Bulimia nervosa is characterized by recurring periods of binge eating, during which large amounts of food are consumed in a short period of time — sometimes as many as 20,000 calories during the course of a single binge. The bulimic is aware that his or her eating is out of control. He or she is fearful of not being able to stop eating, and is afraid of being fat. The bulimic usually feels depressed and guilty after a binge. Frequently, the binges are followed by purging, through self-induced vomiting, abuse of laxatives and/or diuretics, or periods of fasting. The bulimic’s weight is usually in a normal or somewhat above normal range; it may fluctuate more than 10 pounds due to alternating binges and fasts.
Source: ANAD (National Association of Anorexia and Associated Disorders) www.anad.org
DSM-IV Technical Criteria for Bulimia
1. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
– eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and similar circumstances
– a sense of lack of control over eating during the episode (e.g. a feeling tha tone cannot stop eating or control what or how much one is eating)
2. Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, enemas or other medications; fasting; or excessive exercise.
3. The binge eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for three months.
4. Self-evaluation is unduly influenced by body shape and weight.
5. The disturbance does not occur exclusively during episodes of anorexia nervosa.
Types Of Bulimia
During the current episode of Bulimia Nervosa, the person has regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas.
During the current episode of Bulimia Nervosa, the person has used other inappropriate compensatory behaviors, such as fasting or excessive exercise, but has not regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas.
Source: Diagnostic and Statistical Manual of Mental Disorders DSM-IV, American Psychiatric Association
What Do I Do Now?
As with anorexia, there are many health problems caused by bulimia, including tearing of the esophagus, electrolyte imbalance, severe tooth decay, eye blood vessel hemorrhages, kidney damage, liver damage and a weakened immune system. And this does not take into account the psychological problems caused by bulimia (or any type of disordered eating) including loss of confidence, loss of self-esteem, depression, guilt and shame.
Unlike the slow, silent process of anorexia, bulimia is a violent cycle – the ‘high’ one experiences during bingeing, followed by the ‘low’ of fear, followed by a ‘rush’ of purging, followed by more guilt, shame and fear. The important thing is to start breaking the cycle. For help in doing that, we highly recommend you talk with someone who is experienced in working with eating disorders.
- Search for videos and other resources on bulimia by typing it in the search box on the site.
- Read our article, “Finding Treatment,” to get ideas about who to talk to.
- Visit www.somethingfishy.org, www.nationaleatingdisorders.org, or www.aacc.net to search for a counselor, therapist or treatment center in your area.
- If you are seeking Christ-centered treatment, contact us for referrals to programs that treat bulimia in a Christian setting.
- Visit your primary care physician or ob/gyn and tell them exactly how you’re eating/exercising/dieting.
- If you are under eighteen, tell your parents or an adult you can trust about your fears of weight gain and/or obsession with thinness.
- Read “Binge No More” or “Overcoming Binge Eating” for keys to overcoming the urge to binge and purge.
Even though it may seem impossible to break the cycle you’re trapped in, please know that others have done it successfully, and you can too. It will take hard work, determination, and faith, but you can do it. And the benefits of being free will exceed even the highest ‘high’ you may have felt before.
You may also feel that your struggle has separated you from God’s love. This is not true. Here is one of our favorite verses to inspire you in your journey toward freedom:
“Let us then with confidence draw near to the throne of grace, that we may receive mercy and find grace to help in time of need.” Heb. 4:16 (ESV)