Bulimia: everything you wanted to know but were afraid to ask. Bulimia, help, what to do with it? According to the mechanism of occurrence

In the 21st century, diseases associated with eating disorders have become more frequent. This is due to factors such as the imposition of social stereotypes, increased stress levels and the spread of fast food.

On screens and magazine covers, certain standards of beauty are promoted that people strive to meet. Sometimes, against the background of constant nervous breakdowns, this becomes an obsession and develops into a real phobia. One such case is bulimia, which, according to statistics, affects about 7% of the population.

The figure is still small, but tends to constantly grow. Many people suffer from it without even realizing it and having no idea what kind of disease it is. Therefore, it is so important to familiarize yourself with the basic information: forewarned is forearmed.

What it is?

While many people have heard about anorexia, information about this disease comes up much less often, although these diseases are similar. According to medical reference books, bulimia is an unhealthy eating behavior that is characterized by bouts of overeating and an obsessive desire to shape up and lose weight, although in most cases it does not exceed the norm.

People suffering from this disorder have very low self-esteem, are mentally unstable and often abuse laxatives to flush out the body again and again, causing diarrhea or vomiting by any means. Such stress leads not only to numerous health problems, but also to alcohol addiction and even suicide.

Today, this disease has overtaken anorexia and compulsive overeating in its prevalence. Many patients do not even realize that they suffer from bulimia. For them, the picture looks like this: they lead a healthy lifestyle (play sports, constantly cleanse the body, go on diets), but at the same time nature has deprived them of ideal body proportions. They are guided not by their BMI, but by the parameters of beauty flashed in the media and their own reflection in the mirror, which they cannot evaluate objectively.

Bulimia is a cyclical disease, since the patient has to move again and again in the same circle, which he is unable to break: an attack of overeating - cleansing the body (through vomiting, enemas or laxatives) - - a new breakdown.

In connection with this situation, psychotherapists and nutritionists today are trying to convey to the masses as much information as possible about bulimia: how to identify it and how to get rid of it. The American National Association of Anorexia Nervosa and Related Disorders (ANAD) called it a fatal mental health condition.

Etymology. The term "bulimia" comes from two Greek words: "βοῦς" means "bull" and "λῑμός" means "hunger."

Causes

In each individual case, the reasons may be different. Their identification and elimination is the main task of therapy for this disease. Without getting rid of the provoking factor, it is impossible to cure the patient. All of them are divided into 3 large groups.

Organic:

• impaired metabolism;
• metabolic syndrome;
• diabetes mellitus, insulin resistance;
• lesions (toxic, tumor) of the brain in the hypothalamus;
• hypothalamic-pituitary insufficiency (hormonal disorder);
• genetics, heredity;
• lack of nutrients as a result of constant hunger strikes.

Social:

• the desire to meet the standards of beauty imposed by society;
• internal complexes originating from childhood and adolescence (bullying by classmates and relatives about excess weight at 10-16 years old);
• constant comparison of oneself with someone from the environment, unhealthy competition with a thin and slender friend (colleague, neighbor...);
• dependence on social networks, in which acquaintances constantly publish pictures with flat tummies, wasp waists and inflated butts;
• careless and tactless remarks, jokes, comments from acquaintances, parents, coaches, friends about their figure or weight.

Psychogenic:

• psychological trauma received in childhood, and these include not only obesity in adolescence, due to which relationships with peers did not develop, but also the starvation of a newborn, and a lack of parental love;
• constant nervous breakdowns;
• depression;
• prolonged depression;
• low self-esteem associated with appearance flaws;
• inferiority complex;
• negative attitude towards life;
• high anxiety.

Moreover, attacks of overeating can be triggered by both negative stress (due to the loss of a loved one, divorce, failures at work) and positive stress (a new romance, a promotion at work). In the first case, food becomes the only pleasure that helps to calm down. In the second, it acts as a reward for merit.

Most often, a person suffering from bulimia is not able to independently understand the true cause of bouts of overeating. But finding the trigger is important so you can take the appropriate steps to curb your appetite.

Other names. Bulimia is also called ravenous disorder or kinorexia.

Kinds

There are several classifications.

Clinical and pathogenetic approach

1. Bulimia nervosa - develops against the background of mental disorders when comparing oneself with others.
2. Hereditary.
3. Depressive - begins after serious stress or psychological trauma.
4. Emotional - bouts of overeating for a person are a method of emotional release; such patients are characterized by irritability, short temper and sudden mood swings.
5. Dietary - develops against the background of too long a hunger strike in order to correct the figure.

According to the mechanism of occurrence

1. Reactive - the outbreak of the disease occurs at the age of 20-25, the provoking factor is unbearable psychological stress, the main manifestation is a constant struggle between the desire to eat tasty and a lot and the need to limit and control food.
2. Autochthonous - begins in adolescence, characterized by frequent attacks, uncontrollable cravings for tasty and forbidden foods, lack of understanding of the presence of the disease, and lack of a feeling of satiety.

Structural and psychopathological analysis of attacks

1. Obsessive - the patient constantly struggles with himself, with his own attacks, often he manages to control overeating for weeks and even months, but then a powerful breakdown occurs, and he cannot stop, absorbing food in exorbitant quantities.
2. Dysthymic - the patient is emotionally worried that he is drawn to food, but is unable to fight the attacks, so they happen almost every day.
3. Impulsive - a person does not understand what is happening to him, so he does not particularly worry about the attacks, although internal complexes about the imperfection of his own figure are present.

By weight loss method

1. Medicinal - uncontrolled use and.
2. Emetic - artificially inducing vomiting several times a day.
3. Sports - grueling workouts.

Classifications of bulimia are used in medical practice to clarify the diagnosis, identify the main causes and prescribe optimal treatment.

Statistics. 10% of those suffering from bulimia are men. 10% of teenage girls aged 12 to 16 years are diagnosed with this condition. In 10% of cases, the disease ends in death due to cardiac arrest, exhaustion or suicide.

Clinical picture

Main signs of bulimia:

• overeating, when a person cannot control the amount of food eaten and it exceeds the daily norm;
• constant use of various methods of combating excess weight: cleansing the body through emetics and laxatives, hunger strikes, grueling training programs;
• excessive dependence of self-esteem and mood on body weight and body shape parameters.

Bulimia often develops against the background of mental disorders, diseases of the central nervous system and endocrine system. It manifests itself differently in each individual person:

• self-harm, when a person suffers from the fact that his body does not meet the standards of beauty imposed by society;
• appetite, which leads to the absorption of large amounts of food, can be sudden (most often this happens at night) and constant (a person always chews something without stopping);
• attacks are accompanied by severe weakness, painful hunger, dizziness and pain in the stomach.

Some symptoms are simultaneously a consequence of the measures taken by the patient and his lifestyle. They relate to his mental and physical health:

• prostration;
• predisposition to ENT pathologies;
• disruption of the menstrual cycle up to amenorrhea;
• fluctuations in weight;
• metabolic disorders;
• gastrointestinal pathologies;
• depression;
• self-hatred, constant feelings of guilt for bouts of overeating;
• painful need for approval from other people;
• muscle pain;
• dental problems;
• too frequent conversations about diets, models, nutrition, weight;
• bowel disorders caused by overeating;
• dry skin, poor condition of nails and hair.

At the same time, the majority have a normal weight, i.e. the idea of ​​extra pounds is invented, obsessive, and does not correspond to reality.

Since bulimia is a mental disorder, a person cannot objectively assess either his own behavior or the parameters of his body. It seems to him that he is doing everything right (fasting, exercising, cleansing the body), but he is so imperfect that even this does not lead to the desired result (sizes 90/60/90, six-pack abs, wasp waist, etc.). ). This provokes constant bouts of irritability, and internal complexes quickly develop into real self-hatred.

