Bulimia is also excellent. What causes bulimia: symptoms, treatment and consequences of the disease

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.

Bulimia is primarily a disorder eating behavior, which, like anorexia nervosa, is a psychological disorder and can cause serious consequences.

If with anorexia people prefer to simply starve, then with bulimia patients eat without control, after which they try various methods to pull the food back out.

People suffering from bulimia are more likely than others to consume various weight loss products:

• diet pills;
• diuretics;
• laxatives.

By using induced vomiting(and other techniques for emptying the digestive tract of food) bulimics (people suffering from bulimia) “solve” 2 problems for themselves:

• prevention ;
• relief of depression.

The most common people to suffer from bulimia are young women(as well as anorexia). But due to the fact that the process of uncontrolled eating and emptying the digestive tract occurs in secret, researchers are not entirely clear about the exact figures for the spread of this disease among the population.

But still, there is some evidence that about 20% of girls already at school or college show early signs of bulimia. Most often, the disease begins at 18 years of age.

The health status of bulimics depends on the frequency bouts of uncontrolled eating and induced vomiting. Attacks can be random (once a month) or very frequent (up to several times a day!).

Symptoms of bulimia

Main symptoms

The main signs of bulimia are:

• repetitive episodes of uncontrolled eating followed by emptying of the digestive tract;
• unreasonable fear of obesity;
• digestive system disorders;
• disorders of teeth and gums due to frequent induction of vomiting due to acidic stomach contents entering the mouth:
  • changes in tooth color;
  • caries;
  • gum infections;
  • erosion of tooth enamel.
• abuse of laxatives;
• uncontrollable appetite for certain foods;
• large weight fluctuations.

Anorexia (starvation)

Even though bulimia is considered an independent disorder, some people experience it may be accompanied by anorexia. For example, due to psychological problems, the patient, after consuming food in secret, artificially empties the food system (vomiting, laxatives), and in some periods does not eat anything at all (artificial hunger).

About 20% of bulimics often go on a hunger strike with their body, preparing for the next uncontrolled meal. In other words, I won't eat today so I can eat more tomorrow.

During the fasting period, women can resort to special appetite suppressant pills.

Even though bulimia and anorexia occur in some patients, the two diseases are very clearly distinct from each other. Patients with anorexia suppress all their desires (even sexual ones), but bulimics tend to satisfy their desires.

Physical signs of illness

The most common physical signs of bulimia are:

• gum problems and, due to frequent induced vomiting, during which very strong acids enter the mouth from the stomach, which destroy teeth;
• an increase in the volume of the salivary glands;
• inflammation of the esophagus;
• congestion of the stomach and pancreas.

The following behavior can often be found in bulimics:

• drug problems;
• uncontrolled purchases;
• shoplifting;
• promiscuous sexual relations.

Severe forms of the disorder

Frequent induced vomiting “takes away” the necessary water and amount of potassium for the normal functioning of the body. As a result, the following violations occur:

• muscle spasms;
• heart problems;
• paralysis.

In severe cases of the disease, the consequences can be fatal. Bulimia is often accompanied by depression, which creates additional risks for the patient (self-harm).

Even if family members or friends discover a bulimic, their advice usually does not help and can even be harmful. Bulimia is treated by specialized doctors!

When should you see a doctor?

• If you avoid sharing food with other people;
• if you consume food in secret, then take laxatives or artificially induce vomiting;
• if your child avoids eating with others and runs to the toilet every time after eating;
• if your child afraid of obesity, and also thinks that he is overweight, when in reality he is not.

Causes of bulimia

The most common cause of bulimia is problems and conflicts within the family.

Bulimic women (or girls) want to be idealists, and their behavior is due to the fact that, in their opinion, they do not rise to the level of expectations of their relatives (parents).

Because of this, they lack self-confidence and often become depressed.

In some cases, bulimia in women is consequence of physical or sexual violence in childhood.

Treatment for bulimia

There are 3 types of therapy available to treat bulimia:

• psychotherapy;
• antidepressants;
• nutritional counseling.

For this you need not a simple psychologist or psychiatrist, but a psychologist (psychiatrist) who understands mental eating disorders.

Of course, first you can consult a doctor and he will refer (if he considers it necessary) the patient to the right psychiatrist.

As a rule, bulimia is treated under the supervision of psychotherapists, psychiatrists and nutritionists, so a whole science is needed here!

Psychotherapy

Psychological treatment of the patient can be carried out in 3 ways:

• individually;
• in the family;
• group therapy.

The patient is also prescribed behavioral and cognitive therapy.

Behavioral therapy

The main goal of behavior therapy is lifestyle change the patient (in the case of this disease, teach the bulimic not to eat uncontrollably and not to resort to vomiting).

During sessions of this therapy, the patient's behavior is studied, and after that he is given special tasks in order to control his eating behavior.

Cognitive therapy

Cognitive therapy identifies possible problems in the patient’s environment that force him to such behavior. Thanks to this type of treatment, the patient can fight “black” thoughts and find the necessary solution to the problem.

Individual or group psychotherapy focuses on eliminating emotional problems that are the causes of bulimia.

Combination therapy

Combination therapy of antidepressants and psychotherapy works well for bulimia.

It was noticed that selective serotonin reuptake inhibitors(sertraline and fluoxetine) are better at treating bulimia than tricyclic antidepressants (amitriptyline and imipramine).

Alternative medicine

Any plant (or plant-based product) used to combat depression and anxiety will be suitable for treating this disorder.

Attention! It is important to understand that not a single type of traditional medicine can cure the true cause of this disease! Traditional medicine can only alleviate some aspects.

Marshmallow and red elm

If the patient has abdominal pain or inflammation at the level of the oral cavity, then marshmallow root or red elm powder can be used.

Psychosomatic medicine

This type of therapy can change the patient's mental processes so that he no longer eats uncontrollably or uses vomiting to empty the stomach.

Physical exercise

Yoga, Tai Chi, Qigong or just dancing can change the way a bulimic feels about himself and his body.

Hypnosis and biofeedback (BFE)

With the help of hypnosis and biofeedback, you can achieve good results in changing eating behavior.

Attention! When choosing hypnosis or biofeedback as a treatment for bulimia, be sure to ask if the practitioner is experienced in treating this disorder.

Nutrition for bulimia

You can avoid (or reduce the number of) uncontrolled attacks with a rich diet in nutrients and sugar free.

• stop drinking alcohol;
• reduce the amount of salt consumed;
• give up coffee;
• Avoid using flavorings when cooking.

Take regular supplements containing vitamins:

• (1 g/day);
• B-complex vitamins (50 mg/day);
• multivitamin preparations.

We hope you understand what bulimia is and what its consequences may be.

Bulimia (bulimia nervosa) is a disorder associated with eating in which patients have a sharp increase in appetite, and it manifests itself in the form of an attack, accompanied by painful hunger, pain in the pit of the stomach and weakness. Bulimia, the symptoms of which can also accompany a number of diseases of the endocrine system and central nervous system, also manifests itself in mental disorders, and also in frequent cases becomes a cause of obesity.

general description

The basis of bulimia is considered to be a neuropsychiatric disorder; it manifests itself in the loss of control over the food consumed, as well as in the patient’s concentration on calories, weight and, in fact, on food. This disorder is combined with the appearance of attacks of severe hunger in the patient, the use of laxatives and weight loss drugs, in addition, patients also, to top it off, provoke vomiting in themselves. Distinctive features of bulimics are their low self-esteem, excessive self-criticism, and constant feelings of guilt. The idea of ​​their own weight in such patients is distorted. The severe stage of bulimia is accompanied by sharp fluctuations in the body weight of patients.

