Identifying Bulimia Nervosa
(Defined as: Binge eating combined with inappropriate ways of stopping weight gain)
Often these people are of normal weight or are marginally overweight. Some may be slightly under weight. Individuals with this eating disorder are probably the most difficult group to identify because of the secretiveness of the binge-purge ritual. Quite often family members or spouses are unaware of the ritual.
If you suffer from bulimia nervosa, or have someone in your family who does, medical, psychiatric and psychological professionals would use the following diagnostic criteria to classify the problem. Please remember that the diagnostic category or label is a communication tool used by professionals. Some people internalise labels and then live up to them. Use the following criteria as a guideline to understand the problem rather than to label someone. If you or someone you know seems to manifest with the following symptoms, try and encourage him/her to seek professional help. Please remember never to diagnose yourself or someone else! Always speak to a professional specialised in diagnosing and working with eating disorders.
1. There is recurrent binge eating:
This consists of an excessive intake of food within a particular time frame. The binge is totally excessive. For normal people a binge might be a slab of chocolate or a whole big pizza. The severe bingers start off by colour coding the food with, for example, green cool drink so that they know when they have cleared out all the food, followed by a whole cream cake, a loaf of bread, 2 litres of coke. In worst-case scenarios, frozen food may be consumed and if there is no more food in the house, they may resort to rummaging through the rubbish bin. Many movies have recently been made which show how extreme this behaviour can become.
There is a sense of lack of control over food. Food controls the person not the other way round.
2. Compensatory Behaviour:
i. There could be self-induced vomiting. Often family members are unaware of the behaviour as they become very good at covering their tracks. For some, they no longer need to put a finger down the throat. They can simply flex the stomach muscles, or bend over the toilet. In these cases the body has become conditioned to react in this way.
ii. They may use laxatives excessively. Remember that certain foods also have the same effect as laxatives e.g. high-grained cereals.
iii. They may also use diuretics, medications, enemas and fasting.
iv. Remember that excessive exercise is also a form of purging. This group often goes unnoticed as exercise is highly appraised in our society. If you or someone you know has to spend hours exercising on a daily basis, then warning bells should go off!
3. The behaviour occurs at least once a week for three months.This is the minimum, but I have seen individuals who regurgitate every meal. Numerous professional sports people are seriously bulimic.
4. Self-evaluation is influenced by body shape and weight. There is little connection with a sense of self-worth. If the weight is down, then the person may feel better. If the scale is up, even though the person may have felt better before weighing, the entire mood will be influenced by shape and weight.
If you, or anyone manifests with the above symptoms, please do not delay. Seek help immediately. Bulimia Nervosa is damaging to one’s health!