Bulimia - Medical experts

Beauty, recognition and attention are deeply human needs and not just modern-day phenomena. However, the new media (social media, Instagram and co.) provide the ideal breeding ground for eating disorders such as bulimia. Bulimia is a serious mental illness that can cause dangerous long-term damage.

You can find more information & specialists here.

Beauty, recognition and attention are deeply human needs and not just modern-day phenomena. However, the new media (social media, Instagram and co.) provide the ideal breeding ground for eating disorders such as bulimia or anorexia.

In a press release, the German Eating Disorder Association reports on an interesting study: two thirds of the patients surveyed stated that formats such as "Germany's Next Top Model" had influenced the development of their illness.

Bulimia is a serious mental illness that can cause acute circulatory collapse and dangerous long-term damage. For this reason, it is important to recognize the illness at an early stage and initiate treatment.

Bulimia - the clinical picture

Bulimia is a mental illness and belongs to the group of eating disorders. It is colloquially known as binge eating disorder. Bulimia is coded as F50.2 in the World Health Organization (WHO) ICD-10 diagnostic catalog.

The disease primarily affects women. Estimates put the figure at 90-95 percent. Teenage girls and young women (risk group: 15 to 35 years) in particular tend to develop this disorder. Bulimia is often accompanied by an increased focus on performance and self-doubt. As a result, those affected are under increased pressure.

In some cases, anorexia is followed by bulimia. Or anorexia patients repeatedly suffer from bulimic phases because they cannot stick to their strict diet program.

Symptoms of bulimia

While patients with anorexia voluntarily abstain from food, bulimia leads to food cravings. During a binge, those affected consume particularly fatty and sugary foods. They can reach quantities of up to 10,000 calories.

Patients use various strategies to avoid gaining weight:

• Deliberate vomiting
• Taking laxatives or appetite suppressants
• fasting
• Excessive training

Between bouts of binge eating, sufferers reduce their food intake, which is why they tend to fluctuate in weight. In contrast to anorexia nervosa, patients with bulimia nervosa are often of normal weight.

During binge eating, sufferers experience a loss of control. When they vomit, they feel relieved for a short time. Bulimia patients are generally ashamed of their eating behavior and suffer from feelings of guilt. Their self-esteem drops. It is a vicious circle.

The psychological symptoms of bulimia include

• Emotional outbursts of an aggressive or desperate nature
• isolation
• depression
• Boredom (inner emptiness)
• Great inner tension

Patients with bulimia usually have a constant feeling of shame or guilt. This results in a disturbed, negative relationship with themselves.

Typical symptoms of bulimia are ravenous hunger and subsequent vomiting @ Monkey Business /AdobeStock

Warning signs

Bulimia is not immediately obvious because patients with binge eating disorder are predominantly of normal weight. Nevertheless, there are typical characteristics that indicate the onset of bulimia nervosa:

• Increased interest in nutrition and the calorie content of food
• Eating only "healthy" food
• Patients avoid main meals
• Dissatisfaction with their figure and appearance
• Performance orientation
• Increase in physical activity
• Social withdrawal
• Menstrual disorders

If you know someone who has these characteristics, talk to them about it. Alternatively, you can also consult your family doctor.

If you don't know how to broach the subject, visit the website of the Federal Center for Health Education. You will find comprehensive information there.

Diagnostics

It usually takes a long time before a patient is diagnosed with bulimia nervosa. The reason: although those affected suffer enormously from the illness, they avoid going to the doctor because they are ashamed.

A reliable diagnosis can be made by a specialist or psychologist. To do this, they will take a detailed medical history in advance.

In order to diagnose bulimia, the affected person must have two binge eating episodes per week over a period of at least three months. At the same time, the patient takes various measures to avoid gaining weight.

In medicine, a distinction is made between the purging and non-purging types of bulimia :

• The purging type, for example, resorts to appetite suppressants, diuretics or uses regular vomiting to balance out the binge eating.
• The non-purging type uses fasting cures, diets or intensive training to maintain their weight.

Differentiation (differential diagnosis) from other eating disorders is sometimes difficult. Some patients with anorexia also experience phases of bulimia, for example when they are unable to maintain their strict food restriction.

The specialist must rule outother mental disorders (depression, anxiety disorders, suicidal tendencies). The doctor also examines the patient's physical condition. Among other things, he will order a comprehensive blood test and check the heart function using an ECG.

The course of treatment can be monitored using psychological methods such as the "Structured Interview for Anorexia and Bulimia Nervosa".

Consequences of bulimia nervosa

Bulimia nervosa has serious consequences:

• Regular vomiting burns the mucous membranes in the mouth and esophagus. It also promotes reflux (acidic stomach contents flow back into the oesophagus). The teeth are also damaged by stomach acid.
• Laxatives disrupt the function of the gastrointestinal tract and may lead to a lack of nutrients. The loss of potassium is particularly dangerous. It provokes life-threatening cardiac arrhythmia. Dehydration medication damages the kidneys.
• In addition to the medical aspect, the long-term consequences (e.g. yellow or dead teeth) cause additional psychological and financial burdens.

Treatment of bulimia

In many cases, inpatient treatment in a psychosomatic clinic is advisable. The treatment of bulimia nervosa consists of various components (multimodal treatment):

• The focus is on psychotherapeutic individual and group discussions. Patients are given comprehensive information about their clinical picture (psychoeducation).
• In addition, the aim is to critically question their own expectations and values and build up a positive self-image. Patients learn to recognize their needs and feelings and to deal with them appropriately.
• Nutrition and exercise play an important role in this. For example, cooking groups with communal meals are held. The participants support each other to avoid falling back into old patterns. Specialist staff accompany and support the group during this phase.
• In sports groups, physiotherapists reintroduce patients to moderate and healthy physical exercise.
• Some patients find it helpful to attend a self-help group. There, participants can exchange ideas and support each other. When choosing a group, pay attention to who leads it. Professionals or formerly affected people who are stable are suitable. Otherwise there is a risk that the group will reinforce the illness instead of fighting it.

The success of treatment depends on the severity of the bulimia on the one hand and the extent of any secondary illnesses on the other. Bulimia sufferers usually also suffer from panic disorders, social phobias, depression or addictions.

An important role in whether the patient recovers is the insight into the illness. Those affected must recognize the problem and want to break the vicious circle.

Antidepressants are also used in individual cases. These not only influence the mood, but also alleviate binge eating. In the long term, those affected are able to lead a normal life.

As eating disorders cannot be clearly distinguished from one another, the information on anorexia and eating disorders will also help you.