From Greek, the literal translation of the term “bulimia” in its component parts means “bovine hunger”, in addition, this disease can also be referred to as “kinorexia”. A pathological increase in hunger in some cases may be accompanied by abdominal pain and weakness; food intake does not reach the stage of saturation, which leads to gluttony (it is defined as the corresponding term - polyphagia).

As already indicated, bulimia can act as a companion to actual disorders of the central nervous system (CNS) in the functional or organic part (epilepsy, traumatic brain injury, tumors, etc.), as well as as a companion to mental pathologies (obsessive-compulsive disorder, psychopathy , schizophrenia, etc.). In addition, bulimia can also be triggered by an increased level of insulin in the patient’s blood.

In recent years, the incidence of bulimia, diagnosed mainly among women, has increased and, unfortunately, positive changes in terms of reducing its growth have not been observed at the moment. It is customary to highlight the connection between bulimia and certain ethnic and social predispositions that predispose to the development of this disorder.

In general, it can also be said that bulimia is one of the variants of obsessions directly related to food. Another option for this type of disorder is.

Mostly bulimia, which is not caused by the influence of any organic factor, has a psychological nature that causes the sick person to eat food as a way to correct the general emotional state in which he currently resides. At a subconscious level, the patient, through overeating, makes attempts to escape from objectively existing reality.

Thus, an outbreak of negative emotions (uncertainty, anger, fear, rage, etc.) becomes a reason to turn to food, through which positive emotions are expected to be obtained. In other words, troubles that arise “get eaten up”; food helps to push such emotions to the subconscious. Considering that at the physiological level, eating actually allows you to achieve the production of the happiness hormone (endorphin) due to pleasant taste sensations, a kind of fixation is formed associated with the corresponding situation, it looks simple: after eating, a person receives positive emotions and, accordingly, pleasure.

As a result of this attachment, people are increasingly turning to food as a way of escaping problems that arise, regardless of their scale. Subsequently, prolongation of pleasant sensations is achieved by increasing the time spent on eating while simultaneously concentrating the patient on the fullness of the stomach and the volumes consumed. Even later, those taste sensations associated with food consumption are lost; concentration, again, concerns the fullness of the stomach and the volumes consumed. At the physiological level, the concentration of blood supply is concentrated on the organs of the digestive system, the functions of the nervous system are subject to deterioration, the psychological state of patients is reduced to focusing interests exclusively on nutritional needs.

The considered option of avoiding the problems that exist in the reality of patients has some attractiveness, which determines the main danger of falling into a vicious circle associated with this disease. The principle of such attractiveness is extremely simple, it lies in the fact that “delicious” is available always, everywhere and to everyone, that is, in fact, food is available to everyone. And if a person is predisposed to search for simple ways to avoid psychological problems, then food, due to which this becomes possible to a certain extent, becomes an almost natural option in their choice.

Based on these aspects, it can be added that bulimia is a psychophysical addiction for the simple reason that it has not only a specific psychological background, but also a specifically existing instinct associated with the need to satisfy hunger. The development of biological dependence occurs in cases in which regular overeating leads to disruption of the mechanism through which appetite regulation is ensured.

Thus, the basis for the regulation of hunger is no longer reduced to normal biological factors (such as the fullness of the stomach or the content of carbohydrates in the blood), but to the subjective principle of its activation. That is, the feeling of hunger in such cases does not arise according to, again, a normal principle, according to which a person really needs to eat, but in other situations under the influence of factors that cause a pathological feeling of hunger, which becomes possible even after eating. Thus, if a patient with bulimia initially consumed food only in those conditions under which he did not feel hunger as such, then the progression of this disease leads to the fact that hunger becomes his constant companion, that is, an irresistible feeling of hunger will be constant for the patient.

Eating behavior may be disrupted in accordance with one of the following options:

• food absorption occurs in fits and starts in huge quantities, that is, there is a sudden onset of appetite;
• constant consumption of food by the patient, that is, as is clear, the patient eats all the time;
• night consumption of food, accompanied by a feeling of hunger at night.

Bulimia: classification

The classification of bulimia comes down to its compliance with the following options:

• primary bulimia - a feeling of constant hunger associated with an uncontrollable desire to “eat, eat, eat”;
• bulimia resulting from anorexia - with anorexia, attacks of overeating that cannot be controlled are also allowed, after which the same feeling of guilt appears as in bulemics, and attempts are made to cleanse oneself in one form or another.

The course of bulimia can also be determined by one of the following patterns of patient behavior:

• attacks of gluttony are accompanied by the subsequent implementation of measures to cleanse the body of what has been eaten through vomiting, an enema or a laxative;
• cleansing from consumed food does not occur, attempts are made to control one’s own weight through diets, which is associated with periodic breakdowns in gluttony, which is why measures are taken to worsen dietary restrictions regarding nutrition.

Bulimia: reasons

The causes of bulimia are closely related to symptoms, therefore the selection of this particular section is rather symbolic in nature, due to which, nevertheless, we can determine for the reader some principles of the cause-and-effect factor in the development of this disease. Considering that the problem of bulimia is strictly individual, although it has some similar features in different cases, some of the causes of this disease can be gleaned directly from the section describing the manifestations of bulimia, that is, from the section on symptoms.

Let's start with the fact that bulimia, in accordance with the causes that provoke it, can be of a physiological or psychological nature.

The physiological nature implies previously identified organic brain lesions, as well as lesions affecting metabolic processes and hormonal disorders. As for the psychological nature of its occurrence, it occurs in the vast majority of cases of diagnosing bulimia.

In particular, for example, it can be noted that quite often bulimia is a disease that develops in people from wealthy families, which is determined by the ambition and general pretentiousness of the attitudes existing within them. Quite often, children from such families exhibit an inferiority complex, combined with the fear of letting their family down, not living up to their hopes (or imaginary hopes), disgracing themselves, etc.

Initially, patients with bulimia do not stand out “from the crowd” in any way, although it may be noticeable that they have inflated demands on themselves, susceptibility to depression and being alone. Over time, their life is completely concentrated on food and only on it, and therefore communication and society as such are already in the background. Because of the current situation, patients with bulimia begin to completely withdraw into themselves, in one way or another finding reasons to avoid any communication.

One of the problems with bulimia is that with this disease, unlike anorexia, for example, which can be found in people who are visibly exhausted, the weight of bulimics remains within the normal range for a long period of time, sometimes only reaching some moderate fluctuations to a large extent. side. This is explained by the fact that bulimia is accompanied by the patient’s need to get rid of consumed food through vomiting, which, despite a significant appetite, excludes excess calorie intake as a fact. Meanwhile, this is not a final statement, because about half of what you eat still manages to be absorbed. Thus, patients may practically not stand out in any way; they are mostly silent about their mania, allowing only very close people to see it.

