Bulimia
DEFINITION
Bulimia is an eating disorder where excessive eating or
bingeing is followed by induced vomiting or purging with laxatives.
Due to their obsession with food, people with Bulimia tend not to
lose a lot of weight and may be prone to depression.
bingeing is followed by induced vomiting or purging with laxatives.
Due to their obsession with food, people with Bulimia tend not to
lose a lot of weight and may be prone to depression.
DESCRIPTION
Like people suffering from anorexia nervosa, people with
Bulimia have a distorted body image. They may suffer from a high or
unrealistic expectation of how they should look. The disease may
also be associated with past medical illnesses, and a mother’s
over-concern with eating and weight control. Bulimics may have a
history of being overweight and past history of emotional
problems.
Bulimia have a distorted body image. They may suffer from a high or
unrealistic expectation of how they should look. The disease may
also be associated with past medical illnesses, and a mother’s
over-concern with eating and weight control. Bulimics may have a
history of being overweight and past history of emotional
problems.
Binge eaters tend to consume large quantities of food at night.
Often they will awake from sleep and start eating. The habit of
eating at night is more associated with an eating disorder rather
than being overweight.
Often they will awake from sleep and start eating. The habit of
eating at night is more associated with an eating disorder rather
than being overweight.
Bulimics tend to binge on carbohydrate foods. Carbohydrates
increase the levels of brain serotonin which is a chemical that
increases the feeling of satisfaction and fullness after a meal.
Research is demonstrating that there may be a problem with
serotonin metabolism in Bulimic people.
increase the levels of brain serotonin which is a chemical that
increases the feeling of satisfaction and fullness after a meal.
Research is demonstrating that there may be a problem with
serotonin metabolism in Bulimic people.
Bulimic and anorexic women are unlikely to reach the normal bone
density and may possibly develop osteoporosis later in life.
Frequent vomiting can lead to an erosion of tooth enamel and gum
problems. Other side effects of this eating disorder are reduced
digestive function, infertility, amenorrhoea (lack of menstrual
periods) and irregular heart beats.
density and may possibly develop osteoporosis later in life.
Frequent vomiting can lead to an erosion of tooth enamel and gum
problems. Other side effects of this eating disorder are reduced
digestive function, infertility, amenorrhoea (lack of menstrual
periods) and irregular heart beats.
Childhood sexual abuse is found to have occurred to a substantial
minority of women with Bulimia. Some Bulimics may also suffer
alcohol and drug dependence, conduct and behavioural disorders and
avoidant personality disorders.
minority of women with Bulimia. Some Bulimics may also suffer
alcohol and drug dependence, conduct and behavioural disorders and
avoidant personality disorders.
TREATMENT OPTIONS
This patient must be under the care of a Doctor at all times.
The patient needs careful monitoring and care. Psychotherapy may be
needed to help control the ailment. The initial step may have to
include hospitalisation. As Bulimics may make themselves vomit
after eating, it is IMPORTANT to closely monitor their actions. The
patients are encouraged to put on bodyweight and gain confidence in
their body shape. Assessment should include an evaluation of the
quality of interpersonal relationships and family
environment.
The patient needs careful monitoring and care. Psychotherapy may be
needed to help control the ailment. The initial step may have to
include hospitalisation. As Bulimics may make themselves vomit
after eating, it is IMPORTANT to closely monitor their actions. The
patients are encouraged to put on bodyweight and gain confidence in
their body shape. Assessment should include an evaluation of the
quality of interpersonal relationships and family
environment.
DIET HINTS
This ailment is very difficult to treat with a simple “diet”
as the patient is usually resistant to suggestions to eat and has
already developed severe food restrictions. Sometimes he/she
pretends to have an appetite and eats a large meal only to disgorge
it as soon as possible by induced vomiting.
as the patient is usually resistant to suggestions to eat and has
already developed severe food restrictions. Sometimes he/she
pretends to have an appetite and eats a large meal only to disgorge
it as soon as possible by induced vomiting.