On a note. The age peaks at which outbreaks of the disease occur are adolescence (13-16 years old) and young girls (22-25 years old).

Diagnostics

The disease is not diagnosed by conventional tests, as it belongs to the category of psychological disorders. There is a test for bulimia - this is EAT-26: it stands for Eating Attitudes Test. It was developed in 1979 in Toronto at the Clark Institute of Psychiatry. Other similar tests have already been released based on it. They can be found on the Internet and completed online, but interpretation of the results and the final diagnosis should be carried out exclusively by a doctor.

If you suspect bulimia, you should consult a psychotherapist. To confirm the diagnosis, consultations with a gastroenterologist, therapist and nutritionist are also required. To identify concomitant diseases, traditional tests are taken: blood, urine, ECG, ultrasound of internal organs that may have been damaged.

For comparison. Many experts believe that bulimia is akin to drug addiction, only food acts as a drug. The signs of addiction are obvious: the patient cannot independently break out of the cyclical circle. Over time, the feeling of fullness is lost, so you have to increase portions and the number of meals.

Treatment

For treatment to be effective, a comprehensive examination of the body is carried out and opinions from various specialists are collected. But the main course of therapy will be led by a psychotherapist.

Medication

Bulimia can be treated with medication - in some cases, antidepressants are prescribed. They are effective if:

• obvious depressive disorder;
• neuroses;
• obsessive-compulsive disorder.

In the course of ongoing research, the effectiveness of the following antidepressants has been scientifically proven:

• selective inhibitors: Fluoxetine, Sertraline, Paroxetine, Citalapram, Escitalopram;
• tricyclic: Amitriptyline, Imipramine, Clomipramine, Maprotiline, Mianserin, Trazodone;
• monoamine oxidases: Moclobenide, Pirlindol.

Most often other drugs are prescribed (tablets), since tricyclic drugs, for example, in 30% of cases cause multiple side effects, due to which therapy is forced to be interrupted.

It is believed that treatment of bulimia with antidepressants alone is not effective, since it only eliminates mental disorders against which the underlying disease develops. Therefore, they are most often prescribed in conjunction with cognitive behavioral therapy.

Cognitive behavioral therapy

To cure bulimia, you need to seek help from a psychotherapist or psychiatrist. Hospitalization is required only in the most extreme cases, so most often patients are seen by a doctor on an outpatient basis. The most effective treatment method is CBT, cognitive behavioral therapy. It includes the following work with patients.

1. The goal is to teach the patient to control his diet.
2. Tools to achieve this goal: Patients record how much they eat at each meal, and then try to identify factors that provoke binges.
3. Work to eliminate these factors.
4. Reducing food restrictions: instilling proper, healthy eating habits.
5. Developing skills to cope with seizures.
6. Identifying and changing dysfunctional thoughts and attitudes about body shape and weight.
7. Fighting negative emotions.

How effective CBT is in treating bulimia can be judged by the following facts:

• in 50% - complete relief from the disease;
• 80% - reduction in attacks;
• results can last for a year or more;
• the patient is registered for about 6 years after completing the CBT course, which is an excellent prevention of further development of the disease;
• the frequency of attacks decreases after 3-4 sessions.

Neither antidepressants nor other psychotherapeutic methods have such an effect. The latter include:

• behavioral therapy;
• psychodynamic therapy;
• family psychotherapy;
• analysis of experiences;
• the Twelve Step program (adapted from a system for treating substance use disorders);
• interpersonal therapy (interpersonal) is one of the most promising techniques after CBT, which also gives good results.

The treatment program is drawn up in each individual case individually, as it depends on the presence of mental disorders against which the underlying disease develops.

Additional measures

1. In some cases, diet helps. It is not a panacea and is prescribed purely individually. Most often it concerns a clear schedule of meals and exact portion sizes, as well as the exclusion of fast food and sweets from the diet.
2. Taking multivitamin complexes is only necessary if there is a deficiency of certain microelements and vitamins.
3. Treatment of concomitant diseases.

To cope with bulimia, the patient must learn to accept himself as he is and lead a normal life. Restoring health (both physical and psychological) takes a lot of time, the results manifest themselves gradually, so you need to be patient. The positive attitude of the patient himself and the professionalism of the doctor are the main components of successful therapy.

Folk remedies

Many people are interested in how to get rid of bulimia on their own, without the use of antidepressants and CBT. You can try, but no one can guarantee a complete cure, since it is very difficult to cope with a mental disorder.

First, you need to try:

1. Eat in small portions: organize 5-6 meals a day, portion sizes should be no more than 250-300 g.
2. Get up from the table with a slight feeling of hunger.
3. Drink at least 2 liters of plain water daily.
4. Food should be light, low-fat, low-calorie, so that the stomach digests it quickly.
5. You need to have breakfast before 9 am, lunch - until 14.00, dinner - around 18-19.00.
6. Between main meals you need to have light snacks of fruits, nuts, smoothies, berries, and dairy products.
7. Avoid soda, fast food, sugar, coffee and alcohol.
8. Try to lead a healthy lifestyle.
9. Spend a lot of time outdoors.
10. Get enough sleep (but not oversleep), the optimal amount of time for sleep varies from person to person, but on average it is 7-8 hours.
11. Do not be nervous.
12. Walks must be on foot.
13. Intense sports (gym, swimming, running) are not recommended, as they lead to the burning of a large number of calories, which can lead to increased appetite, exhaustion of the body, and even anorexia.
14. As soon as you feel another attack, drink kefir, green tea or regular water.

The most difficult thing is to choose the right products. Having learned that it is recommended to abandon a certain list, many go to extremes, which entail new breakdowns and attacks. Therefore, if you cannot wake up in the morning without coffee, you do not need to force yourself under any circumstances: you can afford 150 ml of your favorite sugar-free drink once a day. The same goes for chips or a hamburger. Once a week, a small pack or a small portion will not cause serious harm. Make allowances, otherwise the more you limit yourself in food, the more powerful and dangerous the attacks will be later.

Secondly, at home you can try to use folk remedies to dull your appetite.

• Garlic

Chop 3 cloves of garlic, add a glass of warm water, leave for 24 hours, drink a tablespoon daily before bed. Garlic infusion has a beneficial effect on the valve that connects the esophagus and stomach. If you have problems with the gastrointestinal tract, this recipe is contraindicated.

• Linseed oil

Before each meal (both main meals and snacks) drink 20 ml.

• Mint and parsley

An infusion of mint and parsley has a calming effect. They need to be dried, crushed, mixed in equal proportions (a teaspoon each), and poured with a glass of boiling water. Strain after half an hour. Drink as soon as the attack begins. Dulls the feeling of hunger for 2-4 hours.

• Wormwood

Pour 20 grams of dried and crushed herbs with a glass of boiling water, leave for half an hour, strain. Drink a tablespoon 30 minutes before meals three times a day.

• Plum and fig

Take 250 g of plums and figs. The fruits are crushed, mixed and filled with 3 liters of water. Place on fire and boil to 500 ml. Drink half a glass 4 times a day, regardless of meals.

• Celery

Pour 20 g of fresh celery stalks with a glass of boiling water. Keep on fire for 15 minutes, strain. The resulting volume should be drunk 1 day in 3 doses 10 minutes before meals.

• Corn silk

Pour 10 g of corn silk into a glass of boiling water and steam in a water bath for 20 minutes. Take a tablespoon immediately before meals.

• Collection of herbs

Mix 40 g of dried herbs lemon balm, wheatgrass, chamomile, yarrow, dandelion, St. John's wort, horsetail. Pour 500 ml of boiling water. Leave for 2 days. Drink a glass twice a day for a month.

• St. John's wort

Mix 30 g of dried St. John's wort, 10 ml of concentrated lemon juice, 50 ml of cold water, a teaspoon. Whisk thoroughly, drink a tablespoon before meals for a month.