Basically, bulimia nervosa, as already noted, is diagnosed in the female part of the population, from the age of 13 years and older. The critical age for the peak manifestation of bulimia symptoms is determined to be from 15 to 16, from 22 to 25 and from 27 to 28 years, although this disease can also be diagnosed in older patients; at this point we will dwell in a detailed examination of the symptoms of the disease. Mild bulimia is often diagnosed in both sexes. It also happens that this disease can be the result of a previous long-term diet. In other words, with a long-term restriction of oneself in taking the desired food, a person at one moment “breaks down”, going, so to speak, “in all seriousness” in this direction.

What is noteworthy is that bulemics themselves often highlight such an aspect of the problem that provokes this disease as a lack of appropriate volitional qualities. That is, in accordance with this principle, precisely because of this, the patient cannot, through certain volitional efforts, refuse to consume food according to a given scenario, while at the same time adhering to the diet without any deviations. Isolating this side of the problem is incorrect.

The fact is that bulimia has common aspects with drug addiction, except that food, as we have already noted, is even more accessible and, in fact, for this reason it is considered as a drug - due to the direct comparison of effects, behavior and other aspects. Similarly, with the depth of the problem of drug addiction, the problem of bulimia can be considered, because with this disease, the patient will also not be able to get rid of the harmful cravings for food, that is, getting out of the vicious circle on one’s own turns out to be an impossible option. Considering that over time, with bulimia, a feeling of satiety does not occur, the “dose” of food consumed has to be increased, meals are needed even more often, snacking becomes an almost constant occurrence, then the parallels with drug addiction, as the reader can see, are undeniable.

A special feature of bulimia is that the main food preferences of patients are starchy and sweet. The reasons for this choice are, in general, clear: such food is more conducive to the enjoyment of it, thereby increasing the body’s production of endorphins, and, of course, such food has a higher calorie content, which is why blood sugar rises, and with it, saturation also increases accordingly.

There is another side to such love for food, it lies in the fact that patients, consuming it in too large quantities, begin to feel guilty about what they have eaten. The feeling of guilt, as is clear, refers to negative feelings, that is, to “overwhelmed” feelings, which, accordingly, leads to the fact that with guilt regular bouts of hunger appear, which, as is clear, again closes the vicious circle. Bouts of gluttony in many cases are accompanied by a feeling of guilt, a desire to get rid of what was eaten, which can also be done under the influence of fear of being overweight due to the abundance of what was eaten. The simplest way is to induce vomiting for such patients, although they do not disdain enemas and laxatives. In addition to this, bulemics try to achieve weight regulation through certain dietary restrictions and diets.

Thus, the development of bulimia is similar to a cycle in which first there is binge eating, then attempts self-cleaning (vomiting, enemas, laxatives), and after diet, all this - until the next one breakdown, which is present in this cycle in any case.

For the most part, few bulemics have an idea of ​​what digestion is and how it happens. Because of this ignorance, accordingly, the fact remains unknown to them that vomiting, artificially caused by them after eating, completely prevents the food just eaten from leaving the stomach; moreover, almost half of what was eaten still remains in it after vomiting. Next, this food is sent, as expected, to the intestines, after which it naturally leaves the body in the appropriate form. As for the use of laxatives, it actually causes fluid loss, but in no way becomes a means of reducing the digestibility of calories consumed.

In addition, an important point is the practical danger of cleaning procedures due to the methods noted and used by bulemics. It consists in the fact that the water-salt balance in the body is subject to disruption, and the mucous membranes of the pharynx and esophagus are also irritated. Thus, patients who regularly use enemas for “cleansing purposes” often encounter various types of proctological disorders. And this is not to mention the fact that severe dehydration, again, achieved through the use of certain drugs and against the background of the overall picture of the disease, can cause death.

Taking into account the characteristics of bulimia, it should be noted that the treatment of this disease requires not only the implementation of measures in the direction of gastroenterology, but also measures of psychotherapy, moreover, psychotherapy is the main and primary direction of influence on the patient to achieve appropriate results. The absence of measures to correct psychological problems in treatment reduces to zero the likelihood of a cure for bulimia, which is important to remember.

Bulimia: symptoms

We discussed the basics associated with the disease, as well as its main manifestations, briefly above, but now we will try to delve into the essence of the manifestations of symptoms and their nature in more detail.

The disease, for example, may be based on the following scheme. Thus, a child in childhood did not receive enough tenderness, affection, warmth, etc., in addition to this, he also came under certain restrictions regarding contact with other children, due to which he could receive the share of pleasure, joy and positive emotions corresponding to such communication, but, as Of course, I didn't receive them. That is, the child grew up in strictness, with a tight rein. The result of this way of life is that, having no other sources of joy and positive emotions at his disposal, he finds them, figuratively speaking, in food.

As a result, the main influx of such emotions comes through food, while the parents, not having the opportunity or desire to give him more (emotionally, again), indulge in an increased appetite that compensates for the lack of such needs. This, in turn, leads to the child starting to overeat, which affects his weight. In a group, for example, at school, for this reason he is faced with rejection of himself by others, ridicule, lack of popularity and various antics of his peers due to excess weight. The child begins to understand that the reason for all this may be precisely obesity, which is why he gradually begins to hate his own eating habits and his own body. Various methods of influencing the body are used as destructive measures to combat weight, such as hunger strikes, induced vomiting, etc. In some cases, children reach a state of exhaustion; in addition, they lose interest in everything that is not related to the topic of losing weight.

The body reacts appropriately to the child’s attempts to fight excess weight; attacks of hunger appear as a protest on his part; controlling them becomes more and more difficult with each manifestation.

It is also possible that bulimia develops in people whose weight can be called normal, but the essence of the disease is that it develops as a result of frequent attacks on a child in childhood. In such cases, it often happens that for the parents the child is “not good enough”, regardless of what such a statement concerns - in particular, comparison with peers is used. Similarly, reproaches are used regarding the child’s clumsiness, his awkwardness, or, which is also, unfortunately, not uncommon, regarding his ugliness; this is also issued “to the top” in the form of appropriate reproaches. The situation is aggravated by the fact that girls (and it is they who mainly have to face such attacks) make every possible, and sometimes impossible, attempt to “prove to everyone” what they can achieve (in terms of beauty, relevance and fashion) , reaching the reference samples of “supermodels”. By them, their body, similar to the reproach of parents and the environment, is perceived as “not so” before achieving any results, after which radical measures are taken to combat it, and this is a scheme of such components that are alternately repeated in action, such as “hunger strike - excessive appetite - induced vomiting - overeating.”

Bulimia can also manifest itself episodically, which is accompanied by the appearance of attacks of hunger in people who are apparently healthy and prosperous at first glance. Basically, the manifestations of bulimia here consist of attempts to “eat up” the problem that has arisen in front of him, a problem that the person does not want to face. This can relate to anything, for example, problems arising in family life or at work - that is, in any situation and area in which a person refuses to perceive them as they should. Because of anxiety, prerequisites arise for the need to make some kind of decision. As a result, the consciousness seems to refuse to accept the problem, while the body, figuratively speaking, finds a problem to “solve”, through the subconscious, compensating for the resulting anxiety by increasing appetite. Even such a seemingly simple example requires qualified assistance.

