Bulimia (bulimia nervosa) is an eating-and-vomiting addiction, making it one of the eating disorders. Unlike anorexia, bulimia sufferers are rarely seen to have an eating disorder as they are usually of normal weight. Typical signs are high calorie foods, vomiting, tooth decay and a lack of self esteem.

What is bulimia?

The causes of food cravings for bulimia have depth psychological reasons, while vomiting at bulimia can be related to the ideal of beauty.
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Bulimia (Bulimia nervosa) is derived from the Greek and actually means "ox hunger". In psychological and general parlance, however, bulimia is synonymous with eating-crushing addiction. It is eaten excessively (food cravings), but for fear of gaining weight, vomited again.

In advanced cases bulimia is continued after vomiting and the circulation begins again. Meanwhile, there are also sub-types of bulimia, in which is not vomited, but too much sport is to train what is eaten (Sportbulimie) or is discharged with various means.

causes

The causes of food cravings for bulimia have depth psychological reasons, while vomiting at bulimia can be related to the ideal of beauty. Possible reasons for bulimia may be trauma experiences that the person concerned could not mentally handle. These include fear of loss, abuse, rape, neglect and / or other physical and psychological violence.

Bulimia is often associated with co-dependency. This is also referred to as relational addiction and involves the unconditional care of a close person in the environment. For example, alcoholics or drug addicted parents, siblings or closest friends.

Add to this the fear of gaining weight, which may be due to the beauty ideal of the media and the general public. Many persons suffering from bulimia also work in occupations in which a good figure is important (eg model industry). However, the bulimia is not to be committed to the profession.

Symptoms, complaints & signs

Bulimia-affected people are usually of normal weight. Sometimes they are - overweight or underweight - according to the healthy normal population. In this respect, bulimia does not express itself in externally affected. Rather, the disease is characterized by more or less regularly occurring binge eating, which can occur several times a day, or even every few days. The perceived control over the eating behavior goes back. In the binge eating large amounts of food and a fast Esstempo play a role.

The disease picture bulimia is defined by the fact that the person concerned tries to compensate his eating behavior. For this purpose, self-induced vomiting is particularly often considered. But also driving a lot of sports, the introduction of extreme diets and the use of laxatives and emetics appear to be good action for the person concerned. Combinations of these measures also occur.

Cravings continue to be promoted as the disease progresses, with the countermeasures taken against the food putting a strain on the body's energy balance. In this respect, a vicious circle of binge eating and exhausting countermeasures is initiated.

Possible sequelae affect the teeth and esophagus (due to stomach acid), the stomach, the metabolism and intestines (due to laxatives) and much more. Head, neck and back pain are particularly common and nonspecific symptoms common with bulimia sufferers.

The disease often occurs around the age of 17 or 18 years and is occasionally linked to anorexia past. The list of possible psychological comorbidities is long and includes, for example, substance abuse, feelings of inferiority and impulse control disorders.

complications

Bulimia is a serious illness that needs to be treated by a doctor or a psychologist. It is not uncommon for patients to be admitted to a clinic for treatment, so that they can no longer harm themselves. If the bulimia is not treated properly, it can cause very serious damage to the body and, in the worst case, lead to death.

Bulimia usually has several symptoms and complications. The affected person often shows aggressive behavior and social isolation. Added to this are depression and feelings of inferiority, which are no longer exacerbated by social exclusion.

Not infrequently, bulimia also occurs with the abuse of alcohol and other drugs and leads to the use of drugs that cause vomiting. These drugs are harmful to the body in high amounts and cause problems with the stomach. Due to the ascending gastric acid, the teeth are permanently damaged and must be replaced by crowns.

Treatment takes place primarily on the mental level. In addition, the treatment of physical symptoms, as the body has to get used to a normal food intake again. As a rule, the treatment of bulimia is successful, but does not rule out that the person affected by the disease again.

When should you go to the doctor?

In case of bulimia, a medical treatment is necessary in any case. The disease can in the worst case lead to death. In severe cases, those affected must be treated in a closed clinic. Usually the patients themselves do not confess to the disease, so that especially parents and friends have to initiate treatment and diagnosis.

A doctor must be consulted if the person loses a lot of weight in a short time. Persistent vomiting or reduced self-esteem may also indicate the disease. Likewise, patients often suffer from tooth decay and take high-calorie food. In addition, a doctor should be consulted, if it comes through the bulimia to mental and social complaints.

In acute emergencies, an emergency doctor must be called. A comprehensive treatment of bulimia should be done in a clinic. However, those affected must admit the disease. A treatment in self-help groups is possible.