• Lavender baths

Their main function is calming. Add a few drops of lavender essential oil to your bath. Take twice a week before bedtime.

• Motherwort

Pour a tablespoon of dry crushed motherwort into a glass of boiling water. Keep in a water bath for 20 minutes. Strain. Drink 50 ml before meals three times a day.

If you have taken all possible measures to eliminate bouts of overeating, but they return again and again, it is better to begin medication or psychotherapeutic treatment as soon as possible.

Data. People suffering from bulimia have a preference for sweets and starchy foods. Scientifically this is quite understandable. Firstly, such products provide maximum pleasure and contribute to the production of large amounts of endorphins. Secondly, they are high in calories and increase blood sugar levels, which allows you to feel full for at least some time.

Forecasts

Is it possible to completely recover from bulimia? Many sources claim that even after completing a full course of therapy, the disease still returns. Indeed, the risk of such a development is very high for two reasons. Firstly, the main trigger is stressful situations that await a modern person at every turn. Secondly, the disease is a mental disorder, and it is extremely difficult to overcome problems with the central nervous system even with the help of medications.

Here are the forecasts given by experts:

• complete relief is not guaranteed by any method known today;
• the main symptoms and consequences are eliminated by CBT for a sufficiently long period of time, provided that all medical recommendations are followed;
• There are known cases of spontaneous disappearance of signs of bulimia in the absence of treatment after a strong mental shock that was positive in nature, but they are extremely rare;
• attempts at self-medication rarely result in recovery;
• in the absence of psychotherapeutic and drug treatment, the prognosis is extremely unfavorable - complications begin to develop, the risk of death due to heart failure, gastrointestinal bleeding, and suicide is high;
• With the support of relatives and immediate circles, the chances of recovery increase.

An unfavorable prognosis occurs if the patient does not realize the presence of a problem for a very long time and refuses treatment.

Complications

Unfortunately, most patients have no idea how dangerous bulimia is. In the absence of proper treatment, the consequences for the body can become irreversible and lead to death. The most common complications are:

• neurasthenia;
• various forms of addiction: drug, alcohol, drugs;
• suicide;
• acute heart failure;
• antisocial behavior, isolation, cessation of communication up to autism;
• irritation of the pharynx and esophageal mucosa (due to constantly induced vomiting);
• violation of water-salt balance;
• proctological disorders due to frequent use of enemas;
• severe dehydration;
• caries, bleeding gums due to repeated vomiting (stomach acid destroys tooth enamel and irritates the oral mucosa);
• inflammation of the esophagus;
• electrolyte imbalance leads to muscle cramps;
• intestinal disorders;
• disorders of the liver and kidneys;
• internal bleeding;
• amenorrhea;
• heart diseases.

Such serious and severe consequences of bulimia once again indicate that it poses a danger to human life and health and requires timely medical attention.

Prevention

Prevention is necessary if such a diagnosis has already been made in the past, after just completing a course of CBT, or if one of your relatives has similar diseases. It is aimed at acquiring and consolidating normal eating habits and maintaining psychological health. What measures need to be taken for this?

1. Avoid any stressful situations if possible.
2. Find something not related to food that will give you pleasure: hobby, work, family, etc.
3. Do not abuse medications.
4. Strengthen your character.
5. Take multivitamins twice a year.
6. If you have low self-esteem, sign up for training.
7. Don't close yourself off, expand your social circle.

A very big responsibility in preventing bulimia falls on the shoulders of parents. The risk of its development may depend on their upbringing in the future. To protect your child from this problem in the future, you must:

• maintain a comfortable psychological microclimate in the family;
• to form correct self-esteem in the child;
• do not use food in educational measures: you cannot use it as a reward or punishment;
• instill in the child the correct attitude towards food as a normal physiological need, and not as a way of obtaining emotional and physical pleasure;
• form correct eating habits: eat according to a schedule, eliminate (or minimize) harmful foods.

The support of loved ones and family plays a huge role. Their help is a guarantee that a person will never encounter this disease, and if this happens, it will be much easier to recover.

Helpful information

Bulimia is a disease that is not yet so widespread, but doctors are sounding the alarm. It is expected that the number of people suffering from it will increase several times every year. Massive use of the Internet, which describes all kinds of diets and methods of cleansing the body, leads people (most often young and inexperienced girls) to a stressful state when they want to achieve an ideal figure by any means, even to the detriment of their own health.

Not everyone rushes to see a doctor with this disease, even if they suspect they have it. A block of useful information will help dispel some of your doubts.

What films can you watch about bulimia?

1. Starving.
2. Maledimiele.
3. Sharing the Secret.
4. Kate's Secret.
5. When friendship kills.

How does bulimia affect pregnancy?

It is important to prevent bulimia and pregnancy from occurring at the same time. The disease depletes the strength and resources of the mother's body, and this is fraught with numerous complications in the development of the fetus and further labor. In most cases, this results in a caesarean section, miscarriage or stillbirth. Children born to mothers suffering from severe bulimia turn out to be weak and are often diagnosed with:

• developmental delay;
• low blood sugar;
• increased red blood cell count;
• weakened immune system;

As practice shows, in the future the risk of cardiovascular diseases, type II diabetes, and hypertension increases in such children. Considering the seriousness of the situation, when diagnosing bulimia in a pregnant woman, timely and comprehensive assistance from doctors of various specialties is necessary. The chances of a successful birth of a healthy child in this case increase several times.

How is bulimia different from anorexia?

Which famous people suffered from bulimia?

Princess Diana fell ill when she found out about her husband's infidelity and fell into depression. The treatment took 10 years.

Elvis Presley became the saddest and most famous example of a fatal outcome due to bulimia, which the singer constantly aggravated by drug use.

Diane Keaton (actress) - fell ill after losing weight for one of her roles.

Jane Fonda is an actress who was one of the first to admit that she had been treated for an illness for almost 30 years. She even founded a foundation to help women with this diagnosis.

Lindsay Lohan also made an official admission that she had been suffering from the disease for several years.

Nicole Scherzinger hid her illness for a long time not only from the public and doctors, but even from her family and friends.

Famous in the 70s. the last century fashion model Twiggy was very fashionable, as she resembled a reed girl, but after another attack of overeating, her heart failed, she was in a state of clinical death, but they managed to save her.

Elton John struggled not only with drug addiction and prolonged depression, but also with bulimia.

Kate Moss used to starve constantly in order to have a flat, almost child-like figure. But once she started eating, she often couldn’t stop. She underwent long courses of treatment in many prestigious clinics around the world.

Nicole Kidman suffers from a very serious illness - anorexia nervosa combined with bulimic attacks.

Bulimia is a very serious and dangerous disease, often leading to death. Most people are not even aware that they suffer from this disease. Therefore, you need to carefully monitor your eating habits and any changes in weight. As soon as any doubts arise, it is better to seek medical help so that it does not lead to complications and hospitalization.

This article is a short encyclopedia of bulimia from Svetlana Bronnikova. Symptoms, course, consequences of the disorder, and most importantly - specific advice on what to do to get out of all this.

Katya's story

Katya is 27 years old. Katya starts every morning with black coffee, an egg and a cucumber. No bread. She is a successful PR specialist, passionate about her work... and “You understand, we work with celebrities, it is very important to look good.” Katya easily lights up, takes on new things with pleasure, and understands nutrition no worse than a professional nutritionist.

She professes a healthy lifestyle and proper nutrition: she drinks two liters of water a day, gets on a treadmill three times a week. At lunch, Katya also tries to eat right - steamed fish, salad, no, no, no dessert!

The hardest part begins at about 4 o'clock, when the strength is already running out, but the end of the working day is still far away. Katya decides to treat herself to a cup of coffee and candy. She doesn’t always manage to resist - sometimes, while drinking a cup of coffee, she starts eating one candy after another and can’t stop... A day that started correctly and well is hopelessly ruined.