So, now back to anorexia and bulimia, which, by and large, are two sides to one common problem. Anorexia itself is the result of uncontrolled measures implemented in attempts to lose weight in combination with the fear of “gaining” extra pounds. That is, anorexia is accompanied by loss of appetite and the development of depressive states in patients. In this case, if an anorexic is forced to eat, he will develop a “defensive reaction”, accompanied by vomiting with convulsions. About 5% of American businesswomen suffer from anorexia, while housewives account for about 2%.

As for the Russian Federation, here this disease occurs on average in 0.5% of the female population aged 25-55 years. This disease mainly affects women in the “public” sphere of activity (show business, TV, etc.), as well as the elite. On average, the mortality rate from anorexia is about 11.5%, which is, in part, due to insufficient food intake into the body, various vitamins and microelements it needs. If we talk about more precise figures, then on average about 2,500 patients die (as part of the consideration of annual statistics on this disease). In addition, one in ten cases is associated with exhaustion, heart attack or suicide.

The disease of interest to us, bulimia itself, is considered as a practical antipode of anorexia. Bulimia, as the reader has already been able to understand, consists in part of its manifestations in uncontrolled overeating. The result of this disease at certain stages is convulsions, gastric lavage in a hospital setting and subsequent treatment in a number of areas. Additionally, bulimia is accompanied by pathologies of one scale or another that affect the gastrointestinal tract (GIT). Basically, as we have already found out, women get sick, and one can roughly determine the territorial predisposition. Thus, only adult Americans account for 1.5% of the population, while out of 10 cases, 9 occur in women, 1, respectively, in men. The statistics for European countries are approximately similar. But in Japan, bulimia is somewhat rare, here the prevalence of the disease is only about 0.25%. Regardless of geographical location, bulimia is a purely “female” disease.

There can be many situations that provoke overeating. This could be the process of divorce, which is relevant for a woman, or a session for a student, or misunderstanding of parents or “unrequited love” for teenagers, etc. What is noteworthy is that the statistics for Russia not only differ from other countries regarding this disease, but also deviate somewhat from the standards set aside for it. The fact is that the current incidence accounts for about 34% of cases of diagnosing bulimia in men, and about 22% of cases of diagnosing it in children.

Now let's move on to the features of clinical manifestations accompanying bulimia. In particular, patients may experience a certain swelling of the glands in the neck and face, the enamel of the teeth from their back surface is subject to the development of erosive processes, hemorrhages may appear on the face, the salivary glands may also swell (which gives patients a characteristic appearance in which they are compared with chipmunk). There is constant soreness in the throat, the esophagus is inflamed, which is accompanied by heartburn. All these symptoms manifest themselves as a result of exposure provoked by vomiting artificially induced by patients. Bulimic episodes of “eating and vomiting” are also accompanied by impulsive actions performed against the background of emotional overstrain; actions of this nature are performed when patients are alone. Eating involves the need for significant efforts to neutralize the harm that overeating brings with it, which is also directly associated with the need to get rid of calories absorbed from the food itself.

Patients with bulimia also implement the corresponding line of behavior in public, due to which it can be quite difficult to “suspect something is wrong.” Thus, due to the shame associated with uncontrollable behavior caused by excessive appetite, bulimics make attempts to hide the real state of affairs. Often, patients secretly eat a lot, after which, as is standard for themselves, they induce vomiting to get rid of what they have eaten. In public, they eat in moderation, if not limited. If something interfered with the process of eating in everyday life or if someone caught a bulimic eating a “hungry meal”, the actions, accordingly, are bashfully and quickly hidden and interrupted/completed. The absorption of food is often associated with preparation for the “ritual,” which is accompanied by preliminary bulk purchases and preparations. To implement the plan for such a “ritual,” the patient may even steal food.

The listed episodes and the line of behavior truly inherent in bulimics can be hidden for a long period of time until they are discovered.

The progression of bulimia gradually leads to the fact that the thoughts of a sick person are reduced only to satisfying hunger, as a result of which any type of problem (interpersonal, family, professional, etc.) fades into the background. Outwardly, as already noted, most patients with bulimia look normal, giving the impression of healthy people, although their tendency to loneliness, exactingness (primarily towards themselves), and depressive moods may stand out. They inflate standards, while self-esteem, on the contrary, is subject to underestimation. Again, as we have already highlighted, life is fully focused on food, body shape, and also on the fact that you have to hide your own preferences from those around you.

Another, no less specific sign of bulimia is the bulimic’s feeling of loss of control over himself, which is especially important during the period of his overeating attack. This concerns, for example, the feeling that it is impossible to control the amount of food eaten, or that in principle it is impossible to abstain from food. There is also the patient’s fear that he will not be able to stop eating from the moment he begins an attack of overeating, and this fear can reach serious states of panic. It is due to such fears and the feeling of lack of control that he performs compensatory actions, that is, these are the previously discussed attempts to artificially induce vomiting, use an enema, laxatives, fasting and dieting. This, according to patients, makes it possible to counteract both overeating and weight, which may increase due to this.

Bulimia is accompanied, among other things, by the appearance of anxiety in patients regarding their own weight and overall shape. This explains the seriousness of the attitude and the appropriate approach to caring for your figure and weight, including systematic dieting. If we consider the specific areas through which self-esteem is formed, then for bulimics it is focused specifically on weight and figure, often being in first place in the distribution of priorities that are relevant to them. Moreover, it is precisely the characteristics of the state in these areas that determine for them the corresponding “mood” in assessing themselves, in relation to themselves.

Next, we should also highlight another feature characteristic of patients with bulimia, and it lies in their emotional fragility, which is also complemented by difficulties in controlling their own emotions. Figuratively speaking, it can be said that fat is a kind of protection for bulimics, allowing them to protect themselves from anything that can generally hurt a person, this applies in particular to relationships with the opposite sex and general emotions that could lead to a similar result. Food, in turn, is seen as a substitute for any pleasures that exist in life.

In patients with bulimia, two main areas of life predominate as a result, these are attacks of constant and uncontrollable appetite/absorption of food and fear associated with loss of control regarding emotions. The fear of losing control over them gradually transforms into a peculiar attitude towards food. This is manifested, roughly speaking, in the fact that here you can easily “let loose” and “allow yourself everything,” which cannot be said about emotions in life, which can be dangerous and can “hurt” them with their manifestation, that is, food acts as a counterbalance to the other components of life, outside of which bulimics, in fact, exist.

Basically, patients try to cope with the problem through dietary restrictions, but the more significant restrictions they set for themselves and the more they try not to eat, the more their desire to uncontrollably consume food increases.

There are different types of bulimia for certain categories of patients, due to which there is a difference in terms of psychological characteristics, which, accordingly, requires a difference in the implemented measures of therapeutic influence. So, for some patients the problem of excess weight is urgent; in principle, they cannot follow any diet, therefore the treatment of bulimia for them is mostly medicinal. In most cases, such patients come to realize the essence of the problem, that is, that they once went through a certain experience, as a result of which a fear arose regarding their further inability to correct and control emerging impulses. This is accompanied by the awareness of the fact that the existing attitude towards food is protective, and that they would also like to realize unrestrained impulses in other areas, thereby going beyond the scope of such impulses only in relation to the food consumed.