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Treatment & Therapy

Bulimia is a disease that can only be treated with the help of a bulimic specialist. This doctor is usually a therapist or psychologist. The treatment of bulimia can usually only begin as soon as the affected person recognizes the need for help.

Thereafter, a weeks-long psychosomatic spa stay is the best foundation for getting back to a healthy life. In this therapy, an attempt is made to find out the causes of bulimia, in order to then work it up. People who suffer from bulimia must learn to use alternative options instead of overeating.

A person suffering from bulimia will have to pay attention to their eating behavior throughout their lives, just as a dry alcoholic must be careful not to drink alcohol. However, the bulimic has the disadvantage that he has to eat to survive and can not live abstinently.

Proper handling of food is just as important a point in bulimia therapy as different methods of dealing with the causes. After the intensive therapy, an outpatient, regular talk therapy should continue in order to be able to survive in everyday life and to learn to relapse without falling back into bulimia.

Outlook & Forecast

The eating disorder can be cured with the right therapy and the essential cooperation of the patient. Approximately half of all patients achieve freedom from symptoms after several years. In about 30%, only a partial improvement of the clinical picture is observed and 20% of all patients show no cure of the existing symptoms.

The sooner the disease is diagnosed, the better the overall cure. At the same time, the age of the patient plays a significant role in prognosis when treatment is initiated. Younger teenage patients have a much better chance of recovery than adults.

By taking a therapy, the healing prospects improve significantly without the help of a doctor or therapist. Many patients often experience one or more relapses in the recovery process despite medical care. Especially young patients are affected. In addition, there is a risk that the disease will develop into a chronic course and persist for many years.

At the same time, this increases the probability of the onset of a secondary disease. Patients with bulimia often experience depression, obsessive compulsive disorder, addiction or impulse control disorder. Patients who additionally suffer from borderline disease have a significantly worse prognosis. With them, the suicide rate and the likelihood of alcohol abuse are significantly increased.

prevention

Preventing bulimia is very difficult, as the causes of bulimia are usually subconscious. Before the person concerned realizes that he is stuck in a bulimic spiral of thoughts, he is usually no longer able to recognize himself that he needs help. It is important to have a good self-reflection and a healthy sense of self-esteem in order to be able to prevent as much as possible.

A bulimia, like all addictions, is the expression of a mental illness that is unprocessed. Anyone who has experienced bad things should always seek therapeutic help, even if he believes that he does not need it. The awareness of this is vital, because bulimia, like other addictions, can be fatal.

aftercare

As a rule, intensive follow-up on bulimia is necessary. Especially after inpatient therapy, it is advisable to visit an outpatient psychotherapist and continue the treatment. This can help those affected to find their way back into everyday life and prevent any relapses. In addition, visiting self-help groups can be helpful in most cases.

In most clinics, the individual aftercare concepts are agreed upon prior to discharge in consultation with the attending physicians. Such instructions should be followed by patients. In some serious cases, those affected by inpatient therapy may be referred to special care homes for former bulimia patients for the period of follow-up.

In addition, many medical facilities in patients with eating disorders offer the option of online aftercare. Outpatient psychotherapy is especially recommended for people who have not previously been treated in a clinic. This should be continued in any case, even if those affected perceive a significant improvement in the disease. Throughout the period of aftercare, family members and relatives should be involved in the process. If it comes to a relapse, patients should always consult a doctor.

You can do that yourself

Bulimia is a serious eating disorder that can cause significant physical and psychological harm if it is not detected and treated in a timely manner. Self-therapy should therefore be avoided at all costs. But those affected can help to support the recovery process.

The earlier the disease is detected, the lower the risk that those affected will sustain long-term damage. Therefore, a doctor should be consulted at the first sign of an eating-refractive addiction. In addition to a drug treatment, the patients should necessarily take an accompanying psychotherapy.

If the treating physician does not encourage this on his own initiative, the therapy must be actively called for by those affected. In particular, cognitive behavioral therapies are very often successful in bulimia.

It is also important that those affected are not ashamed of their suffering and at least inform their social near field such as parents, roommates and, where appropriate, colleagues or superiors about their disease. Many patients also find it helpful to join a support group or to share with other stakeholders in bulimic online forums.

In addition, a bulimia diary is recommended. Such records can help keep track of eating habits and identify the triggers of the disease. Eating attacks, which occur predominantly at night, can also be controlled by consumer behavior. Instead of storing food for the whole week, only the daily needs should be purchased.

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