Bulimia Nervosa — expert tips to deal with this eating disorder

An eating disorder can take a toll on a person’s health both mentally and physically. Excessive eating or not eating much are both a result of some kind of eating disorder. Bulimia Nersova is an eat

By: Dr Neha Sanwalka | | Updated: June 4, 2014 10:52 am

An eating disorder can take a toll on a person’s health both mentally and physically. Excessive eating or not eating much are both a result of some kind of eating disorder. Bulimia Nersova is an eating disorder which involves both binge eating and extreme dieting. Dr Neha Sanwalka, a nutritionist with a PhD in Health Sciences, explains the causes, symptoms and treatment options for bulimia nervosa. Also Read - Is it difficult for you to seek help for your eating disorder? 5 tips to control binge-eating

What is bulimia nervosa? Also Read - Do you experience these symptoms frequently? You're probably suffering from eating disorder

Bulimia nervosa is a serious, potentially life-threatening eating disorder characterised by a cycle of recurrent episodes of binge eating followed by extreme weight-control behaviours. Also Read - People with eating disorders more prone to exercise addiction: Study

Types of bulimia nervosa

Purging type: Binge eating followed by regular self-induced vomiting or the misuse of laxatives, diuretics, or enemas.

Non-purging type: Binge eating followed by other inappropriate compensatory behaviours, such as fasting or excessive exercise or strict dieting.

Symptoms of bulimia nervosa

Binge eating, i.e. eating large amounts of food in a short period of time than what normal person would eat
Lack of control over how much food one eats at each meal
Regular use of inappropriate compensatory behaviour such as self-induced vomiting, laxative or diuretic abuse, enemas or other medications
Extreme use of weight control methods such as strict dieting, fasting for prolonged periods or excessive exercise
Extreme concern with body weight and shape

How do you recognise if someone is suffering from bulimia nervosa?

A person suffering from this disorder would exhibit the following behaviour which would help you identify if they are suffering from bulimia nervosa:

Preoccupation with his/her body shape
Always having the fear of gaining weight
Low self-esteem and depression
No control over the amount of food he/she eats and eats until a discomfort or pain
Excessive and rigid exercise regime even during illness, injury or fatigue
Increased use of laxatives, diuretics or enemas after eating
Fixation on the number of calories consumed
Withdrawal from friends and family, especially at the times of meal
Prefers eating alone
Evidence of frequent visits to the washroom especially after meals, smell of vomiting
Calluses on the back of the hands and knuckles, discoloration or staining of teeth, mouth ulcers from self-induced vomiting

Treatment options for bulimia nervosa

Bulimia nervosa is best treated using an interdisciplinary approach comprising psychotherapy, family help and support, medical therapy and nutrition education.

Psychotherapy: Psychotherapy also known as talk therapy or counselling involves talking about the disorder and other mental health problems. It helps the person learn more constructive ways to solve their problems. Cognitive behavioural therapy which helps identify unhealthy, negative thoughts about oneself and dialectical behaviour therapy that helps individual regulate emotions and tolerate stress are two of the most effectively used psychotherapy for treating bulimia. Other psychotherapies such as interpersonal psychotherapy, motivational interviewing are also shown to be effective in treating it.

Family therapy and support: Family therapy explores family’s attitudes and dynamics, dysfunctional relations, behaviour patterns and other factors that may precipitate an eating disorder. It helps parents/partner (if in case married) to prevent unhealthy eating behaviour and help regain control over weight in those suffering from bulimia. Family therapy also helps in regaining self-confidence and builds a positive self-esteem about oneself preventing relapse of bulimia.

Medication: Antidepressants have shown to help reduce the symptoms of bulimia when used along with psychotherapy. The only antidepressant specifically approved by the Food and Drug Administration to treat bulimia is Prozac which is a type of selective serotonin reuptake inhibitor (SSRI).

Nutrition education and support: A dietician who is an expert in treating eating disorders would play an important role in helping one recover from bulimia nervosa. Adequate and optimal nutritional intake will prevent craving for binge eating and promote satiety. The dietician will design a healthy diet plan to help a person suffering from bulimia achieve a healthy weight, reduce episodes of binge and purging and achieve nutritional adequacy.

The expert can educate the person regarding healthy eating options, concepts of nutrition especially those related to maintaining healthy weight and promote consumption of a variety of healthy food items. A nutritionally balanced diet plan with meals placed at equal intervals is an ideal plan for a person suffering from bulimia nervosa.

Electrolyte imbalance is a major consequence of frequent episodes of purging. Correction of electrolyte imbalance is an important part of treating bulimia nervosa. Multivitamin-mineral deficiencies especially those of calcium, iron, zinc, magnesium, copper, Vitamin B12, and Vitamin D are very common in those suffering from bulimia. The diet plan should thus include foods rich in these minerals and vitamins such as milk and milk products, fruits and vegetables, eggs and lean meat.

With adequate help, this eating disorder can be treated.

Dr Neha Sanwalka has a PhD in Health Sciences and has completed her BSc, MSc Dietetics. She is the recipient of INSPIRE Fellowship from the Department of Science & Technology, Government of India and a certified diabetes counsellor. She is also the director of a start-up, NutriCanvas which provides diet and statistical consultations and conducts various nutrition workshops. She specialises in neonatal, paediatric nutrition and endocrine nutrition, bone health & SPSS (statistical software). She is also amember of the editorial and advisory board of Current Research in Nutrition and Food Science Journal. She teaches various subjects at colleges to Masters and PhD students.

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Published : January 21, 2014 11:13 am | Updated:June 4, 2014 10:52 am