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What's Eating You?

"Understanding Bulimia"
By: Stef dela Cruz, MDWhat's Eating You?

Have you ever been to an all-you-can-eat restaurant? Because of the way I feel about food, enjoying the buffet is like getting a tiny taste of heaven here on earth - but that isn't always the case with other people, especially those who suffer from bulimia nervosa. To someone with bulimia, indulging one’s palate leads to self-inflicted punishment. A girl with bulimia may prefer to stick her fingers down her throat – sadly, not for the first time – hoping to expel all the delicious food she has previously eaten with gusto minutes ago.

Sadly, according to Dr. James Hudson and colleagues in a 2007 article published in Biological Psychiatry, bulimia nervosa is more common than we think. About one in every hundred teens has this disorder, consuming the victim while she consumes food the way she does.

Spotting bulimia: What to look for

Someone close to you may be suffering from bulimia nervosa and you just don’t know it. If you could spot the signs, you can reach out to them so that they don’t have to suffer in silence anymore. Here are a few things you should know.

  • Someone with bulimia has recurrent episodes of binge eating. Such an episode, as specified by the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders, is described as eating an amount of food larger than what others would consume in a specific discrete period of time.
  • Someone with bulimia has recurrent and inappropriate compensatory behaviors to prevent weight gain. Because of the binging episodes, someone with bulimia feels it necessary to compensate accordingly – that is, to get rid of the excess calories. Inappropriate compensatory behavior may either be purging or non-purging in nature. Examples of purging methods include laxative abuse, self-induced vomiting, and misuse of diuretics (which leads to temporary loss of “water weight”). Non-purging methods include fasting or exercising in excess.
  • For someone with the disorder, both binging and purging episodes occur at least once a week for three months. 
  • People with bulimia are unfair critics of their own bodies. A female teenager suffering from bulimia may feel that she is overweight. To her, all her curves may look ugly, even if she looks absolutely beautiful and her weight is perfectly normal.
  • There are many tell-tale signs of bulimia.  Based on a person’s weight alone, it may be tricky to tell if someone has bulimia – after all, most people with this eating disorder are of normal weight. There are, however, signs which help confirm the truth:
    • Absence of menses. This occurs quite often – about one out of every two females with bulimia complain of amenorrhea. Others report having irregular menstrual periods.
    • Parotid gland enlargement. These salivary glands are located just in front of each ear, which makes them easy to spot if they’re bigger than normal.
    • Dental caries. Someone who vomits after meals exposes his teeth to stomach acids, which lead to tooth decay.
    • Russell sign. A person with bulimia nervosa may induce vomiting by poking the back of his throat with his fingers.

What isn’t true

Here are some of the falsehoods that still make the rounds today. Learning about them just might help you save someone you love.

Myth #1: Bulimia is not an emergency. Bulimia can be life-threatening. Excessive vomiting, for instance, can lead to potassium depletion, which can affect the normal rhythm of the heart.

Myth #2: Only women suffer from bulimia. Although more women have bulimia, men also get diagnosed with the disease. About one out of every 200 men is diagnosed. There may be more men who actually have it, given how bulimia is believed to be an especially under-recognized disorder. 

Myth #3: Bulimia often goes away on its own. The diagnosis may stay the same over the years, or it may shift to other eating disorders, according to a 2007 article by Dr. Manfred Fichter and Norber Quadflieg published in the International Journal of Eating Disorders.

When people continue to shed light on bulimia, it can no longer stay in dark corners where gossip and humiliation thrive. It becomes what it truly is: a condition that can be treated, one that is suffered by people just like you and me – people who need not only therapy, but also understanding.

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