One suggestion is to encourage the Bulimic to eat with other
members of the family. Encourage nutritious snacks between meals
and concentrate initially on a good amount of foods she/he feels
comfortable eating. Avoid eating rich or sugary foods that may
encourage binge eating.
members of the family. Encourage nutritious snacks between meals
and concentrate initially on a good amount of foods she/he feels
comfortable eating. Avoid eating rich or sugary foods that may
encourage binge eating.
Encourage the use of normal foods, rather than “diet” foods or
low fat foods. Ensure some protein is eaten daily and if possible,
include oysters and red meat for zinc. Present the food in an
appetising way. Protein supplements contain all the essential amino
acids and are easy to digest.
low fat foods. Ensure some protein is eaten daily and if possible,
include oysters and red meat for zinc. Present the food in an
appetising way. Protein supplements contain all the essential amino
acids and are easy to digest.
VITAMINS/MINERALS/HERBS
Nutritional supplements are only to be taken if the dietary
vitamin intake is inadequate.
vitamin intake is inadequate.
- A Multi-vitamin/mineral is recommended to replace some of the
nutrients lost through vomiting. A liquid form is recommended to
aid absorption. - Supplementation with zinc may help to resume normal eating
patterns, as zinc deficiency can lead to a reduction in the sense
of smell and taste. - Calcium helps to improve bone density. Studies show
osteoporosis is a common complication in people with Bulimia. - The amino acid Glutamine helps thicken and regenerate the
lining of the gut which may be damaged in people with Bulimia. - Slippery elm (Ulmus fulva) is a herb which when ingested helps
to protect and reduce inflammation in the lining of the digestive
tract. - Chamomile (Matricaria chamomilla) and Passionflower (Passiflora
incarnata) are herbs with calming properties which may help to
reduce anxiety commonly associated with Bulimia. - St. John’s Wort (Hypericum perforatum) is a herb proven to be
effective in mild to moderately severe depressed outpatients. St
John’s Wort should not be taken in conjunction with certain types
of prescription medication. Check with your Doctor. - Isotonic drinks – these drinks (in powder or pre-prepared form)
help to reduce the risk of an electrolyte imbalance developing as a
result of dehydration from repeated vomiting or laxative
abuse.
PHARMACIST’S ADVICE
Ask your Pharmacist for advice.
- Follow the Diet Hints.
- Do not eat junk food, sugar and refined carbohydrates as these
foods are harder to digest and do not provide the necessary
nutrients for good health. - Do not drink any caffeine drinks. They include tea, coffee and
cola. Caffeine increases nervous tension and can suppress
appetite. - The practise of vomiting after a meal is NEVER encouraged. This
Practise can lead to tooth decay due to the acidity of the contents
of the stomach during vomiting. Rinsing with bicarbonate of soda
and water or another alkalising agent after vomiting can help to
alkalise the mouth. - Moderate any alcohol consumption as this puts extra strain on
the liver. Alcohol dependence has been associated with some eating
disorders. - Diuretic abuse may lead to low levels of sodium, potassium, and
magnesium along with elevated levels of uric acid and calcium.
Daily potassium and magnesium supplements and regular monitoring of
serum electrolyte levels in a person who cannot stop purging may be
considered. - Have adequate rest and relaxation and try to avoid unnecessary
stress. There is a notable interaction between anxiety disorders
and eating disorders. - If the diet is considered inadequate, include vitamin C, B
Group vitamins, and zinc to enhance the immune system of the body.
Zinc deficiency can lead to a reduction in the sense of smell and
taste. Tryptophan is a precursor of serotonin and can be prescribed
by your Doctor. Together with vitamin B6 it is effective in
improving mood and eating behaviours. Tryptophan is found in soy
beans, cottage cheese, fish, beef, lentils, pumpkin seeds and
sesame seeds.
