Bulimia is an eating behavior disorder characterized by the presence of binge eating, that is, episodes in which the person ingests large amounts of food significantly higher than what is normal to eat in similar situations. This food intake is experienced with a feeling of loss of control over it, the person feels that he/she cannot stop eating.
The type of food ingested during the binge is that which is normally rejected as hypercaloric: carbohydrates and fats. The irrepressible impulse sometimes forces them to eat frozen foods or even those in the garbage. The way they eat is also abnormal: they eat quickly, voraciously and compulsively, gobbling it down without tasting it, mixing some foods with others.
Other symptoms of bulimia
Binge eating is accompanied by certain practices aimed at compensating for its effects on weight, i.e. on body shape. People with bulimia have an unhealthy fear of gaining weight. Vomiting is the most frequent means of avoidance, together with the abnormal use of laxatives, diuretics, etc. Dietary restriction is also the most common, and this contributes to maintaining the problem because as the restriction intensifies, the risk of binge eating increases.
Other symptoms are inordinate preoccupation with weight and the body, and the excessive influence of the same in determining self-esteem.
Binge eating triggers
When binge eating is already established, it is often precipitated by various circumstances. Dysphoric mood states (anxiety, sadness, anger, boredom) are common triggers. So are stressful situations and other situations of daily life that have previously been associated with binge eating.
One of the most important symptoms is body image distortion. This means that these people do not see their body as it is but see it as larger, especially those parts of their body that most concern them (hips, thighs, belly). The negative evaluation of one’s own body diminishes self-esteem and produces anxiety and negative mood.
The bulimic usually experiences significant difficulties in controlling his impulses, not only those related to the food area; hence the frequency of drug use, sexual promiscuity, changes of job and partner, and even stealing and lying. The presence of bulimia nervosa together with other psychological disorders such as anxiety, personality and affective disorders is frequent.
Prevalence of bulimia
The prevalence is about 2-3% of the adolescent and juvenile female population. It occurs in women in 90% of cases, and the average age of onset is around 17 years. Most people with bulimia nervosa are women of normal weight, although there are also those who are overweight.
The number of cases is increasing alarmingly in recent years. As it is a secretive behavior and does not present a marked weight loss, it usually goes unnoticed for a long time.
The causes of this disorder are multiple. Let us look at some of them:
There are genetic factors that, at the very least, would act as predisposing agents.
Sociocultural factors play a very important role in both the onset and maintenance of the disorder. In Western society there is great pressure to achieve an ideal of slim beauty and this causes a large part of the population to engage in weight control or weight loss behaviors. In a study carried out at the Autonomous University of Barcelona (Raich, Torras and Figueras, 1996), it was found that 80% of women who were in the normal weight range wanted to lose weight, 100% of those who were overweight, and even 18% of those who were very thin.
From a very young age, children receive messages about standards of physical attractiveness from a variety of sources. To the extent that these messages are internalized, they become personal ideals that can negatively affect satisfaction with one’s physical appearance, in some cases leading to illnesses such as anorexia and bulimia.
At the individual level, the yearning for thinness, dissatisfaction with one’s own body and the practice of restrictive diets are often constant antecedents. This is often accompanied by emotional fragility, low self-esteem and perfectionism. A history of obesity is also frequent: 40% of bulimic women had been obese in childhood.
The factors that usually provoke the onset of an eating disorder are those circumstances that appear in a person’s life and lead to changes. These include the illness or death of a close relative, marriage, divorce, death of a spouse or partner, or the death of a family member. Among them we can talk about the illness or death of a close relative, getting married, getting divorced, losing or starting a job, moving house, separation from a friend, or the first sexual relations.
Consequences of bulimia
The consequences of bulimia can be very serious:
At the psychological level, there is an alteration in mood, irritability, sadness, guilt, apathy, fatigue, low self-esteem, anxiety, decreased academic and/or work performance due to a reduced capacity for functions such as attention, learning and memory, addictions to other substances, self-harm….
At the social level, social and family relationships are greatly affected by this problem. A very frequent situation of conflict occurs with the mother, who is usually the one who is responsible for nutrition in the family nucleus. When a person stops eating and loses weight, or eats large amounts of food, it creates problems that usually generate a lot of discomfort. Also, people with bulimia tend to avoid social relationships for fear of being observed and judged.
On a physical level there may be abdominal dilatation, constipation, loss of tooth enamel, abrasions on the back of the hands, hernias or ulcers in the esophagus, electrolyte imbalances, kidney problems and cardiovascular alterations that can lead to death.