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Bulimia

1/20/2014

1 Comment

 
So, are your “friends” Ana and Ed still bothering you?  A while back we talked about anorexia U Friends with Ana and Ed?  and hopefully that helped a few of you understand it better and learn why it is a problem.  You know there are a whole host of other types of disordered eating, and today we will spend some time talking about Bulimia.   While collecting information for this discussion, I came across this video called "You Are Beautiful."   It was created by Olivia Maloney and Cameron Dreyer, two 7th graders with a class assignment to create a PSA on any subject they wished. What really struck me was learning that their video moved their teacher when he saw it because his very own daughter once struggled with an eating disorder.  Sadly these disorders are not uncommon, so if you have one, you are not alone.  Before we get further along, take a look:
Back to our discussion.  I like the Q&A format – so let’s do that here again.

What exactly is bulimia?
Bulimia is repeated episodes of binge eating where you feel out of control of your eating and you eat excessive amounts of food.  Then those binges are followed by episodes of purging, or making yourself vomit, using laxatives or water pills, extreme fasting or excessive exercise or any combo of these behaviors.  People suffering from bulimia are obsessed with food. And purging does not result in weight loss.  This cycle can range from several times a week to several times a day.  Usually this is all done in private because it is embarrassing and people are ashamed of the binging and the purging and disgusted with themselves.  Most people with bulimia are normal body weight or slightly overweight.

Why do people do it?
People who suffer from bulimia are like people with anorexia in that they are really unhappy with their bodies, have an obsessive need to lose weight and they have an intense fear of gaining weight.  There is a really strong connection between self-respect and bulimia (and other eating disorders).  Self-esteem is important to protect against eating disorders.  Your body image and self esteem can get challenged as you start to go through puberty.  Body changes are uncomfortable, and you are often looking and comparing with other people.  Everyone changes at a different rate!  What you see on TV, in magazines, all over the media can start to make you feel bad about how you look. 
 Remember, those images are NOT REALITY!  Did you see this video from a while back?: 
It is so important that in your mind you talk to yourself kindly – stop yourself when you start to think or say to yourself “I hate my…..” Or “I am so fat” or any negative thoughts like that.  
 
If you are being bullied and people are making you feel bad about yourself, get help from a trusted adult - Triggers for eating disorders can be bullying about weight and appearance.  This happens to famous people too -  like Demi Lovato :
What happens if I have bulimia and why is it dangerous?
  • Your throat will be sore and inflamed from the repeated vomiting – stomach contents have a lot of acid in them which really burns your throat.
  • That stomach acid is not only bad for your throat but it will wear off the protective enamel on your teeth – so they will become more sensitive to temperature and tastes, and also are more likely to get cavities and decay.
  • You may have swollen salivary glands in the neck and jaw area – repeated vomiting can cause this.
  • If you take laxatives to purge, your intestines will become irritated and not work properly any more.  You may always feel uncomfortable – bloated, gassy, constipated or have chronic diarrhea.
  • You can get heartburn and acid reflux and other stomach and bowel problems
  • Eating disorders affect nutrition – this means your bones may not develop properly (not reversible!) or you may not fully grow.
  • If you vomit a lot, take a lot of diuretics (water pills), or laxatives, a ton of your body fluids are purged along with the food.  Body fluids are important and with purging them you can get seriously dehydrated.  Dehydration can damage your kidneys, make you faint, and mess up the electrolytes in your body.  Too low or too high levels of sodium, calcium, potassium and other minerals) are dangerous and can even lead to a irregular heart beats and heart attacks.
  • Repeated vomiting can cause your esophagus (tube that goes from your mouth into your stomach) or stomach to actually rupture (or tear).
  • There is an increased risk of suicide for many patients with bulimia and eating disorders.  If you or someone you know is having thoughts of suicide, contact the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255).

How do I know if I have a problem?
Overeating can occur with all of us – a great example is Thanksgiving or another big holiday where a feast is part of the festivities.  Overeating in this setting is not binging.   ANAD describes binging this way: “A binge is defined by several characteristics, including consuming a larger amount of food than most people would eat during the same time period (potentially thousands of calories) within a short period of time (typically 2 hours or less). It is also characterized by a feeling that one CANNOT STOP or CONTROL one’s eating, accompanied by physical or emotional distress.”

Here are a couple quizzes you can take if think you might have an unhealthy issue with food and eating:
Do I Respect My Body? Quiz from The Renfrew Center
NEDA Confidential Screening tool for Eating Disorders 


Can Bulimia be treated?  YES!  But the chance for success is highest the earlier bulimia is recognized and treatment is given.   Treatment is usually tailored to the individual patient, since each person struggling with Bulimia and other eating disorders is different.   It usually is covers a bunch of areas including some form of psychotherapy or psychological counseling and careful attention to medical and nutritional needs.  Treatment can be inpatient or outpatient.

Where can I get help?
  • NEDA has a helpline and a chatline.  Here is information to access those:  NEDA Help Line and Chat Line
  • ANAD also has an Eating Disorders Helpline at  630-577.1330 (open Monday-Friday, 9:00 am-5:00 pm, Central Time) or a special email address, anadhelp@anad.org if you prefer email instead of phoning.
Are you worried a friend might have a problem?  Here are some more clues that she might suffer from bulimia:
  • Increased obsession with food and weight loss, including obsessive exercise schedules
  • Bloodshot eyes
  • Calluses on hands and knuckles from self-induced vomiting
  • Frequent trips to the bathroom after meals
  • Signs and/or smells of vomiting
  • Finding wrappers or packages of laxatives or diuretics
What can you do?  Tell her you care.  Reach out to a trusted adult – a parent, teacher, coach, school nurse, guidance counselor – you know someone.  And you can pass on this information and links to helpful websites and organizations so that she can start to get better.

One more powerful video for you courtesy of the Teen Health Boards:
Sources: 
NIMH – Eating Disorders:  http://www.nimh.nih.gov/health/publications/eating-disorders/index.shtml#pub2
​National Association of Anorexia Nervosa and Related Eating Disorders:
http://www.anad.org/get-information/bulimia-nervosa/
National Eating Disorders Association:  http://www.nationaleatingdisorders.org/bulimia-nervosa
The Renfrew Center:  http://renfrewcenter.com/
Eating Disorders in Adolescents:  Position Paper of the Society for Adolescent Medicine. 2003
1 Comment
D. Conwell
11/3/2014 02:35:23 am

Great blog Dr. Offutt,

Very helpful information presented in a clear way. I also appreciate the use of videos to bring the issues to life.

Keep up the great work!

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