The deadly consequences of bulimia are a bitter reality. Bulimia - what is it, symptoms and treatment of bulimia

Bulimia - what is this disease? It's simple - it's a mental disorder associated with eating disorders. In medical practice, as an independent disease, it began to be considered relatively recently. The main manifestation of bulimia is bouts of overeating, in which a person is able to use a large number of food without being satiated.

After a breakdown, bulimics feel guilty and try to get rid of what they have eaten in various ways, such as taking a laxative or making themselves vomit. Such behavior inevitably leads to exhaustion of the body and the development of many complications from various internal organs.

What it is?

Bulimia is a mental disorder associated with eating, which is characterized by a sharp increase in appetite, beginning in the form of a paroxysmal agonizing hunger. This disease often affects young women, whose psyche is most susceptible to influence. Patients do not have willpower and are not able to control the amount of food eaten.

Reasons for development

Despite the fact that the disease has been known to mankind for a long time, the causes of its autonomous occurrence are still insufficiently studied. That's why modern medicine adheres to the following, the most likely causes of the development of the disease, namely:

low self-esteem inherent in upbringing or in the process of growing up, which provokes stress, a state of constant self-doubt,
severe stress in which a person is for a long time, and is not able to eliminate the cause that caused it,
violation of metabolic processes in the brain due to prolonged action of a toxin or chronic chemical poisoning,
bulimia is more common in people who childhood deprived of food as a punishment for misconduct, or vice versa, rewarded them for success with additional dishes,
burdened heredity (one of the close relatives was diagnosed with bulimia).

Bulimia is the opposite of anorexia. People with bulimia are much more difficult to identify than those with anorexia or general overeating because they tend to maintain a healthy weight. In their behavior in the intervals between attacks, such people can be no different from healthy people.

More often, however, patients with bulimia are characterized by almost complete uncontrollability, and, even in between attacks, a tendency to overuse can manifest itself in relation to alcohol or medications.

bulimia nervosa

There are only a few people who are satisfied with their appearance and not everyone can put up with it. In pursuit of an ideal figure or after relieving nervous tension, people fall into the trap of bulimia.

How does this happen? After starvation or nervous strain, a person pounces on food, not having the willpower to stop. For this reason, people become addicted to bulimia nervosa. Personalities who suffered from bulimia nervosa are Princess Diana, the famous fashion model Twiggy, Ernest Hemingway's granddaughter Margot Louise, fashion model Kate Moss, Elvis Presley, aerobics host and actress Jane Fonda.

The causes of bulimia nervosa lie in a constant state of stress, in the vulnerability and insecurity of a person, as well as in loneliness, constraint by various conventions. That is why the very process of eating food brings a person joy, satisfaction.

Bulimia Symptoms

The main symptom of bulimia is constant feeling hunger. A person is very strongly drawn to food, and he cannot overcome this feeling. Absorbing a large amount of food, he does not feel full. Bulimics are predominantly depressed. Their mood rises only when they eat, and if they are deprived of the opportunity to eat, they can become depressed, become irritable, their mental capabilities and performance decrease.

In bulimia, another characteristic symptom is being overweight. But this does not apply to all bulimics: the constant fear of gaining excess weight can cause them to starve, artificially induce vomiting, take laxatives, or play hard sports. Thus, one more characteristic symptom of bulimia can be identified - a special behavioral model.
Bulimia, like any other disease, has its stages. Usually the initial stage is characterized by rare uncontrollable bouts of craving for food. In a month, there are no more than one or two episodes when the disease makes itself felt. But bulimia can also become chronic.

As a result, the organs suffer. gastrointestinal tract, heart, blood vessels and, most importantly, the psyche. A person becomes emotionally unstable, anxious, hysterical and insecure, which only aggravates the disease.

Bulimia causes depression, obesity and can become one of the main symptoms of anorexia.

Possible consequences

The most common complications of the disease:

Lack of the element chlorine in the body causes digestive dysfunction and dehydration.
due to vomiting, under the influence of gastric juice, tooth enamel is significantly damaged.
low levels of free calcium ions (bleeding disorders, weakening of bones and teeth, impaired nerve impulses, increased risk of osteoporosis)
during vomiting, an infection is introduced into the oral cavity. The result is irritation of the throat, swelling of the submandibular salivary glands, ulcers on the tongue.
electrolyte imbalance - especially hypokalemia, usually leads to impaired cardiac activity (arrhythmias, cardiogenic shock, myocardial infarction), and weakness of the heart muscle.
the wall of the rectum weakens and hemorrhoids develop.
sometimes vomiting leads to rupture of the esophagus or stomach.
the most fatal consequences are cancer of the larynx or esophagus.

