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BULIMIA (Binge-Eating Syndrome;Binge-Purge Syndrome; Bulimarexia)

BULIMIA (Binge-Eating Syndrome;
Binge-Purge Syndrome; Bulimarexia)

DESCRIPTION

Bulimia is a psychological eating disorder characterized by abnormal, constant craving for food and binge eating, followed by self-induced vomiting or laxative use. The brain and central nervous system, kidneys, liver, endocrine system, and gastrointestinal tract are involved. Bulimia usually affects adolescents and young adults.
Appropriate health care includes:
  • Physician's monitoring of general condition and medications.
  • Psychotherapy or counseling that may include hypnosis or biofeedback training.
  • Hospitalization (severe cases).
  • Self-care after diagnosis.

    SIGNS & SYMPTOMS
    Recurrent episodes of binge eating (rapid consumption of a large amount of food in a short time, usually less than 2 hours), plus at least 3 of the following:

  • Preference for high-calorie, convenience foods during a binge.
  • Secretive eating during a binge. Patients are aware that the eating pattern is abnormal, and they fear being unable to stop eating.
  • Termination of an eating binge with purging measures, such as laxative use or self-induced vomiting.
  • Depression and guilt following an eating binge.
  • Repeated attempts to lose weight with severely restrictive diets, self-induced vomiting, and use of laxatives or diuretics.
  • Frequent weight fluctuations greater than 10 pounds from alternately fasting and gorging.
  • No underlying physical disorder.
  • Etching of teeth from stomach acid.
  • Reddened and sore throat from irritation of vomiting stomach acid.

    CAUSES
    Unknown. The disorder often begins during or after stringent dieting and may be caused by stress related to insufficient food intake.

    RISK FACTORS

  • Anorexia nervosa.
  • Depression.
  • Stress, including lifestyle changes, such as moving or starting a new school or job.
  • Neurotic preoccupation with being physically attractive.

    PREVENTING COMPLICATIONS OR RECURRENCE

    Raise your children in a wholesome family environment with emphasis on caring and good communication rather than on external appearances.

    BASIC INFORMATION

    MEDICAL TESTS

  • Your own observation of symptoms. Many patients are secretive, and parents may be unaware of this condition.
  • Medical history and physical exam by a doctor.
  • Laboratory blood studies, including measurement of electrolyte levels.

    POSSIBLE COMPLICATIONS

    Fluid and electrolyte imbalance from vomiting, inducing life-threatening heartbeat irregularities.

    PROBABLE OUTCOME
    Most patients can control the behavior with counseling, psychotherapy, biofeedback training, and individual or group psychotherapy. Without treatment, complications can be fatal.

    TREATMENT

    HOME CARE

    See Appendix 19 for suggestions to reduce stress and improve overall health.

    MEDICATION

  • Medication is usually not necessary for this disorder. However, some doctors have successfully treated bulimia with anti-depressants.
  • See Medications section for information regarding medicines your doctor may prescribe.

    ACTIVITY
    No restrictions.

    DIET & FLUIDS
    If hospitalization is necessary, your doctor may prescribe intravenous fluids for your child. During recovery, vitamin and mineral supplements will be necessary until signs of deficiency disappear and normal eating patterns are established.

    OK TO GO TO SCHOOL?

    When appetite has returned and alertness, strength, and feeling of well-being will allow.

    CALL YOUR DOCTOR IF

  • You suspect your child has bulimia.
  • The following occurs during treatment: -- Rapid, irregular heartbeat or chest pain. -- Loss of consciousness. -- Cessation of menstrual periods. -- Repeated vomiting or diarrhea. -- Continued weight loss, despite treatment. ‡
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