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Bulimia Nervosa Treatment

Bulimia nervosa (BN) is a disorder in which individuals eat excessive amounts of food in a short period of time and afterwards eliminate this food from their body through some type of purging behavior. It is estimated that 1.1 to 4.2% of the female population suffers from BN and over 10,000 cases of bulimia nervosa are estimated for Long Island. Some studies have shown that up to 15% of female college students meet some criteria for bulimia nervosa.

Criteria for diagnosis of bulimia nervosa include:

  • Recurring episodes of binge eating, characterized as the consumption of food in a short period of time (under 2 hours), eating substantially more than most people would eat under similar circumstances. During these episodes a sense of a lack of control over the behaviors is experienced.
  • Recurrent episodes of compensatory behaviors following binging episode in which the individual tries to prevent weight gain through self-induced vomiting, laxatives, diuretics, enemas, fasting, or excessive exercise.
  • Self-evaluation is significantly influenced by weight and body shape.
  • The binge eating and compensatory behaviors occur, on average, at least once a week for a period of at least 3 months.

The new DSM-V eliminated the subtypes of bulimia which previously included purging type and non-purging type described as when one will compensate for binge episodes by not eating (restricting/fasting) and/or excessive exercising for a period of time after binging. While these distinctions have been eliminated in the new DSM-V, it can be useful to note that one does not need to use vomiting, laxatives, pills, or enemas to meet criteria for bulimia nervosa.

What is important to note with bulimia nervosa is that it can be one of the hardest conditions for others (parents, friends, spouses) to recognize in another. There are rarely any distinguishing features that identifies one who has bulimia nervosa. Patients can be underweight, ‘normal’ weight, overweight or obese, male or female, any age, any race or culture. Bulimia nervosa is usually kept private with secret eating/binging, secret purging, and excessive exercise in some that goes unnoticed or is even admired and supported. Even some patients and families minimize the condition if one is not significantly underweight. Yet, bulimia nervosa places great stress both physically and mentally on the brain and body. Patient’s usually have a significant mood disorder related to their condition, are easily agitated and often have poor sleep and energy expenditure.

Treatment should be with an experienced team of eating disorder professionals including a medical doctor, a therapist, a nutritionist and often a psychiatrist. Bulimia nervosa is a serious condition that can destabilize a patient at any given moment.