Somewhat less often in practice, specialists have to deal with those patients who do not recognize the protective factor as a pressing problem in their own disorder. Because of this, their attitude towards food can be compared to the perception of it as a demon that has possessed them. Such patients cannot understand and accept the connection between their incontinence with food and their own inability to control themselves in other areas of life. Often this attitude on the part of some patients is associated with an increased sense of guilt and moralism regarding their own promiscuity, as well as with its complete denial. Basically, the majority of patients in question face significant difficulties associated with relationships with the opposite sex.

What is noteworthy is that for some patients, symptoms of bulimia develop by the time in life when children grow up, or more precisely, when they leave the parental home. Here, as is clear, we are talking about older women, whom we initially identified in the general consideration of the disease. The problems that arise in the relationship between spouses, in this case, take on more obvious contours, which is explained by the fact that the husband, as before, is busy with professional activities, and the wife, left “out of work”, having exhausted her main role, that is, the role of the mother, faces a certain depressive background. In such conditions, due to the unbridled absorption of food, attempts are made to compensate for one’s own state through the pleasant emotions received from food, which also makes it possible to fill the days with meaning in a unique way.

There is another type of patient. Here, with bulimia, it is possible for a certain period to withstand diet-related restrictions and conditions that arise against this background, but after that there is a loss of control and a breakdown. As a result, the weight is in constant fluctuations between the optimal indicator and between the figure that exceeds this indicator by 5-6 kg. In this case, patients alternate between periods of control and periods of loss of control. They are in a constant struggle with diets, although they never reach excessive weight.

In this case, patients, having achieved a normal weight through weight loss, realize their own attractiveness, but internal fear leads to the fact that they again begin to eat excessively, which is done so that a certain layer of fat appears, due to which it is possible to fence and protect against the people around them. A feature of such patients is also their increased resistance to therapeutic measures taken against them. To solve the problem, they, as a rule, make attempts to seek specialized help from nutritionists and other doctors, missing the need for psychocorrection, due to which disappointment and the lack of effect from other measures leads to the fact that they simply ignore further therapy.

An extremely relevant aspect for patients with bulimia is the dependence on positive evaluation from those around them. Stabilization of one’s self-esteem, in other words, is achieved through the confidence that there is approval from the environment. Because of this, bulimics often try to behave in such a way that their behavior and actions correspond to the expectations that exist from their environment, which, however, leads to the suppression of their own desires, which, as is understandable, are in the background.

Patients with bulimia then strive to make others happy, holding the idea that in order to be loved they must achieve perfection. Such behavior, as well as thinness, are criteria for compliance with both perfection and the achievement of love and recognition from others, in their opinion. It is difficult for them to accept themselves in a different version than expected, which causes difficulties with self-perception and difficulties in relationships.

Considering that bulimics strive to be liked by people around them, one of the measures to achieve this is hiding their true emotions, because if, for example, anger is shown, then the person to whom it is directed will be offended , which means that he won’t be able to please either. Ultimately, bulemics commit many actions that they do not want to do, which, in turn, is accompanied by a low degree of self-expression. The origins of this behavior, as well as the problem of bulimia, can go back to early childhood. We can also add to this that as a condition that also originates from such a trait as “being liked by others”, such a characteristic trait of bulimics as the desire for perfectionism, based on dependence on the approval of the people around them, can also be considered. The desire to achieve perfection has a slightly different form if it is associated with food. Weight correction through diet in most cases becomes ineffective, because it is impossible to stick to the diet for a long time, due to a failure in it, discomfort and feelings of guilt increase, eliminating them becomes possible only through food, which leads to the repeated formation of a vicious circle according to the “food” scheme - guilt - food."

In any case, food itself becomes a means of relieving stress only for a while. At the same time, the longer overeating manifests itself (bulimia itself as a defining condition), the shorter the periods of “quiet” that follow the consumption of food become. As a result, food also acts as a mood regulator for patients. Based on these points, it is necessary to emphasize how important it becomes to treat bulimia in the early stages, and the treatment is not only medicinal, but also psychotherapeutic, and not only the treatment of a specific patient with this disease, but also work with his family (in particular, this means, again , method of psychocorrection).

To summarize, I would like to dwell on the fact that bulimics in the overwhelming majority of cases tend to categorically deny the existence of a problem in the form of the disease we are considering. Taking this into account, the main signs of bulimia can be detected by relatives and close people of the alleged patients, therefore, in fact, we will highlight them separately:

• Behavioral signs of bulimia
  • eating food in significant quantities, swallowing large pieces, with poor chewing, food is absorbed hastily;
  • after eating, bulimics rush to leave the table to go to the toilet, which is extremely necessary for them to induce vomiting;
  • with bulimia, patients lead a secluded lifestyle, non-standard signs of behavior may appear, indicating some mental health disorders, and they are also secretive;
  • excessive enthusiasm for diets, persistent counting of calories consumed from food;
  • the presence of diuretics, emetics, and laxatives in the patient’s arsenal;
  • pushing yourself to the point of exhaustion through physical exercise;
• Physiological signs of bulimia
  • weakness, general health problems, low energy levels throughout the day;
  • susceptibility to inflammatory diseases of the pharynx and throat (they manifest themselves in the form of pharyngitis, tonsillitis, etc.);
  • menstrual irregularities, amenorrhea (lack of menstruation);
  • frequent weight fluctuations up or down;
  • metabolic disorders, diseases of the digestive system;
  • hypertrophy of the salivary glands, increased salivation;
  • the presence of dental diseases, which in this case are the result of regular vomiting;
  • the appearance of signs of dehydration, sagging skin, dermatitis, changes in the general condition of hair, nails and skin;
  • depression.

Complications of bulimia

Due to systematic overeating, supplemented by inducing vomiting, a number of serious health problems can develop, they are as follows:

• the development of diseases in the oral cavity, in particular periodontitis, periodontal disease and caries, tooth enamel is also destroyed;
• due to vomiting, the voice becomes constantly hoarse;
• mumps may develop;
• cycle disorders develop, which, as has already been highlighted, can reach a state of amenorrhea;
• Pregnancy becomes a separate problematic area, which concerns both the changes associated with it and the actual fact of its occurrence (that is, problems with conception are considered);
• disorders of the digestive system (chronic forms of enteritis, gastritis, inflammation of the esophageal mucosa, disturbances of intestinal motility, flatulence, constipation, dysfunction of the liver, pancreas, etc.);
• development of endocrine diseases (hypothyroidism, diabetes);
• disturbances in the functioning of the cardiovascular system, which is accompanied by disturbances in heart rhythm, dizziness, and loss of consciousness; in rare but not excluded variants of the course of the disease, bulimia due to the loss of microelements (magnesium and potassium) accompanying the occurrence of the listed problems can cause cardiac arrest;
• rupture of the stomach (this complication occurs rarely, but is also not excluded; it is caused by excess food in the stomach);
• a tendency to alcoholism due to depressive states, provoked by constant anxiety about one’s own weight and combined with a feeling of guilt arising from overeating.

Diagnosis and treatment

The main directions on which the diagnosis of bulimia is based can be defined as interviewing the patient, in some cases - talking only with people from close circles or with relatives, that is, with the exception of communication with the patient due to certain circumstances that do not allow this. The main circumstances relating to the development of the disease, symptoms and characteristics of the patient’s well-being and appearance are clarified. Additionally, test results may be required, based on which it is possible to identify specific changes accompanying bulimia. The diagnosis of “bulimia nervosa” can be made by a specialist based on a pattern in which overeating combined with “purging” is carried out at least twice a week for three months or more.

