Bulimia nervosa

The notion of bulimia was known already in the ancient times. The word is Greek origin “boüsz”═ ox, “limosz”═ appetite meaning bulimia. In 1979 bulimia nervosa was recognised as an illness. The frequency of this illness cannot be determined and surveyed because of the hidden cases. Mainly 18 and 25 year old females suffer from these disorders (Túry, 2005). Bulimia nervosa is less common in men.

Features of bulimia nervosa: a dietary history may reveal attempts to control weight by abstaining from high calories foods except during binge eating periods. Losing control is an accompanying symptom of this illness. Symptoms may include, self-induced vomiting, fasting, and using laxatives, diuretics and excessive trainings. These symptoms are often interchangeable and similar with anorexia nervosa, yet patients’ histories contain symptoms of both disorders. It is also characterised by inappropriate premium placed diet with the purpose of becoming slender and changing appearance. They may rapidly have daily calorie allowance in a single binge episode. Understandably patients try to avoid situation when they feel that they will not be able to control their calorie and food intake (Túry 2005).

Patients with bulimia may experience the following symptoms: unlike anorexia in case of bulimia patients may have normal body weight. It often starts with anorexia. Patients are constantly focusing on their diet. Generally they are not abnormally slim therefore it is not easy to diagnose these disorders. There are regular binge eating periods in their life as they feel guilty and ashamed and are afraid of losing control over their body. They start using purging techniques, laxatives and diuretics to relieve themselves and prove that they can afford to eat as much as they want without getting fatter. The main impulse of purging is a powerful and overriding fear of gaining weight. The most common method is patients’ making themselves vomit with their fingers but soon they learn how to use their abdominal muscles as well (Túry, 2005).

Patients suffering from bulimia nervosa have very low self-esteem, and they are often extrovert personalities (Tringer, 2010) with body image disorder (Resch, 2007).

Patients want to eat in privacy and go out alone on unexpected food run. When binge eating is a symptom of bulimia it happens regularly, not just once or twice a day and the calorie intake can be 50.000. Due to this habit the occasions of self induced vomiting can happen at least 10-20 times daily in extreme cases (Túry, 2005).

These episodes are often pre-planned. Patients eat food which can be easily swallowed and then thrown up. These are fatty and carbohydrate rich nourishments which otherwise they would refuse to eat. Eating is usually a quick event but patient peck spending hours eating (Túry, 2005).

A more serious form of bulimia is multi impulsive bulimia nervosa. It is defined as the presence of two more impulsive behaviours marked by alcohol, drug addiction, sexual promiscuity, substance abuse, self-aggressiveness, suicide attempts and several other deviant behaviours (Túry and Szabó, 2000). These behaviours happen on the “spur of the moment”, there is no pause to consider their long-term consequences. Patients are often depressed, have little self-control, self-discipline and deliberation (Lacey and Evans, 1986).