Then, on the way home, she stops at ABC of Taste to buy croissants, marmalade, cake or pastries and another liter package of ice cream. When Katya gets home, she eats it all and then vomits in the toilet.

Katya is 27 years old. 6 of them she has bulimia.

Sometimes attacks do not start with candy at work, but as if on their own. A hard day, an unpleasant conversation with your boss, a feeling of dissatisfaction with what you have done. Risky moments include buying clothes (just look at yourself in the fitting room mirror and discover that size 27 jeans are too small) and your mother coming to visit you from out of town. Mom’s caustic comments that Katya is still not married, doesn’t look very athletic, and that at her age, with such education and a good job, she could already take out a mortgage for an apartment, lead to despair.

Sometimes Katya gets tired from bouts of vomiting, and then she runs kilometers on the elliptical until she's stupefied, and sometimes she goes down to the pharmacy for a laxative.

Usually Katya doesn't feel like there's anything wrong with her. A good half of the girls in her circle disappear into the toilet after dinner and return with the scent of toothpaste and fresh lipstick. Everyone is on diets and constantly losing weight. This is a healthy lifestyle, isn't it? And only in the evenings, after an attack, does Katya cry because she feels fat and lonely. She feels that something is wrong with her.

Where did bulimia come from?

Bulimia is by no means a product of the new century with its cult of thinness. Attacks of overeating and induced vomiting have been known to mankind since ancient times. For example, doctors in Ancient Egypt recommended fasting and vomiting once a month for three days to maintain good health. It is widely known about the Roman emperors who introduced the fashion of inducing vomiting in order to “free up space” in the stomach to continue the feast.

It is less widely known that the anorexic medieval nuns, who exhausted themselves not in the name of Holy Thinness, but for the glory of our Lord, periodically developed bouts of overeating, attributed, of course, to the machinations of the devil, and some of them induced vomiting in order to “cleanse themselves from sins."

Does this mean that bulimia as an eating disorder has existed since ancient times? No. The most important component is missing: the need to control weight. We can only talk about full-blown bulimia when there is a goal of weight control.

Is bulimia congenital?

About 2% of the population of every developed country suffers from bulimia. To date, it has not been precisely established whether there is a genetic predisposition for the disorder. One thing is clear to scientists: there are hidden mechanisms, most likely innate, that facilitate the search and consolidation of so-called compensatory behavior - this is the name given to inducing vomiting and other measures to get rid of what has been eaten as quickly as possible.

The fact is that inducing vomiting is not so simple and not at all a pleasant experience. Try it and see for yourself. Who among us did not eat something inappropriate as a child? One common recommendation is to drink a lot of water and induce vomiting. So, often this is simply impossible to do - no matter how much we want, we can’t do it. The fact that people with bulimia do this easily and naturally sets them apart from everyone else. The nature of this difference is unknown to us.

We know for sure that social factors - a general belief in the necessity and usefulness of dietary behavior, dietary restrictions, the cult of thinness - provoke the development of bulimia. In so-called primitive cultures there is no bulimia. As you know, the disorder did not exist on the Fiji Islands until the 70s, when the Americans brought television there. After this, the statistics of bulimia quickly approached global levels.

Symptoms of bulimia

In order to be diagnosed with bulimia, a combination of several symptoms is necessary.

Bouts of overeating that is, consuming huge amounts of food in a limited period of time, accompanied by a feeling of loss of control.

Compensatory behavior, that is, any behavior aimed at getting rid of what you have eaten, whether it is inducing vomiting, using laxatives and diuretics, or excessive exercise (there is a term for this “sports bulimia”). Food cannot be a reason for increased physical activity. Even if you overeat and feel like you need to work off what you ate, you have symptoms of bulimia!

Now you understand that many healthy lifestyle apologists, Instagram divas with gym selfies, and even professional fitness trainers are just bulimics.

This is the paradox of modern life. People with eating disorders teach others about healthy lifestyles and nutrition.

Binges of overeating and compensation occur at least once a week within 3 months.

Self-esteem and self-awareness, even a person’s mood depends on size and weight bodies. I weighed myself in the morning - the scale showed a plus - my mood was ruined for the whole day. They told me at work that I’ve lost weight – I’m flying like I’m on wings. If you can’t fit into your new jeans, that’s a tragedy. In an evening dress, folds are visible on the sides - I’m not going to a party.

A person who suffers from bulimia, and this can be both men and women, has initially certain psychological characteristics. These are emotionally mobile, impulsive people who are easily involved in new activities. It is difficult to unequivocally classify them as introverts or extroverts - they are shy, reserved and timid in communication, and at the same time they want to be the center of attention and conquer others. The result of this combination is constant self-doubt.

Consequences

Okay, so what's so scary about that? Well, I ate too much - vomited, worked out or took a laxative, is it really that dangerous?

There is an opinion among people that if anorexia is fraught with serious health consequences, then they don’t die from bulimia - “all girls do it.” In fact, bulimia can be fatal and extremely damaging to your health.

The human body is not designed to spew out what it has just eaten - the bulimic’s body begins to consistently break down from the inside. The teeth suffer because gastric juice enters the mouth along with food. Anemia and tachycardia develop—the body lacks microelements. The endocrine system suffers - bulimics often experience hormonal destabilization and disruption of the thyroid gland. Gastritis and disorders of the gastrointestinal tract are also typical.

How to treat bulimia?

The first case of bulimia was described in 1979 - then the only method used in the treatment of mental disorders was psychoanalysis - and he did not find much success in the treatment of bulimia.

Does this mean that psychoanalysis is ineffective? Of course not. The problem with eating disorders is that they affect both the emotional sphere and behavior. Stabilizing the emotional sphere may reduce the frequency of attacks, but is unlikely to help get rid of them. The fact is that bulimics all come to weight loss offices with the same request: “I’m addicted to food” - although in fact they are addicted to attacks.

An attack is a method of getting rid of negative emotions, calming down, and “rebooting.” Indeed, after such a shocking experience there is simply no resource left for emotions - emotions are turned off. Over time, the connection “attack - pleasant oblivion and relaxation” is formed, and addiction is formed.

More hope for bulimia sufferers came with the advent of CBT - cognitive behavioral therapy. CBT is based on the idea that our behavior is caused by faulty thoughts. If you change the way you think, you will change your behavior. Indeed, bulimics tend to entertain negative, critical thoughts about themselves. CBT is not always effective for bulimia, but it is still one of the evidence-based treatment methods.

Some of the best results in terms of effectiveness in the treatment of bulimia today have DBT - dialectical behavioral therapy. 80% of patients stop having attacks and are kept from them for 2 years. This is the “younger daughter” of CBT, which focuses not on wrong thoughts, but on destructive emotions that a person cannot cope with. Using carefully selected techniques, DBT teaches you to master your emotions, regulate them, understand and analyze them - and change behavior from a more stable and calm state.

It can be difficult to get treatment. Admitting that you have an eating disorder can be very embarrassing.

In fact, bulimia is the same disease as hepatitis A or thyroiditis. It is not your fault that you are sick. Bulimia rarely goes away without treatment - you need professional help.

How to help yourself?

Your enemy is not overeating, but undereating.

Every day you start with a new attempt to eat healthy. Leave these attempts for a while if you want to get rid of attacks. Eat nutritious meals at least 5 times a day until you feel comfortably full.

Remember - there should be no excluded products on your menu! Potatoes, breads and sweets, pasta and bacon should be part of your menu. Satiety and variety of tastes are what will protect you from attacks.

The art of the pause.