As for such an issue as the treatment of bulimia, it, as has already been highlighted, is based on the implementation of a set of measures of drug therapy and measures of behavioral psychotherapy. Thanks to behavioral psychotherapy, it is possible to “reach out” to the patient in terms of his understanding of the existing problem, and then decide how exactly to deal with it in a particular case. The duration of such therapy is about 5 months; due to the appropriate impact, the number of episodes associated with overeating can be reduced, which, in turn, makes it possible to subsequently relieve the patient of the addiction that has arisen. Drug treatment is focused primarily on replenishing lost microelements (magnesium, potassium), as well as treating complications caused by bulimia. Additionally, antidepressants are prescribed, which complement behavioral psychotherapy, thereby helping to improve treatment results.

Mental disorders, characterized primarily by decreased mood, motor retardation and disruption of thinking, are a serious and dangerous disease called depression. Many people believe that depression is not a disease and, moreover, does not pose any particular danger, which they are deeply mistaken about. Depression is a rather dangerous type of disease, caused by a person’s passivity and depression.

Herpes is a viral disease that manifests itself in the form of characteristic rashes (vesicles), grouped together and localized in the mucous membranes and on the skin. Herpes, the symptoms of which arise against the background of exposure to herpes viruses, most often occurs in the form of a labial (more precisely, labial) infection; its manifestations are traditionally defined as “colds on the lips.” There are other forms of the disease, for example, genital herpes (predominantly affecting the genitals), as well as forms in which a variety of areas are affected.

Bulimia or kinorexia is a type of mental illness. It is based on an eating disorder expressed in the form of uncontrolled overeating. To relieve the consequences of excess food consumption, patients resort to the use of various compensatory mechanisms: they take laxatives, induce vomiting, and resort to heavy physical activity. Most of the life of patients is focused on their own attitude towards food, counting calories, analyzing their nutrition, and controlling body weight.

Kinorexia refers to disorders of neuropsychic activity, and the disease directly affects the functioning of the digestive tract. Patients suffering from this disorder experience frequent breakdowns. During such crises, the patient consumes huge amounts of food in a short time. Sometimes the amount of food eaten is so large that a person begins to vomit. In other cases, the patient himself tries to immediately remove food masses from the gastrointestinal tract. For this purpose, laxatives and diuretics, cleansing enemas, and various methods for inducing vomiting are used.

After overeating, the patient experiences a strong feeling of guilt, which forces the person to engage in excessive physical activity, sharply reduce the amount of food consumed, and take all kinds of weight loss measures. This period usually ranges from several days to 5-6 months, after which another crisis follows. As the disease progresses, eating disorders occur more frequently.

Attention! This lifestyle quickly depletes the patient’s body, which leads to disruption of various systems. Without treatment, death can occur.

Bulimia occurs as a result of the patient developing one of two types of disorders:

• organic pathologies in which polyphagia develops, that is, uncontrolled hunger: deviations of the hypothalamic-pituitary function, epileptoid disorders, endocrine pathologies, brain tumors and various lesions of the central nervous system;

• mental illnesses: psychopathy, various forms of neuroses, depression and schizoid disorders.

Kinorexia is an addictive disorder. If the disease has developed as a result of mental pathologies, then there is an extremely high probability that it has social roots and is determined by the ideas of a certain social group about beauty standards.

Attention! Addictive disorders are forms of deviant behavior caused by the presence of obsessive ideas in the patient.

Kinorexia is diagnosed several times more often in women than in men. At the same time, the number of cases is increasing every year. When examined, patients are shown to be fixated on two main ideas: food and the need to reduce their body weight. Patients may spend several hours in a row thinking about their favorite dishes or spend a long time in stores, choosing the products they like. At the same time, people suffering from bulimia experience an obsessive feeling of guilt after every meal, and are constantly engaged in the selection of diets, exercises and procedures to lose weight.

Kinorexia causes rapid depletion of the body's resources. Therefore, the patient’s health deteriorates sharply against the background of stress, lack of food and excess stress. Bulimia is dangerous due to the development of a large number of complications: dysfunction of the immune system, severe forms of anemia, hypovitaminosis, destruction of bone tissue, etc.

As the disease progresses, the patient develops a pathological addiction to certain foods. Only when eating food does he release a large amount of endorphins. As a result, a psychological fixation is formed: pleasure can be obtained from food. The patient begins to increase the volume of dishes in order to prolong the pleasant sensations. Over time, the quality and taste of food gradually lose their paramount importance; for the patient, the quantity of food begins to play a major role. In this case, the patient uses food as a way to relieve discomfort.

The biological disorder of kinorexia occurs when the mechanism for regulating hunger and satiety is disrupted. The patient's appetite ceases to be based on natural physiological parameters: the content of sugars in the blood plasma, the presence of chyme in the digestive tract, and the fullness of the stomach. In people suffering from bulimia, hunger persists almost constantly and increases significantly as a result of stress or psychological experiences.

Classification of bulimia

Today in medical practice there are several types of kinorexia.

Types of filmrexia

Type	Image	Characteristics of the disease	Features of the pathology
		It occurs in the form of frequent attacks of uncontrolled overeating and constant hunger. Seizures are usually weakly related to changes in the patient’s psychological state	Often organic in nature
		Patients due to mental disorders periodically experience “breakdowns”, which are accompanied by excessive absorption of food, after which the patient develops a strong feeling of guilt	Formed against the background of anorexia nervosa

In this case, kinorexia nervosa can be expressed in two ways:

1. Forced cleansing of the gastrointestinal tract. After eating, patients provoke attacks of vomiting, take laxatives, and give enemas.
2. Diets. Patients try to lose weight by following a diet. However, dietary restrictions lead to bouts of compulsive overeating. After this, patients try to make their diet even more meager, which ultimately again leads to uncontrolled gluttony.

Attention! Depending on the form of kinorexia, the specialist selects the therapy regimen necessary for a particular patient.

Symptoms of the disease

Bulimia was identified as an independent disease about 25 years ago. It refers to eating disorders, that is, a condition in which the patient cannot independently control his or her eating. When diagnosing, the pronounced symptoms of this pathology are of paramount importance, since the presence of the disease is established based on the results of interviewing the patient and monitoring his condition.

Attention! Auxiliary examination methods for diagnosing kinorexia are ultrasound examination of the abdominal organs, computed tomography, ECG, and FGDS. These procedures make it possible to determine the presence of pathologies of the gastrointestinal tract and cardiovascular system.

There are four main signs, the presence of which allows us to determine the presence of kinorexia in a patient:

1. Pathological cravings for food. In this case, the patient is not able to control his need for food, which is why he consumes an abnormally large amount of food over a short period of time.
2. Reluctance to eat in the presence of other people. In some cases, patients can physically eat food only alone. Otherwise, due to spasm of the muscles of the esophagus and stomach, they begin to vomit.
3. A person takes inadequate measures to combat excess weight. Instead of giving up excess nutrition, the patient engages in excessive physical activity, tries to follow strict diets, and takes laxatives or appetite suppressants.
4. The patient's self-esteem directly depends on his body weight. Moreover, even a slight increase in weight can lead to a nervous breakdown.

