Certified Eating Disorder Specialist
DaLene Forester, Ph D, LMFT, LPCC
Bulimia Nervosa
Bulimia Nervosa is characterized primarily by a cycle of binge eating and compensatory behaviors such as self-induced vomiting in an attempt to undo or compensate for the effects of binge eating.
The primary symptoms of Bulimia Nervosa are:
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Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
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) Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances.
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) A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating).
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Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, enemas, or other medications; fasting; or excessive exercise.
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The binge eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for 3 months.
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Self-evaluation is unduly influenced by body shape and weight.
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The disturbance does not occur exclusively during episodes of Anorexia Nervosa.
There are two subtypes of Bulimia Nervosa:
Purging Type: During the current episode of Bulimia Nervosa, the person has regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas.
Non-purging Type: During the current episode of Bulimia Nervosa, the person has used other inappropriate compensatory behaviors, such as fasting or excessive exercise, but has not regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas.
The more specific the information you offer, the better the person you’re speaking with will understand and be able to help. Answer the following questions and include the answers you are comfortable revealing:
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When did you begin having different thoughts regarding food, weight, or exercise? What were the thoughts?
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When did the different behaviors start? What was the behavior and did you hope to accomplish something specific (lose weight, gain control of something, get someone’s attention)?
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Have you noticed any physical health effects (fatigue, loss of hair, digestive problems, loss of menstrual cycle, heart palpitations, etc.)? Or any emotional effects?
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How are you currently feeling physically? Emotionally? Do you feel ready to stop the disordered eating behaviors?
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How can the people in your life best support you? Do you want them to monitor your behavior?
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Do you want them to ask you how you are doing with your recovery or would you rather tell them?
Source: National Eating Disorders Association
Therapy for Bulimia
Therapy is crucial to treating anorexia and bulimia. There are many ways a therapist can work with you, including addressing any feelings of shame and isolation caused by your eating disorder. Different therapists have different methods, so it is important to discuss with a therapist your goals in working towards recovery.
The most common therapy for eating disorders is cognitive-behavioral therapy. This targets the unhealthy eating behaviors of anorexia and bulimia and the unrealistic, negative thoughts that fuel them. One of the main goals is for you to become more self-aware of how you use food to deal with emotions. The therapist will help you recognize your emotional triggers and learn how to avoid or combat them. Cognitive-behavioral therapy for eating disorders also involves education about nutrition, healthy weight management, and relaxation techniques.
Am I Bulimic?
Ask yourself the following questions. The more “yes” answers, the more likely you are suffering from bulimia or another eating disorder.
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Are you obsessed with your body and your weight?
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Does food and dieting dominate your life?
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Are you afraid that when you start eating, you won’t be able to stop?
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Do you ever eat until you feel sick?
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Do you feel guilty, ashamed, or depressed after you eat?
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Do you vomit or take laxatives to control your weight?