Bulimia Nervosa is an eating disorder that is characterised by a cycle of binge eating followed by purging behaviour. Some people use binge eating as a way of coping with anger, depression, stress, anxiety, loneliness or general unhappiness. The over eating often leads to increased feelings of guilt and anxiety about fatness and results in purging to get rid of the food.
The purging behaviour is different for each person. Some people will do excessive exercise to try and burn off the calories of a binge. Others will force themselves to 'throw up' or take laxatives, diuretics and diet pills, or they might 'fast' for days after a binge.
The average age of onset of bulimia is usually around 10 – 12 years of age. It is estimated that approximately 5 per cent of the female population suffers from bulimia nervosa as a disease, but many more young people engage in purging behaviour at any one time, that may or may not lead to bulimia as a clinical disorder. Boys can also suffer from bulimia although it is not as common as it is with females.
People with bulimia do realise that they have a problem and are usually willing to seek help. It is important that you encourage and support anyone who has an eating disorder to seek help from appropriate sources. It is important to note that there is a high comorbidity between bulimia and other mental illnesses such as depression and anxiety, and this can perpetuate the negative bulimia cycle.
Signs to look for
It can be difficult to determine whether a friend may be bulimic because they are quite often in a 'normal' weight range. However, there are a few warning signs to be aware of if you suspect a friend may need help. Such indicators for bulimia are presented in cognitive, emotional, behavioural and relational facets; physiological and medical presentations; and Dietary indicators. Examples of these are given below:
- binge eating - this is rapid consumption of a large amount of food, more than someone would normally eat
- secretive eating - you might notice that food is missing
- bathroom visits after eating
- excessive use of laxatives/diuretics, stimulants or enema abuse
- a vicious cycle between binging and purging
- harsh exercise programmes
- swollen glands
- mood swings, depression, self-criticism
- fatigue
- complains of a sore throat
- tooth decay
- avoiding restaurants, planned meals or social events
- weight fluctuations
- irregular periods
- stomach pains, dehydration, constipation
Helping friends
You cannot force someone with bulimia to stop binging/purging, but there are some things that you can do to help the person:
- encourage the person to seek help (you can do this by gently expressing concern and bring supportive, knowing where to go for help)
- communication is important – encourage your friend to talk and express there concerns in a safe and secure environment
- let them know you care – it is important to understand and care for your friend, in the best way you know how, but at the same time not to burn yourself out. Give advice on where your friend can go for help.
The important thing is that you be a friend and not a therapist. You cannot solve the problems for them. It can be tough to be a friend to a person with an eating disorder. They may be irritable at times however, it is not a personal attack on you. It is quite often due to the disorder itself.
Hang in there! You are not alone. Recovery takes time and there will be both positive and negative times in the recovery of someone with an eating disorder. Remember to take time out yourself and talk to other people about it, there are a lot of services that can help you or a friend with an eating disorder. More information is available from specialist eating disorder sites on the net.