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Bulimia nervosa

Bulimia nervosa, more commonly known as bulimia, is an eating disorder. It is a psychological condition in which the subject engages in recurrent binge eating followed by intentionally doing one or more of the following in order to compensate for the intake of the food and prevent weight gain: more...

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  • vomiting,
  • inappropriate use of laxatives, enemas, diuretics or other medication,
  • excessive exercising,

The five DSM-IV critera

The following five criteria must all be met for a patient to be diagnosed with bulimia:

  • 1) The patient feels incapable of controlling the urge to binge, even during the binge itself; and he or she consumes a larger amount of food than a person would normally consume at one sitting
  • 2) The patient purges him or herself of the recent intake, resorting to vomiting, laxatives, diuretics, exercising, etc.
  • 3) The patient engages in such behavior occurs at least twice per week for three months.
  • 4) The patient is focused upon body image and the desperate desire to appear thin.
  • 5) The patient does not meet the diagnostic criteria for anorexia nervosa. (Some anorectics may demonstrate bulimic behaviours in their illness: binge-eating and purging themselves of food on a regular or infrequent basis at certain times during the course of their disease. Alternatively, some individuals might switch from having anorexia to having bulimia. The mortality rate for anorectics who practice bulimic behaviors is twice that of anorectics who do not. )
  • 6) The patient is of normal weight or overweight.

Please note that these diagnosis criteria are only a guide, and many doctors will diagnose bulimia nervosa if only one is not present.

Causes

Bulimia is often less about food, and more to do with deep psychological issues and profound feelings of lack of control. Binge/purge episodes can be severe, sometimes involving rapid and out of control feeding that can stop when the sufferers "are interrupted by another person . . . or their stomach hurts from over-extension . . . This cycle may be repeated several times a week or, in serious cases, several times a day." Sufferers can often "use the destructive eating pattern to gain control over their lives".

Patterns of bulimic cycles

The frequency of bulimic cycles will vary from person to person. Some will suffer from an episode every few months while others who are more severely ill may binge and purge several times a day. Some people may vomit automatically after they have eaten any food. Others will eat socially but may be bulimic in private. Some people do not regard their illness as a problem, while others despise and fear the vicious and uncontrollable cycle they are in.

Consequences of bulimia nervosa

  • Electrolyte imbalance, heart arrhythmia, heart failure
  • Teeth erosion and cavities
  • Sialadenosis (salivary gland swelling)
  • Potential for gastric rupture during periods of bingeing
  • Acid Reflux
  • Irritation, inflammation, and possible rupture of the esophagus
  • Laxative dependence
  • Peptic ulcers and pancreatitis
  • Emetic toxicity due to ipecac abuse
  • Potentially death

Read more at Wikipedia.org


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Dentists often see first signs of eating disorders - symptoms of anorexia and bulimia in the mouth - Brief Article
From Nutrition Health Review, 6/22/03

Bulimia and anorexia nervosa are two of the most common eating disorders, especially among young American women. The disorders stem from psychological problems that cause patients to feel an irrational need to lose weight and to be thin, regardless of their current body shape.

Anorexia nervosa is a disorder characterized by severely restricted eating habits and extreme weight loss. In addition to denying the body food, anorexic patients often cause themselves to vomit if they feel guilty about having eaten. In some cases involving women, the weight loss is so extreme that patients stop producing estrogen, the lack of which contributes to significant bone loss.

According to the American Anorexia/Bulimia Association, nearly 10 percent of all patients with eating disorders are male. Bone loss has also been reported in anorexic men. One in 10 anorexic patients die as a result of cardiac arrest, medical complications, or suicide.

Bulimic patients compulsively overeat (binge) and then purge by inducing vomiting. Purging can result in a ruptured stomach and cardiac arrest because of the loss of vital minerals such as potassium.

People who have both of these eating disorders may develop tricks or deceptions to cover up their problems, such as wigs to hide hair loss, extra layers of clothes to appear as if they have a normal body weight, and excessive cosmetics to make the skin appear healthy.

In a large percentage of eating-disordered patients, a correct diagnosis cannot be made until they visit a dentist for a check-up or other oral surgery. Some of the most common symptoms of anorexia and bulimia occur inside the mouth. The erosion of dental enamel, hypersensitivity to hot and cold, redness of the throat, oral sores, signs of malnutrition, and a mottling of the teeth as a result of repeated contact with acidic vomited contents, are all signs of an eating disorder that only a dentist might discover.

COPYRIGHT 2003 Vegetus Publications
COPYRIGHT 2003 Gale Group

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