Do not set yourself the task of suppressing or preventing an attack. Set yourself the task of “delaying” it. Before you start eating “food for overeating,” take a time—let it be 15 minutes at first—and do something else, and after the time has passed, ask yourself whether the desire is still as strong or if it can already be dealt with. Thus, bring the pause to at least half an hour, adding a minute with each episode.

Escape from the attack.

Bulimia attacks always occur in approximately the same circumstances - most often at home, when no one is home. When you feel an attack coming on, leave the house for a long walk, go shopping, window shop, or walk the dog.

Call a friend.

Agree with a friend that you will call him/her in case of emergency. When you feel that you are being “overwhelmed,” call and ask them to distract you with conversation for as long as possible—or better yet, come and go for a walk with you.

Bulimia is not a harmless side effect of a “healthy lifestyle” or “an easy way to get rid of what you eat.” Bulimia drags on, and now you are flushing large sums of money, health, and free time literally down the toilet. For people with “advanced” forms of bulimia, body weight and slimness cease to be of great importance - since almost the whole life is devoted to servicing attacks. Don’t let it get to this point - seek help on time.

Treatment plan

At IntuEat Intuitive Eating Center, we offer the following treatment plan for people suffering from bulimia:

• Individual nutrition counseling: structuring meals and avoiding diets with the help of program “Down with diet!” — “Traffic rules” .
• Group therapy - training emotional regulation using the DBT method, seizure control training.
• Group Conscious or Intuitive nutrition is a way to bring back the pleasure of food to life and gain self-confidence.

Bulimia (bulimia nervosa) is an eating disorder that is classified as a mental disorder. It manifests itself in attacks of overeating, during which a person absorbs a huge amount of food in 1-2 hours, sometimes up to 2.5 kg. At the same time, he does not feel its taste and does not experience a feeling of satiety. Following such an eating breakdown comes a feeling of remorse, and the bulimic tries to correct the situation. To do this, he induces vomiting, takes laxatives or diuretics, uses enemas, actively plays sports, or adheres to a strict diet. As a result, the body becomes depleted and a whole bunch of diseases develop, which can lead to death.

People find themselves in a vicious circle. Hunger strikes, chronic stress, and overwork place a heavy burden on our shoulders. When the stress becomes unbearable, a nervous breakdown occurs, which causes an attack of overeating. While eating, there is euphoria, a feeling of lightness and release. But after this there is a feeling of guilt, physical discomfort and a panicky fear of gaining weight. This causes a new wave of stress and an attempt to lose weight.

Like most other mental disorders, bulimia is not perceived by people as a serious problem. He does not seek help from a doctor or psychologist. The illusion is created that the attacks can be stopped at any time. Bulimia seems to be a shameful habit that brings a lot of inconvenience. Attacks of overeating and “purging” are carefully hidden, believing that people, even relatives, do not need to know about it.

According to statistics, 10-15% of women aged 15 to 40 years suffer from bulimia. After all, it is the fair sex who are constantly concerned about their appearance and excess weight. This problem is less common among men. They make up only 5% of the total number of bulimics.

Some professions are conducive to the development of bulimia. For example, it is very important for dancers, actors, models and track and field athletes not to be overweight. Therefore, among these people the disease occurs 8-10 times more often than among representatives of other professions.

Interestingly, this problem is most relevant in developed countries such as the USA, Great Britain, and Switzerland. But among people with low incomes, bulimia is rare.

Bulimia, like any other problem, rarely comes alone. It is accompanied by self-destructive sexual behavior, depression, suicide attempts, alcoholism and drug use.

Despite all the efforts of doctors, approximately 50% of patients manage to achieve complete recovery, 30% experience relapses of the disease after a few years, and in 20% of cases treatment does not have an effect. The success of the fight against bulimia largely depends on the willpower and life position of a person.

What shapes our appetite?

Appetite or the desire to eat is an emotion that arises when we feel hungry.

Appetite is a pleasant expectation, anticipation of pleasure from tasty food. Thanks to it, a person develops food-procuring behavior: buy food, cook, set the table, eat. The food center is responsible for this activity. It includes several areas located in the cerebral cortex, hypothalamus, and spinal cord. It contains sensitive cells that respond to the concentration of glucose and hormones of the digestive system in the blood. As soon as their level drops, a feeling of hunger arises, followed by an appetite.

Commands from the food center are transmitted along a chain of nerve cells to the digestive organs and they begin to work actively. Saliva, gastric juice, bile and pancreatic secretions are released. These fluids ensure digestion and good absorption of food. Intestinal peristalsis increases - its muscles contract to ensure the passage of food through the gastrointestinal tract. At this stage, the feeling of hunger intensifies even more.

When food enters the stomach, it irritates special receptors. They transmit this information to the food center and there a feeling of fullness and pleasure from eating arises. We understand that we have eaten enough and it’s time to stop.

If the functioning of the food center is disrupted, bulimia develops. Scientists put forward several hypotheses for the development of the disease:

• Receptors in the food center are too sensitive to low blood sugar levels - appetite appears too early.
• The impulse from the receptors in the stomach does not pass well through the chain of nerve cells due to problems at the point of their connection (synapse) - a feeling of satiety does not occur.
• The various structures of the food center do not work coherently.

There are 2 manifestations of appetite:

1. General appetite– you react positively to any food. It arises from the fact that “hungry” blood, which has few nutrients, washes sensitive nerve cells (receptors) in the brain in the hypothalamus region. Violations of this mechanism lead to the appearance of a form of bulimia, in which a person absorbs everything and has a constant appetite.


2. Selective appetite– you want something specific: sweet, sour, salty. This form is associated with a lack of some nutrients in the body: glucose, mineral salts, vitamins. This form of appetite comes from the cerebral cortex. On its surface there are areas responsible for the formation of eating behavior. A failure in this area causes periodic bouts of overeating certain foods.

Causes of bulimia

Bulimia is a mental illness. Often it is based on psychological trauma, as a result of which the functioning of the food center is disrupted.

1. Psychological trauma in childhood
   • the baby in infancy often experienced hunger;
   • the child did not receive enough parental love and attention in childhood;
   • the teenager does not have good relationships with peers;
   • parents rewarded the child with food for good behavior or excellent grades.
   In such situations, the child formed the concept that the main way to obtain pleasure is food. Eating is safe, pleasant, accessible. But such an attitude violates the basic rule of healthy eating: you need to eat only when you are hungry, otherwise the food center begins to fail.
2. Low self-esteem, which is based on flaws in appearance
   • parents convinced the child that he was too fat and needed to lose weight to become beautiful;
   • criticism from peers or a coach about appearance and excess weight;
   • A teenage girl's realization that her body is not like that of a magazine cover model.
   Many girls overly strive to have a model appearance. They are sure that a thin figure is the key to a successful career and personal life. Therefore, they resort to various methods of losing weight.
   A high risk of developing bulimia is found in suspicious people who try to control all events.
3. Effects of stress and high anxiety

   Bulimia attacks can occur after stressful situations. During this period, a person tries to forget with the help of food, to give himself at least a little pleasure. Often this can be done. After all, after eating, a large amount of glucose enters the brain and the concentration of “pleasure hormones” increases.

   Stress can be negative: loss of a loved one, divorce, illness, failure at work. In this case, food remains the only pleasure that helps to calm down. Sometimes pleasant events can trigger bulimia: a promotion on the career ladder, a new romance. In this case, overeating is a feast of joy, rewarding oneself for one’s merits.

4. Nutrient deficiencies

   Among bulimics there are a lot of women who constantly adhere to a diet. Such a restriction in food leads to the fact that a person cannot think about anything other than food. At a certain point, there is no more strength left to endure. The subconscious mind gains control of the situation and gives permission to eat in reserve. The body seems to understand that soon you will repent, and then hungry times will begin again.