There are also many secondary signs on the basis of which we can talk about the development of kinorexia in a patient. They can be divided into two groups: behavioral and physiological.

Behavioral symptoms

1. Eating a large amount of food at one time, hastily devouring food.
2. Desire to leave the table immediately after eating. Typically this behavior is driven by the need to induce vomiting as quickly as possible.
3. Closedness, secrecy, nervousness when trying to discuss the patient’s psychological state.
4. Constant passion for diets, discussion of various weight loss techniques, counting calories.
5. Exhausting physical exercise. Often, after an attack of overeating, bulimics, tormented by feelings of guilt, can engage in running, gymnastics or swimming for several hours.
6. The use of drugs for weight loss, laxatives and diuretics, emetics, etc.
7. Decreased libido, refusal of romantic relationships and sexual activity.

Physiological symptoms

Physiological signs occur when the patient completely loses control over his eating behavior. As the disease progresses, symptoms become more pronounced:

• lesions of the gastrointestinal tract: gastritis, duodenitis, diarrhea or constipation, pharyngitis and stomatitis;
• tooth decay, the appearance of wounds and abrasions on the oral mucosa;
• women experience menstrual irregularities, most often amenorrhea;

Attention! Amenorrhea is the absence of menstruation for several months. In patients with bulimia, a similar condition appears as a result of hormonal imbalance or critical weight loss.

• frequent fluctuations in body weight within 5-10 kilograms;
• lymphadenitis - enlarged lymph nodes behind the ears and in the neck;
• proliferation of the salivary glands, drooling;
• constant vomiting that occurs even after eating a small amount of liquid food;
• dehydration, which is manifested by dry skin and hair, brittle nails, and the appearance of acne;
• skin rash;
• anemia as a result of a deficiency of protein and B vitamins in the body.

Patients with bulimia are often diagnosed with co-occurring mental disorders, such as depression or obsessive-compulsive disorder.

Signs of a bulimia attack

With kinorexia nervosa, a characteristic symptom of the disease is bouts of overeating. As the disease progresses, the patient experiences such breakdowns more and more often. The impetus for uncontrolled absorption of food is the growing need for food. It can manifest itself as obsessive thoughts about favorite foods, dreams, deterioration in well-being, and irritability.

As a result, the patient acquires a large number of products, which he eats when left alone. When eating food, a person pays little attention to its taste, taste and quality. The patient eats until he runs out of food.

After the attack ends, the person feels a sharp deterioration in health. His stomach is full, which puts pressure on other organs and the anterior wall of the abdominal cavity. In order to somehow normalize his condition, the patient provokes vomiting. In this case, the patient’s euphoric state is quickly replaced by a feeling of guilt and fear of gaining weight.

Attention! As the disease progresses, bouts of overeating become more frequent. In patients in serious condition they reach 4-5 times a day.

Bulimia requires complex treatment. The basis of therapy is determined by the psychotherapist. However, to relieve the consequences of the disease, patients also need the supervision of a gastroenterologist, endocrinologist and neurologist. At the same time, kinorexia can be treated both on an outpatient basis and in a hospital setting.

Indications for hospitalization are the presence of the following abnormalities in the patient:

• suicidal thoughts or suicide attempts;
• the presence of severe secondary diseases;
• severe hypovitaminosis and dehydration;
• lack of effect from outpatient treatment of pathology;
• bulimia diagnosed in the patient during gestation.

Therapy for kinorexia involves a combination of pharmacological agents and psychotherapeutic methods. On average, such treatment takes from one month to a year. After recovery, the patient is recommended to visit a psychotherapist or psychologist for several years.

Therapy with a psychotherapist

Psychotherapy is selected individually for each patient. On average, patients are advised to undergo consultations 2-3 times a week for 4-5 months.

Treatment includes both individual sessions and group classes using the following methods:

Therapy with pharmacological drugs

Pharmacological treatment of kinorexia involves the use of antidepressants, drugs for the treatment of gastritis and peptic ulcers, and antiemetics.

Attention! The vast majority of antidepressants cannot be combined with alcohol-containing drinks. These medications also impair attention, so you should avoid driving during treatment.

Patients with kinorexia can be prescribed the following groups of pharmacological agents.

Drugs for the treatment of kinorexia

Attention! The selection of drugs to relieve bulimia is prescribed individually, taking into account the psychological and physiological state of the patient. Please note that some medications cannot be combined with each other.

Bulimia is a psycho-neurological disorder that leads to eating disorders in the patient. The disease requires complex treatment using both psychotherapy and pharmacological drugs.

Video – Bulimia Nervosa

Video - Bulimia

There are many people who often overeat without controlling their appetite. This condition is called bulimia, what is it? According to doctors, bulimia is a neuropsychiatric disease. The patient is completely focused on food, calories, weight, constantly feels hungry, overeats, then drinks weight loss products and often induces vomiting. Such people have low self-esteem, feel guilty, do not feel their weight, distorting their opinion about it.

Bulimia is a mental disorder closely related to food intake. A sign of the onset of the disease is paroxysmal, sharp surges of severe hunger. Typically, this disease affects young girls whose psyche has not yet formed and is subject to external influence. They have no willpower and cannot control the amount of food they eat. Overeating occurs periodically, hence the excess weight, so patients, after they have eaten a lot, try to completely get rid of what they have eaten by any means, even dangerous to health.

Now we should take a closer look at what bulimia is, as well as what its types are. Encyclopedias in this case will be somewhat scattered in information, but the general information is still the same. Bulimia nervosa is usually of a psychological nature; in this way a person tries to correct his condition. At the subconscious level, the patient tries to escape from objective reality, which is unpleasant for him. When attacks of negative outbursts occur - anger, fear, anger, irritation, etc., the patient immediately begins to eat in order to give himself positive emotions.

Physiologically, eating food actually contributes to the production of endorphins - happiness hormones, so food brings pleasure. A person gets used to this pattern: if he gets upset, he eats; the further he goes, the longer the pleasure lasts, that is, the process of eating food is delayed. Gradually, taste sensations are lost, the brain concentrates only on the volume of food, blood circulation shifts towards the digestive organs and nervous activity is lost.

Please note: This method of escaping problems is attractive due to its simplicity, because you can always eat deliciously, you don’t need to have a beautiful appearance, attract personal qualities and standard of living.

That is why bulimia develops - a psychophysical addiction, because in addition to the psychological aspect, the disease is based on the biological instinct to satisfy hunger. Gradually, the addiction gains momentum and the patient constantly experiences brutal hunger.

Expert opinion

Egorova Natalya Sergeevna
Dietitian, Nizhny Novgorod

Eating disorders (anorexia, bulimia) are much more common than we used to think. According to statistics, 5-10% of female representatives encounter them at different periods of life.

I would like to note that bulimia has a negative impact on reproductive health. It often leads to disruptions in the menstrual cycle and even the absence of ovulation. And this, as we know, can cause infertility. Moreover, women with bulimia are often underweight, which also increases the risk of infertility and miscarriage. Not long ago, the International Journal of Eating Disorders published the results of a scientific study that showed that women with eating disorders have a 2-3 times higher risk of miscarriage than healthy women.

And I’ll also add about the risk of spontaneous cardiac arrest. Yes, he really exists. The fact is that in patients with bulimia, the acid-base balance is disturbed due to vomiting. This is what can cause serious disruptions in the functioning of the heart. So if you have an eating disorder (or you suspect your loved ones may have one), contact a specialist immediately. After all, you most likely will not be able to recover on your own. And the lack of treatment can lead to irreparable consequences.

Classification of the disease

The disease occurs in alternating two stages. The first is a strong feeling of hunger and good appetite, with the inability to control satiety. The second is the emergence of a feeling of guilt and getting rid of the food eaten by any means: inducing a gag reflex, enemas, laxatives. This is how patients with anorexia, a consequence of bulimia, behave.

The duration of each stage can be any, depending on the severity of the pathology. It manifests itself in symptoms of varying severity at the level of behavior. Typically, pathology occurs in two ways. The first is that after overeating, the patient gets rid of what he ate. The second is that there is no getting rid of food, but patients are constantly on diets, from which they break and often overeat, so they try to control weight.

This is important: Patients who struggle with the problem on their own simply walk in circles, only aggravating their situation. Without delay, you need to turn to specialists and try together to get out of this situation.

Causes of bulimia and food refusal

The causes of bulimia are not fully understood and are based on assumptions.

But factors that initiate pathology have been identified, these include:

• Inheritance of mental, contrived, depressive and anxiety-phobic pathologies.
• Disorders in certain functions of the central nervous system.
• Problems with metabolism and endocrine system.
• Disorders in the inhibitory functioning of the nerve processes of the central nervous system.
• Hereditary addiction to alcohol and drugs.

Even one of these disorders can form a certain life scenario in the subconscious, the consequence of which is the development of bulimia.

All it takes is one push for this to happen:

• Individual psychological characteristics of a person are excessive anxiety, sensitivity and timidity.
• Low self-esteem and self-doubt.
• Severe parenting methods and criticism of external data by parents.
• Poor attention to the informal environment.
• Self-blame and guilt for parents' divorce.
• The presence of physical, mental or sexual violence.
• Frustration situations - failure, deception, unfulfilled expectations.
• Unrequited first love and fear of loneliness.

The main factors in the development of bulimia lie in the psychology of the patient. Received even in childhood, psychological trauma and other disorders that affect the functioning of the food center and lead to the development of the disease. If you find the trigger for bulimia, you can easily get rid of the disorder.

Symptoms of bulimia

People who consider themselves averse to this disease should carefully study the symptoms of bulimia. The beginning of the development of the disorder is a change in behavior. These are the first signs of the onset of bulimia.

Behavioral symptoms include:

• Increased consumption of food, poor and hasty chewing, practically swallowing food.
• After eating, the patient often goes to the toilet to induce vomiting.
• The person leads a secluded, secretive life, and there are signs of mental illness.

Physiological symptoms of bulimia:

• Weight changes, the patient loses weight sharply and also quickly gains it back.
• General weakness, visible unhealthy state, decreased energy.
• Frequent diseases of the throat and esophagus.
• Gastrointestinal diseases and metabolic disorders.
• Dental diseases caused by frequent vomiting.
• Hypertrophy of the salivary glands, as a result – increased secretion of saliva in the absence of food.
• Loose skin due to dehydration, dermatitis due to lack of food.

This is important: the patient does not consider himself such, refuses help, believes that he will cope with the problem with his own efforts. This is one of the signs of the presence of the disease.

Complications of bulimia

Bulimia or complete refusal to eat can cause any complications:

• Oral cavity. Caries, periodontal disease, periodontitis, destruction of tooth enamel. Frequent invocation of the gag reflex leads to hoarseness and injury to the mucous membranes of the respiratory and digestive tracts.
• Risk of developing mumps.
• Disorders of the menstrual cycle in women.
• Digestive problems: gastritis, enteritis, sluggish intestinal motility, inflammation of the esophageal mucosa, disruption of the pancreas and liver, constipation and gas formation, anal diseases.
• Problems with the endocrine system: diabetes, hypothyroidism, insufficient functioning of the adrenal glands.

All metabolic processes are disrupted, and disorders occur in the water-electrolyte balance. The most unpleasant consequences of bulimia are excess weight gain and obesity. Patients can die from cardiac arrest in their sleep because the salt balance is disrupted. Constantly overeating, you need to be wary of rupturing your overfilled stomach and getting food into your respiratory tract. Often with increased food intake, kidney failure occurs. It happens that alcoholism or drug addiction, as well as depression, develop against the background of bulimia.

Treatment for bulimia

Self-cure of an illness rarely ends in success; you usually have to turn to specialists. The diagnosis is established based on a survey of the patient’s relatives, and the situations that led to the indigestion, his condition and symptoms are clarified.

Important! Personal contact with a doctor is necessary to identify mental abnormalities. Also, if necessary, other examination methods are prescribed: blood and urine tests, ECG and blood pressure measurement.

Therapy is aimed at eliminating the cause of the desire to completely refuse food. The organic form of the disease involves treatment of the primary pathology. Bulimia nervosa is treated by correcting psychological disorders. Treatment of bulimia occurs only under the supervision of a psychotherapist or psychiatrist. It is he who decides whether to carry out treatment in a hospital or whether it can be carried out at home.

When it is necessary to admit a patient to the hospital:

• If the patient has thoughts of suicide.
• Exhaustion has set in and there are many concomitant diseases as a result of complete refusal to eat.
• Severe depression.
• Dehydration of the body.
• Therapy at home is not possible.
• While carrying a baby, as this threatens his life.

An integrated approach effectively helps to get rid of bulimia nervosa: psychotherapy together with medications. Then there is hope for a complete recovery, both mental and physical.

Please note: Treatment lasts a long time, up to several months. Treatment is aimed at getting rid of the constant fear of gaining excess weight and the painful feeling of hunger, as well as starting to gradually eat food.

Therapy with a psychotherapist occurs individually and in groups. It is necessary to undergo 10-20 sessions, 1-2 visits per week. In severe situations, treatment lasts 6-9 months several times a week. A visit to a psychotherapist can also be done online: via email or Skype.

Drug treatment for food refusal begins with the prescription of antidepressants. They improve signal transmission in nerve cells. These drugs slow down the reaction, so after taking them you cannot do work that requires concentration. These remedies replenish serotonin deficiency, have a positive effect on the psychological state, reduce hunger and ideally cleanse the body.

The following drugs are taken when completely refusing to eat:

• Among the effective antidepressants against bulimia, the available ones are: Fluxetine, Sertraline, Prozac, Celexa.
• It is necessary to take antiemetics in small quantities: Ondansetron, Metoclopramide. These drugs eliminate nausea and give a feeling of fullness.
• Drugs are prescribed to eliminate convulsive pathologies: Topsaver, Maksitopir. In bulimia, they reduce the uncontrollable desire to eat something and maintain a neutral mood.
• The doctor may prescribe medications to get rid of addiction and affective psychosis: Naltrexone, Vivitrope. They help eliminate cravings for alcohol and drugs.

To stimulate the desire to get rid of the disease, you should look at a selection of photos of patients with bulimia and anorexia - these are girls who have refused to eat. Prepare yourself psychologically and firmly accept treatment. Then the prognosis will be favorable. Sometimes recovery from bulimia occurs as a result of an unpredictable joyful emotional shock.