Bulimia

Overview

Like anorexia and binge eating, bulimia is a serious eating disorder. It is marked by episodes of binge eating, followed by deliberate vomiting, using laxatives or fasting to avoid weight gain. The causes are family-related and/or psychological in nature. More than 90% of cases concern young women. Family members should be observant, raise awareness of the topic and convince those affected to go for treatment.

Symptoms

• Episodes of binge eating
  • Eating large amounts of high-calorie food within a short time
• Methods to avoid weight gain
  • Vomiting after eating, usually self-induced
  • At times, fasting
  • Misuse of laxatives and diuretics or appetite suppressants
  • Diarrhoea
• Consequences of vomiting
  • Abdominal pain
  • Inflamed cracks in the corners of the mouth
  • Inflammation of the gums, oesophagus and salivary glands
  • Tooth decay, caries
• Physical symptoms
  • Fluctuations in weight
  • Dry skin
  • Sudden loss of consciousness (because of low blood pressure)
  • Heart arrhythmia
• Mood swings
• Social withdrawal

Causes and treatment

Causes

• Family influence/conflict
• Genetic factors
• Psychological problems
  • Childhood trauma
  • Dysfunctional social relationships
  • Feelings of inferiority
  • Debilitating pressure to succeed
  • Exaggerated ideal of being slim
  • Stress
  • Depression
  • Personality disorder
  • Obsessive compulsive and anxiety disorders

Further treatment by your doctor / in hospital

Possible tests

• Conversation
• Physical examination
• Blood test

Possible therapies

• Psychotherapy (first choice: cognitive behavioural therapy)
• Inpatient treatment with individual and family therapy, if necessary
• Social counselling
• Nutritional counselling
• Treatment depending on the symptoms
  • E.g. dentist
  • Anti-inflammatory drugs
  • Antidepressants

What can I do myself?

• Family members
  • Don't hesitate to address the problem if you have any suspicions
  • Important: patients hide their illness for a long time
• Develop an understanding of the personal situation (basis for treatment)
• Try to find help
  • Confide in family members/friends
  • Establish contact with a doctor (family doctor, psychiatrist)
  • Centre of expertise for eating disorders

When to see a doctor?

• Regular episodes of binge eating
• Measures to avoid weight gain (vomiting, medication, etc.) after bingeing
• Understanding/acceptance of own disease
• Pain/burning in the mouth and oesophagus
• “Swollen cheeks” (inflammation of parotid glands)
• Social withdrawal
• Dentist: tooth decay, toothache, etc.

Further information

Schweizerische Gesellschaft für Ernährung SGE (Swiss Society for Nutrition)
www.sge-ssn.ch

Selbsthilfe Schweiz (Self-Help Support Switzerland)
www.selbsthilfeschweiz.ch

Arbeitsgemeinschaft Ess-Störungen AES (Association for Eating Disorders)
www.aes.ch

Synonyms

bulimia, bulimia nervosa