   Episodes of uncontrolled binge eating occur in patients with anorexia. In this case, refusal to eat and aversion to foods is replaced by an attack of bulimia. Thus, the body, bypassing consciousness, tries to replenish the reserves of useful substances that were depleted during the period of hunger strike. Some psychologists believe that bulimia is a mild version of anorexia, when a person cannot completely refuse food.

5. Protection from pleasures

   It happens that a person is not used to giving himself pleasure. He considers himself unworthy of happiness or is convinced that pleasant moments are always followed by retribution. In this case, bulimia attacks play the role of self-punishment after sexual pleasure, relaxation or pleasant shopping.

6. Heredity

   If several generations of one family suffer from bulimia, then they talk about a genetic predisposition to this disease. The reason may be that the tendency to periodically overeat is inherited. It is caused by the peculiarity of the endocrine system and the lack of hormones that control appetite or the increased sensitivity of the receptors of the food center in the hypothalamus.

   In most cases, a person suffering from bulimia cannot realize what is driving him to an attack. If you find this trigger, you can take measures to keep your appetite in check, preventing attacks.

What happens during a bulimia attack

Before an attack, severe hunger or rather a craving for food appears. It happens that a person wants to eat only with his brain, although his stomach is full. This manifests itself in the form of obsessive thoughts about certain dishes, prolonged examination of products in the store, and dreams about food. The person loses the ability to concentrate on school, work or personal life.

Left alone, the patient pounces on food. He eats quickly, not paying attention to the taste of foods, which sometimes do not fit together at all or may be spoiled. Usually preference is given to sweets and other high-calorie foods. Due to the fact that the feeling of fullness disappears, the feast can continue until the food runs out.

After eating, bulimics feel that their stomach is full. It puts pressure on the internal organs, props up the diaphragm, compresses the lungs, preventing breathing. A huge amount of food causes spasms in the intestines, which are accompanied by severe pain. Euphoria is replaced by a feeling of remorse and shame, as well as fear of gaining a little weight.

In order to prevent the calories eaten from being absorbed, there is a desire to induce vomiting. Getting rid of excess food brings physical relief. To lose weight, sometimes a decision is made to take diuretics or laxatives. They remove from the body not only water, which is vital, but also mineral elements.

If at the initial stage bulimics overeat only after stress, then the situation worsens. Attacks become more and more frequent, 2-4 times a day.

Most victims of bulimia suffer greatly, but cannot give up their habit and carefully hide their secret from others.

Symptoms and signs of bulimia

Bulimia is a disease, like alcoholism and drug addiction, and not just bad behavior. It was officially recognized as a disease relatively recently, 20 years ago. The diagnosis of bulimia is made based on a thorough interview. Additional research methods (ultrasound of the abdominal organs, electrocardiography, computed tomography of the head) are necessary if there are disturbances in the functioning of the internal organs. A biochemical blood test allows you to determine whether the water-salt balance is disturbed.

There are 3 clear criteria on which it is based Diagnosis of bulimia.

1. Food cravings that a person cannot control and result in eating large amounts of food in a short period of time. However, he does not control the amount he eats and cannot stop
2. To avoid obesity, a person takes inadequate measures: induces vomiting, takes laxatives, diuretics, or hormones that reduce appetite. This happens about 2 times a week for 3 months.
3. A person develops low body weight.
4. Self-esteem is based on body weight and shape.

Bulimia has many manifestations. They will help determine if you or someone you love is suffering from this disease.
Signs of bulimia:

• Talking about excess weight and healthy eating. Since people's figure becomes the center of self-esteem, all attention is concentrated around this problem. Although bulimics often do not suffer from excess weight.
• Obsessive thoughts about food. A person, as a rule, does not advertise that he likes to eat. On the contrary, he carefully hides this fact and officially adheres to a healthy diet or some newfangled diet.
• Periodic weight fluctuations. Bulimics can gain 5-10 kilograms, and then lose weight quite quickly. These results are not due to the fact that overeating has stopped, but to the fact that measures are being taken to get rid of the calories eaten.
• Lethargy, drowsiness, deterioration of memory and attention, depression. The brain experiences a glucose deficiency, and nerve cells suffer from a lack of nutrients. In addition, worries about excess weight and bouts of overeating place a heavy burden on the psyche.
• Deterioration of the condition of teeth and gums, ulcers in the corners of the mouth. Gastric juice contains hydrochloric acid. During attacks of vomiting, it eats away the mucous membrane of the mouth and ulcers appear on it. Tooth enamel turns yellow and erodes.
• Hoarseness of voice, frequent pharyngitis, sore throats. The vocal cords, pharynx and tonsils become inflamed after injuries that occur during bouts of vomiting.
• Esophageal spasm, heartburn. Frequent vomiting damages the surface layer of the esophagus and impairs the functioning of the muscles that prevent food from rising up from the stomach (sphincters). In this case, the acidic gastric juice burns the inner lining of the esophagus.
• Burst blood vessels in the eyes. Red spots or streaks on the white of the eye under the conjunctiva appear after blood vessels rupture during vomiting, when blood pressure temporarily increases.
• Nausea, constipation or intestinal disorders. These disorders are associated with overeating. Frequent vomiting or taking laxatives disrupts bowel function.
• Inflammation of the parotid salivary gland as a result of frequent vomiting. High blood pressure interferes with the normal outflow of saliva, and stomatitis and other damage to the oral mucosa contribute to the penetration of microbes into the salivary gland.
• Seizures, heart and kidney problems associated with a deficiency of sodium, chlorine, potassium, phosphorus, and calcium salts. They are washed out in the urine when taking diuretics or do not have time to be absorbed due to vomiting and diarrhea, depriving cells of the ability to function normally.
• The skin becomes dry, premature wrinkles appear, and the condition of hair and nails deteriorates. This is due to dehydration and mineral deficiency.
• Menstrual irregularities and decreased libido, erection problems in men. Deterioration of metabolism leads to hormonal disruptions and disruption of the genital organs.

Complications of bulimia can be very dangerous. Victims of the disease die from cardiac arrest in their sleep due to salt imbalance, from stomach contents entering the respiratory system, from rupture of the stomach and esophagus, or from kidney failure. Severe alcohol and drug addiction and severe depression often develop.

Treatment for bulimia

Bulimia is treated by a psychotherapist or psychiatrist. He decides whether it is necessary to go to the hospital or to be treated at home.

Indications for inpatient treatment of bulimia:

• thoughts of suicide;
• severe exhaustion and severe concomitant diseases;
• depression;
• severe dehydration;
• bulimia that cannot be treated at home;
• during pregnancy, when there is a threat to the life of the child.

The best results in the fight against bulimia nervosa are achieved by an integrated approach that combines psychotherapy and drug treatments. In this case, it is possible to restore a person’s mental and physical health within several months.

Treatment with a psychologist

The treatment plan is drawn up individually for each patient. In most cases, it is necessary to undergo 10-20 psychotherapy sessions 1-2 times a week. In severe cases, meetings with a psychotherapist will be necessary several times a week for 6-9 months.

Psychoanalysis of bulimia. The psychoanalyst identifies the reasons that caused the change in eating behavior and helps to understand them. These may be conflicts that occurred in early childhood or contradictions between unconscious attractions and conscious beliefs. The psychologist analyzes dreams, fantasies and associations. Based on this material, he reveals the mechanisms of the disease and gives advice on how to resist attacks.

Cognitive behavioral therapy in the treatment of bulimia it is considered one of the most effective methods. This method helps to change thoughts, behavior and your attitude towards bulimia and everything that happens around you. In classes, a person learns to recognize the approach of an attack and resist obsessive thoughts about food. This method is perfect for anxious and suspicious people for whom bulimia brings constant mental suffering.

Interpersonal psychotherapy. This treatment method is suitable for those people whose bulimia is associated with depression. It is based on identifying hidden problems in communicating with other people. A psychologist will teach you how to get out of conflict situations correctly.

