EATING DISORDERS: BULIMIA NERVOSA

This is a disorder characterized by recurrent (at least twice a week) episodes of binge eating during which the patient consumes large amount of food and feels unable to stop eating, followed by inappropriate compensatory efforts to avoid weight gain, such as self induced vomiting, laxative abuse, vigorous exercise or fasting. It affects primarily young women. Patients, though usually of normal weight, are persistently and overly concerned about shape and weight    http://helpguide.org/mental/eating_disorder_treatment.htm

Symptoms and signs

Most of the physical complications result from purging. Self induced vomiting leads to erosion of dental enamel of the front teeth and to painless salivary gland enlargement. Serious fluid and electrolyte disturbance can occur. Very rarely during binge eating, the stomach ruptures or oesophagus is torn leading to life- threatening complications.

Patients with this disorder tend to be more aware and remorseful or guilty about their behavior than those with anorexia nervosa and are more likely to admit their concerns when questioned. They also appear less introverted and more prone to impulsive behavior, drug and alcohol abuse and depression.

Diagnosis

The disorder may be suspected in a patient who expresses marked concern about weight gain and have wide fluctuations in weight, suspicion is also aroused by swollen parotid glands, scars on kunckles (from induced vomiting) and dental erosion. However diagnosis depends on the patient's description of binge- purge behavior.

Treatment

Two approaches to treatment are psychotherapy and the use of antidepressants. Psychotherapy has long term results. Referral to a specialist is advised because treatment requires expertise and experience.