Bulimia is a more common eating disorder than anorexia and often develops slightly later in life, from mid to late teens or the early twenties. Studies suggest that between 0.5 per cent and 2 per cent of young women in the UK have bulimia.
There are two main features of bulimia. Individuals regularly binge, which involves eating a large amount of food in private until they feel uncomfortably full. They feel they have little or no control during a binge and tend to eat ‘forbidden’ foods with a high carbohydrate content.
Bingeing is normally followed by intense feelings of guilt and shame. To compensate for the food consumed during a binge, the individual then uses other behaviors, such as vomiting, laxative misuse or excessive exercise. This is often termed as ‘purging’ behavior.
People with bulimia are locked in a regular cycling of bingeing and purging and usually have overwhelming feelings of shame about their eating disorder. The frequency of the cycle varies from one individual to another and there are also wide variations in purging behavior.
Teenagers who have tried unsuccessfully to diet but failed sometimes believe that this cycle of bingeing and purging will help them to lose weight successfully. But studies show people with bulimia are often of normal body weight and if untreated, over time, there tends to be weight gain rather than weight loss. Bulimia is often associated with low self-esteem or a general lack of self-confidence.
However, this cycle has a range of harmful effects on the body. Some of these side-effects will be evident from a fairly early stage in the bulimia. They can include:
- Frequent and major weight changes.
- Stretch marks.
- Sore throat, the erosion of tooth enamel and bad breath caused by excessive vomiting.
- Swollen salivary glands making the face round and puffy.
- Poor skin condition and possible hair loss.
- Irregular menstrual periods or loss or periods.
- Lethargy and tiredness.
- Abdominal pain and bloating.
- Chronic constipation and risk of bowel problems due to laxative abuse.
There are a range of very serious effects for people who continue to suffer with untreated bulimia during a long period of time. Many people with bulimia develop chronic dehydration, caused by vomiting and the use of laxatives. This can lead to low potassium levels, triggering a wide range of symptoms ranging from lethargy and muddled thinking to potentially life-threatening heart and kidney problems. Another serious complication of bulimia is the rupture of the stomach.
Bulimia has a lower mortality rate than anorexia. However, very rare and extreme cases, death can occur due to heart failure.
Fortunately, people with bulimia tend to want to overcome their eating disorders and feel less ambivalent about change than those with anorexia. The difficulty usually lies in seeking help, as people with bulimia often feel profoundly ashamed of their eating habits and worries that if they do seek support, their problem will be dismissed.
However, studies show that people with bulimia respond well to treatment. A form of cognitive behavioural therapy designed for eating disorders, called CBT-E is very effective for people with bulimia.