Family therapy Bulimia helps improve family relationships, eliminate conflicts and establish proper communication. For a person suffering from bulimia, the help of loved ones is very important, and any carelessly thrown word can cause a new attack of overeating.

Group therapy bulimia. A specially trained psychotherapist creates a group of people suffering from eating disorders. People share their medical history and experience of dealing with it. This gives a person the opportunity to increase their self-esteem and realize that they are not alone and others also overcome similar difficulties. Group therapy is especially effective at the final stage to prevent recurrent episodes of overeating.

Monitoring food intake. The doctor adjusts the menu so that the person receives all the necessary nutrients. Those foods that the patient previously considered prohibited for himself are introduced in small quantities. This is necessary in order to form the right attitude towards food.

It is recommended to keep a diary. There you need to write down the amount of food eaten and indicate whether there is a desire to sit down again or the urge to vomit. At the same time, it is advised to increase physical activity and engage in play sports, which help to have fun and get rid of depression.

Remote Internet treatment for bulimia. Work with a psychotherapist can take place via Skype or email. In this case, methods of cognitive and behavioral therapy are used.

Treatment of bulimia with medications

Used to treat bulimia antidepressants, which improve the conduction of a signal from one nerve cell to another through special connections (synapses). Remember that these drugs slow down your reaction time, so do not drive and avoid jobs that require high concentration during treatment. Antidepressants do not mix with alcohol and can be very dangerous when taken together with other medications. Therefore, tell your doctor about all the drugs you use.

Selective serotonin reuptake inhibitors

They improve the conduction of nerve impulses from the cerebral cortex to the food center and further to the digestive organs. They relieve symptoms of depression and help to objectively assess your appearance. But the effect of taking these medications occurs after 10-20 days. Do not stop treatment on your own or increase the dose without your doctor's approval.

Prozac . This drug is considered the most effective treatment for bulimia. Take 1 capsule (20 mg) 3 times a day, regardless of meals. The daily dose is 60 mg. The capsule should not be chewed and should not be taken with sufficient water. The duration of the course is determined by the doctor individually.

Fluoxetine . 1 tablet 3 times a day after meals. Minimum course 3-4 weeks.

Tricyclic antidepressants ,

They increase the concentration of adrenaline and serotonin in synapses, improve the transmission of impulses between nerve cells. They have a strong calming effect, help get rid of depression, and reduce bouts of overeating. A lasting effect occurs after 2-4 weeks. Unlike the previous group of drugs, they can cause heart problems.

Amitriptyline . The first days take 1 tablet 3 times a day with meals. Then the dose is doubled, 2 tablets 3 times a day. Duration of treatment is 4 weeks.

Imizin . Begin treatment with 25 mg 3-4 times a day after meals. The dose is increased daily by 25 mg. The doctor sets the daily dose for each patient individually; it can reach 200 mg. Course duration is 4-6 weeks. Then the dose is gradually reduced to the minimum (75 mg) and treatment is continued for another 4 weeks.

Antiemetics (antiemetics) in the treatment of bulimia

At the initial stages of treatment, it is recommended to take antiemetics to quickly suppress the gag reflex while antidepressants have not yet begun to act. Antiemetics disrupt signal transmission from the vomiting center, which is located in the medulla oblongata to the stomach, and block dopamine and serotonin receptors. Thanks to this, it is possible to avoid vomiting, which can be caused by certain types of food in bulimics.

Cerucal . Take half an hour before meals 3-4 times a day. The course of treatment is from 2 weeks. The drug not only reduces nausea, but also normalizes the functioning of the digestive system.

Zofran . Does not have a sedative effect and does not cause drowsiness. Take 1 tablet (8 mg) 2 times a day for 5 days.

Remember, treating bulimia is a long process that requires patience and faith in success. Learn to accept your body as it is and lead an active and fulfilling life. You will achieve the final victory over the disease when you learn to rejoice and get pleasure not only from eating food.

Most girls and women are captive of stereotypes and, in pursuit of an ideal appearance and figure, are constantly trying to change themselves. This struggle does not always end in victory; often the consequence of such a war is; the disease is insidious, which, in turn, leads to irreversible health consequences.

People communicate less and less in reality; communication has been replaced by fashionable gadgets. No one discusses problems in private with each other, no one shares news, but life is “boiling” online. Here people fall in love, meet and even have affairs. People are exchanging real life for a ghostly virtual space.

Julia, 22 years old, says:

“I have few friends, and I don’t meet them often. But online I feel great. I come home from college and start surfing - wandering aimlessly through websites and social network pages. Sometimes I read some materials. I don't communicate much on forums; I mostly read other people's posts. One secret warms my soul: no one knows that I have been suffering from bulimia for 5 years. Do you know what this is? This is when you buy food for a week and eat it all at once. And then you need to vomit the food in order to understand that you have not harmed your body. No, I’m just causing harm, otherwise why in the morning I look like I’ve been drinking water or something stronger all night - my face and eyes are swollen, I’m swelling all over. But my weight is normal.

Only this is not the norm that it was at 15-16 years old, when my weight was ideal. And then, by the age of 17, with a height of 170 centimeters, I began to weigh 65 kilograms and panicked.

Yes, I started eating right, going to the gym, tightening my figure, but then I gave up everything, and the weight began to grow rapidly again.

And then I discovered this wonderful remedy. It’s probably not normal that I drink laxatives and diuretics by the handful, as well as tranquilizers and antidepressants, and sometimes such melancholy attacks me, even if I cry. My teeth are crumbling, colds don’t go away, sometimes I have cramps, but I can’t help it. My main activity is inducing vomiting, and so on from morning to evening.

I promise myself to improve my eating behavior starting tomorrow, but the next day nothing happens. I feel lonely and sad again, and only food becomes a source of pleasure for me, and even communication on the Internet.

I have lost my interests and friends, but I understand that I no longer want to live like this. There is information about bulimia on the Internet, but there is not very much of it. I'm starting to write a blog where I will tell people about how I became bulimic and what consequences it led to. I hope my advice will help someone."

What do you know about bulimia?

Most often, those who want to lose weight by restricting their eating habits suffer from bulimia. Sometimes bulimia is caused by failure, stress, feelings of loneliness and lack of positive emotions.

A person constantly worries due to real or imaginary reasons, and eventually begins to consume food in huge quantities. He swallows it quickly, most often without even chewing it.

Then the patient experiences burning shame, he begins to reproach himself and his body. He is afraid that he will get better, a desire appears at any cost to get rid of the food he has consumed, and he immediately fulfills this desire. The patient induces vomiting artificially, then begins to take laxatives and diuretics. To this, almost all bulimics add increased physical activity.

In this struggle, the body becomes a victim and hostage of the disease. The patient does not realize that the consequences of bulimia can be irreversible - up to the failure of some organs and his death.

Consequences of bulimia:

What happens to the body of a bulimic? The work of all internal organs is disrupted.

Let's name the main health consequences of bulimia.

• 1

  Chronic dehydration (occurs due to constant artificial vomiting and prolonged use of diuretics) leads to an imbalance in water and electrolyte balance. This means that the body experiences a severe deficiency of calcium salts, sodium chlorine, and potassium, which can impair muscle contractility, including the heart muscle. Those who suffer from bulimia, due to disruption of the heart and kidneys, experience numerous edemas. They experience tachycardia, enlarged lymph nodes, shortness of breath and weakness.

• 2

  Metabolism is disrupted, the endocrine system “fails.” Thyroid and parathyroid levels drop while levels of the stress hormone cortisol rise. The production of female hormones also decreases, which can lead to menstrual irregularities in women.

