantly impairs physical health or psychosocial functioning. This disturbance should not be secondary to any recognised general medical disorder or any other psychiatric disorder” (Fairburn & Walsh, 1995:135).

In plain language, a person with an eating disorder does not eat as like normal people do (that’s why it’s called a disturbance).  This has a bearing on the following factors of quantity or size of food portions, the amount that is consumed, when eating takes place, and whether the food and drink has time to be absorbed.

Often, these behaviours are accompanied by strict rules which must be observed, and the rules can be very complicated too.  For example, the rule might be no meat, fish or chicken, pork, seafood or lamb, and no carbs and no fats.  What is left to eat then?

If someone had a medical or health condition that affected the ability to eat, or they have a psychiatric disorder such as depression or anxiety which affects appetite, then that may affect intake of food or drink, but not be considered an eating disorder.

So, if there is no other medical condition and no other psychiatric disorder, and there is disturbed eating or eating-related behaviour, then a diagnosis of an Eating Disorder might be made.  Without medical and psychological interventions, Eating Disorders are potentially life threatening in some individuals.

What then, is Bulimia Nervosa?

It is defined as “a psychiatric disorder characterised by binge-eating followed by some form or combination of purging, including laxative or diuretic use, strenuous exercise and self-induced vomiting, to eliminate unwanted calories.” (Hofland, S. & Dardis, P., 1992:27)

Someone experiencing bulimia may get caught in dieting cycle that involves restricting food intake for a period of time, followed by episodes of uncontrollable overeating (bingeing).

Then, to compensate for overeating and to avoid the subsequent gaining of weight, he or she may use self-induced vomiting (purging), laxatives, diuretics, enemas, fasting, or excessive exercise in a bid to purge themself of everything that was eaten or drunk.

The cycle is reset because now the person has to start at the beginning all over again.  Their weight may apepar reasonably normal with no big fluctuations, and there is often no visible impact on body weight.

What is Binge-eating Disorder?

  1. Binge-eating Disorder is similar to Bulimia except that no purging or other compensatory activities occur, as was outlined above.  Theefore, with Binge-Eating Disorder there are bouts of over-eating/bingeing followed by periods of food restriction.  Weight gain often occurs as a result of Binge-Eating Disorder.

Remember, don’t self-diagnose or diagnose someone else.

Formal diagnosis of an eating disorder should be made by a health practitioner such as a psychologist or doctor, based on a list of specific clinical features.

It is important to remember that although a person may not satisfy the clinical definition of an eating disorder, they may still have an eating problem that is both physically and emotionally damaging. Some people will engage in behaviours characteristic of one or more eating disorders.

Eating disorders can be overcome.  Early intervention may prevent serious problems from developing, so it is important to seek help and advice if there are any concerns about unhealthy eating patterns, rapid weight loss or any other warning signs; preferably before the behaviours and beliefs associated with an eating disorder become well established.

Source1,2: Eating Disorders Foundation of Victoria (Inc.), Information on Eating Disorders for families, partners and friends, 2000. pp .2-3.

What can you do if you suspect you have an Eating Disorder?

Seek medical or psychological help and assessment as soon as possible.  With Eating Disorders, the sooner you get help, the easier it is to resolve.  Having said this, of course, everyone is different.

What causes Eating Disorders?

Again, like obesity, it is very difficult to pin down an exact cause, and while there may be situations and events that result in common problems, that is not true for everyone.

What does Narelle as a Psychologist do for someone with Bulimia?

After an initial assessment, and information provided on Eating Disorders, it is important to begin to reduce stress and anxiety.  I’ve often found that clients with an eating disorder are over-perfectionistic and therefore in a state of high alert not just for themself, but about others doing things right, or correctly.

This constant tension does not allow a relaxed approach to life in general, let alone food because of the constant search for perfection and of course, the often subsequent falling short of those extremely high expectations.

Learning to relax and learning to switch off the mind and it’s constant criticism helps to build a bridge between the old ways of thinking and being and a desire to be well and healthy.

I use Timeline Techniques to release emotional baggage and teach the STOP technique for controlling thoughts, and the pyramid protection exercise to assist in not taking on other people’s emotions.

If you would like to begin learning deep breathing as a means to reduce anxiety and stress, then complete the short form below, so that you can receive a little mp3 audio file: