!!Bulimia Nervosa | Causes, Symptoms, Signs & Treatment Help*

!!Bulimia Nervosa | Causes, Symptoms, Signs & Treatment Help*

What is Bulimia Nervosa?

Bulimia is a disorder of eating behavior characterized by repeated episodes of overeating or excessive food intake and an exaggerated concern for weight control. This leads the patient to take extreme measures to counteract weight gain produced by overfeeding. Therefore, episodes of "binge" occurs, in which compulsively large amount of food ingested in a short time. These episodes often suffer them in secret. After binging, the patient often feels guilty about it and uses a series of inappropriate compensatory methods to prevent weight gain.

Despite being already recognized in ancient Greece, it was only identified and described as a disease with its own characteristics in 1979 by the English psychiatrist Gerald Russell. It is estimated that approximately 1% of the population suffers from this disease, although this figure may be an estimate below the reality. In fact, studies show that up to 7% of young women consulting their GP with symptoms of bulimia nervosa. It is much less common in males.

What are the symptoms of bulimia nervosa?

          According to the World Health Organization, the diagnostic criteria of bulimia nervosa are:

1. 1.     Most patients with bulimia nervosa have a weight within normal limits, although some may be above or below.

1.         persistent preoccupation with food along with an irresistible desire or compulsive overeating.
2.     Supercharging episodes in which large amounts of food are consumed in short periods of time.
3.          The patient attempts to counteract the impact of binge eating on weight by one or more of the following means: excessive exercise, vomiting self-induced after ingestion, prolonged periods of fasting or consumption of drugs such as laxatives, diuretics or appetite suppressants.

5.    

Excessive or morbid fear to obesity . This is also observed in anorexia nervosa. In fact, often bulimic patients have had previous episodes of anorexia nervosa.

Biological factors

          Several research studies have associated with bulimia nervosa alterations in several brain neurotransmitters (messenger substances are neurons use to communicate with each other) such as nor epinephrine, serotonin or endorphins. It has also been described a genetic vulnerability.

psychological factors

          During adolescence patients with bulimia nervosa often they exhibit behavioral disorders, so that may present other problems impulsivity (such as problems with alcohol , or other drugs ) sexual disinhibition, irritability or emotional liability high. Often these patients have low self - esteem associated; in fact, bulimia nervosa occurs more often in people with disorders depressive . Also they occur more frequently various personality disorders, especially borderline personality disorder.

Social factors

          As occurs in anorexia nervosa , bulimia nervosa patients often have a high school performance. Also important are the social and cultural pressures around to maintain a slim figure, although, as noted, most bulimic patients maintain a weight within normal limits. Also worth mentioning that bulimic patients often they perceive their parents as neglectful and feel rejected by them.

What are the causes of bulimia nervosa?

          The cause of bulimia nervosa is unknown, being generally a combination of biological, psychological and social factors:

Gastrointestinal problems

• Damage to the teeth by stomach acid
• Thickening of the salivary glands
• Esophagi is (inflammation of the esophagus) and esophageal ulcers
• Lesions in the stomach and intestine

Cardiovascular and metabolic disorders

• Cardiac arrhythmias
• Alterations in blood ions
• Edema (fluid retention) in the legs

Urinary complications

• Renal impairment
• Urinary infections

Neurological and muscular problems

• Contractures and muscle paralysis
• epileptic seizures
• endocrine disorders
• Declines in female hormones
• Ovarian atrophy
• Ovarian Cysts
• infertility

What is the evolution and prognosis of the disease?:

          While some cases of bulimia nervosa are short, usually symptoms occur months or years before the patient to seek help. As expected, patients who are able to engage in treatment are those with a better evolution. In about one third of patients can occur chronicity of any of the symptoms.

          The prognosis for bulimia nervosa will depend largely on the aftermath. Keep in mind that binging, but especially compensatory behaviors such as self-induced vomiting or I abuse laxatives or diuretics can lead to serious physical complications:

What is the treatment of bulimia nervosa?

          Treatment should be focused both to the symptoms of bulimia nervosa as to the associated physical and psychological disorders. Specific treatments for bulimia nervosa include both psychological therapies and drug treatments. However, as with most psychiatric disorders, it is the combination of both strategies which achieves a better response.

Usually, the treatment of bulimia nervosa patients must be performed on an outpatient basis. Hospital admission, preferably in specialized units is recommended only when they have been repeated failures by outpatient treatment and coexist physical or psychological problems that a more intensive treatment may require

psychological treatments

          Various psychological interventions are being used in the treatment of this disorder of eating behavior:

Also, self-help groups are useful for some.

• Cognitive behavioral therapy: is the mode most commonly used psychological treatment for bulimia nervosa. This treatment modality has been made ​​from previously developed cognitive therapy for depression and other psychiatric disorders.
• motivational therapy
• interpersonal therapy
•  Cognitive analytic therapy: is a therapeutic modality of short duration, usually between 16 and 20 sessions, which combines elements of cognitive therapy and psychodynamic psychotherapies orientation.
•  Rational Emotive Therapy
•  Family therapy: This is a fundamental element of treatment in a significant number of cases.
• group therapy relapse prevention
• Other therapies group
•  drug treatments:

          Antidepressant drugs: in part due to the high frequency of depressive symptoms in bulimic patients are observed, antidepressants -well administered alone or in combination with some form of psychotherapy are most commonly used drugs in this disease. If are well multiple antidepressants that have been employed, such as amitriptyline, imipramine, desipramine, trazodone or phenelzine, are inhibitors of serotonin reuptake as fluoxetine, fluvoxamine, paroxetine, sertraline or citalopram those who have shown greater efficiency.

      Opioid antagonists: Naltrexone is an opioid antagonist which is commonly used to treat heroin addiction and alcohol also has shown some efficacy in the treatment of bulimia nervosa.

      Other drugs: such as fenfluramine, lithium, acamprosate or gabapentin may be useful in certain subgroups of patients.