• 3

  The digestive system begins to work incorrectly: gastritis and ulcers of the stomach and duodenum occur. Most of the beneficial enzymes that are necessary for the normal functioning of the body are excreted before they have time to be absorbed. The mucous membrane of the mouth and esophagus is constantly inflamed. The condition of tooth enamel deteriorates, up to complete tooth destruction. Ulcers form in the esophagus, which are difficult to treat and can lead to serious problems, including cancer.

• 4

  The condition of hair and nails deteriorates significantly, hair falls out, thins, becomes dry, brittle and lifeless. Without timely treatment, bone and muscle tissue weakens.

• 5

  The functioning of the nervous and cardiovascular systems is disrupted. Patients constantly feel anxious and cannot sleep. The biological rhythms of the body change.

The head of the Eating Disorders Clinic, Anna Vladimirovna Nazarenko, considers the main cause of bulimia to be breakdowns that result from many years of “dieting.” All women want to be thin and slender, but when a woman constantly limits herself, she craves delicious (and forbidden) food. She begins to eat everything, becomes horrified at what she has done, and begins to vomit this food. This is how the disease mechanism starts.

Bulimics keep their illness a secret...

It is difficult to recognize patients with bulimia: they are no different from those around them, and they keep their disease a secret, and can only tell their closest friend about it (and more often than not, they do not trust this secret to anyone).

Their life becomes a “running in a vicious circle”, where a diet is followed by a breakdown, then a cleansing, and again all over again. After cleansing, the patient immediately begins to feel hungry, which means that the state of “food binge” is close.

Because of this rhythm of life, he constantly experiences remorse, hence melancholy and depression. At the heart of bulimia are hidden deep psychological experiences. Trying to transfer all feelings to food is a unique way to find answers to vital questions, but food will not help you find a way out.

You need to understand that bulimia is not a simple eating disorder. This disease hides a whole complex of problems, and it is impossible to solve them with one effort of will.

How to help with bulimia

If you have discovered this disease in yourself or your loved ones, do not panic, but act. Just don’t sit on the forum for years and read the advice of others.

When you have a toothache, you go to the dentist. Why are you hoping for a miracle for the hundredth time and thinking that tomorrow morning you will wake up and start eating right?

If the problem is serious, and you understand that you cannot cope with it yourself, you should not go into a new “round of weight loss/eating/vomiting/exhausting workouts”, but look for a specialist who will help you cope with the disease.

Specialists at the Anna Nazarenko Eating Disorders Clinic have many years of successful experience in treating bulimia. You can schedule an initial consultation to determine the severity of your bulimia and receive recommendations for further treatment.

Bulimia is an eating disorder caused by factors affecting a person's mental health. Women are more at risk for bulimia than men. The peak age for bulimia attacks in women is between 15 and 35 years of age. The main negative ones are violations of the patient’s physical health and somatic condition.

Symptoms indicating the presence of bulimia

The most noticeable symptoms of bulimia are: eating a lot of food (large portions, a wide variety of dishes), poor chewing of food, fast eating. These signs should alert others; the sooner the disease is detected, the faster and easier the recovery process will be and the less harm the patient will have time to cause to his health.

Characteristic signs of bulimia also include:

• negative attitude towards one's appearance;
• excessive preoccupation with the appearance of one's body;
• frequent and excessive weight fluctuations;
• acute attacks of excessive appetite;
• psychological disorders (depression, insomnia, stress);
• uncontrolled use of diuretics and emetics;
• inability to control your feelings.

Bulimia is characterized by a person’s incorrect attitude towards food intake, namely overeating. During the course of the disease, a person experiences periodic bouts of uncontrollable hunger. It would seem that there could be something wrong with good and nutritious nutrition, but at such moments the patient absorbs an incredibly large amount of food, which leads to disorders of the food system, which manifest themselves in the form of abdominal pain. That is why the patient carries out various, as it seems to him, useful cleansing procedures. This could be induced vomiting, taking diuretics or laxatives, fasting, excessive physical activity, etc.

Types of bulimia

In medical practice, bulimia is divided into two types:

• nervous;
• pubertal.

Bulimia nervosa most often affects patients between 25 and 30 years of age. The causes are psychological disorders of a person. Most often, constant stress, enormous psychological stress, and depression lead to bulimia. A person begins to “eat up” all his failures and dissatisfaction. It is in food that such a person begins to see the opportunity to relieve stress and psychological stress. Food becomes a kind of medicine for all mental suffering and experiences. Quite often the development of bulimia nervosa results from:

• lack of personal life;
• dissatisfaction in personal life;
• dissatisfaction with one's appearance;
• low level of self-esteem.

Bulimia during puberty is common in teenage children. Bulimia in children can also be caused by a lack of love for oneself, one’s body, etc. Against the background of hormonal changes during adolescence, children, especially girls, can be too sensitive and emotional. In order to have what they consider to be a beautiful appearance, many resort to various eating disorders. Teenage bulimia is characterized by alternating periods of prolonged fasting with uncontrolled overeating.

The insidiousness of bulimia

Such an insidious disease as bulimia can manifest itself in completely different ways. The nature of the symptoms of bulimia depends, as a rule, on the factors that influenced the development of the disease. Sometimes bulimia manifests itself in attacks; the patient may feel an uncontrollable feeling of hunger one or several times a week, and the rest of the time have a normal healthy diet. There are cases when the patient feels hungry constantly and needs to constantly eat food. During the course of the disease, the patient ceases to enjoy food and is practically unable to enjoy its taste and smell. At the same time, he actively develops a gnawing state of guilt for the fact that he cannot stop and stop eating food in large quantities.

Ways to combat bulimia

Many people who experience symptoms of the disease want to know how to deal with bulimia on their own. Of course, without the desire of the person himself, it will be extremely difficult to overcome the disease. Therefore, if you discover symptoms of bulimia in yourself or your relatives, the first thing you need to do is consult a doctor.

When you see a doctor, you should honestly talk about what kind of life you lead, how often you are haunted by hunger, what and in what quantities you eat. First of all, the doctor will look for and establish the root cause of the disease. After identifying the main cause of the disease, the doctor will determine methods and methods of treating bulimia.

Having studied the patient's bulimia symptoms in detail, the doctor may prescribe additional examination. Based on the results of laboratory tests, it will be clear whether the patient requires hospitalization or not. If the patient's health condition is not satisfactory, he will be offered inpatient treatment. Inpatient treatment for bulimia includes:

• a course of treatment of organs that have suffered as a result of malnutrition;
• diet therapy;
• psychotherapy;
• taking vitamin supplements;
• taking antidepressants;
• physiotherapeutic procedures.

How to get rid of bulimia on your own?!

It would be more correct to reformulate this question as follows: How to prevent yourself from developing a mental disorder in the form of bulimia? Because it is almost impossible to get rid of bulimia on your own. Not everyone who suffers from this insidious disease can honestly admit that he is sick, which means that a person will not be able to get rid of the disease without outside help.

So, in order to avoid becoming a victim of bulimia, you should:

• lead a healthy lifestyle;
• love yourself and your body as it is;
• do not seek solace in tasty food (sweet, salty);
• do not abuse alcohol;
• in cases of severe stress or depression, seek help from a psychotherapist;
• do not abuse drugs for weight loss;
• Do not use diuretics and laxatives without a doctor’s prescription.

The very first step to recovery from bulimia is the patient's recognition of the symptoms of bulimia. As soon as the patient understands that he is sick and has real problems associated with his relationship to food, immediate treatment should begin.

Successful recovery may take a considerable amount of time. The recovery process can take many months or even years. Of course, the main key to recovery is a stabilized psycho-emotional state of the patient.

A patient suffering from bulimia at certain stages of recovery may feel that he is already healthy or, conversely, that recovery will never occur. But this is not so; if you have a strong desire, you can defeat the disease and prevent relapses in the future. And the most important thing we must never forget is that life and health are worth fighting for.