During the enema procedure, damage to the esophagus and stomach, bleeding in the gastrointestinal tract, gastric perforation, gastric distension, constipation (depending on laxatives), pancreatitis, bowel disease and duodenum.

How to get rid of bulimia?

Bulimic patients have various disorders that are reversible with integrated approach to treatment. Therapy should preferably be supervised by a psychotherapist or psychiatrist and nutritionist. You should not confuse a psychotherapist with a psychologist: psychologists do not have a medical degree and most often do not treat serious diseases, but provide psychological counseling.

Generally, bulimia is treated on an outpatient basis, and only some patients may require hospitalization. Stabilization of the patient's condition is the main goal if the person is in a life-threatening condition. The primary goals of treatment are aimed at the physical and psychological needs of the patient in order to restore physical health and normal food intake.

A well-studied form of treatment for bulimia is cognitive behavioral therapy (CBT), which aims to make the patient himself responsible for controlling his diet. Patients keep records, recording the food they eat and noting bouts of vomiting; they try to identify external stimuli or emotional changes that precede the onset of cravings in order to further eliminate or avoid these factors:38. Procedures are applied to reduce dietary restrictions and to develop cognitive and behavioral skills to deal with binge eating:507. Patients are taught to identify and change dysfunctional thoughts and attitudes about their own figure, body weight and nutrition, as well as any dysfunctional thoughts and attitudes that contribute to negative emotions, against which there are bouts of overeating.
Controlled studies have shown the advantage of cognitive behavioral therapy over other types of psychotherapy and pharmacological intervention. On average, CBT relieves binge eating and GI cleansing activities in about 50 percent of all patients, with a percentage reduction in binge eating and GI cleansing in all patients treated with SBT typically 80% or more. CBT gives good and lasting results: therapeutic changes persist for a year or more. Long-term prospective follow-up after CBT (mean duration = 5.8 years) showed that approximately two-thirds of the patients did not suffer from eating disorders. A feature of CBT for bulimia is also its speed of response: the frequency of attacks begins to decrease after the first few sessions of therapy.
Treatment with antidepressants should be considered if bulimia is accompanied by an overt depressive disorder:38-39; antidepressants may also be prescribed if the eating disorder is accompanied by neurosis, such as obsessive-compulsive disorder. Fluoxetine, an antidepressant of the group of selective serotonin reuptake inhibitors, as well as tricyclic antidepressants, has been proven effective in bulimia:495. Other drugs, such as monoamine oxidase inhibitors, are also used.
CBT is more effective for bulimia than antidepressant therapy alone (and CBT-induced therapeutic changes persist much longer than antidepressant-induced changes), but CBT plus an antidepressant combination is more effective than CBT alone. It is sometimes argued that antidepressant therapy is aimed at treating only the conditions that accompany the eating disorder, and not the disorder itself, and that treating bulimia with antidepressants alone will not lead to recovery.

In addition to CBT, other psychotherapeutic methods are sometimes used for bulimia, such as behavioral therapy, psychodynamic therapy, family psychotherapy; experiential psychotherapy and the Twelve Step program derived from the treatment of abuse disorders psychoactive substances. A very promising method, whose effectiveness in bulimia approaches that of CBT, is interpersonal (interpersonal) therapy.

Psychotherapy is prescribed by a doctor on an individual basis, since its use depends on many factors, including the presence of concomitant mental disorders.

Sometimes it is also noted that in the treatment of eating disorders, diet therapy (which is not a panacea and is prescribed strictly individually), vitamin therapy (used to eliminate the imbalance of vitamins and trace elements that may occur during the course of the disease), a course of treatment of internal organs (if there are appropriate complications of bulimia).

The ultimate goal for the patient is to accept himself as he is and to lead physically and emotionally. healthy life. Recovery of physical and mental health is likely to take a very long time and the results will be gradual. Patience is an important part of the recovery process. A positive attitude, along with great patient effort, is another integral component of a successful recovery.

Iloreflexotherapy

Acupuncture is a healing technique that came from the ancient East. Not used as independent method treatment, but only as an adjunct to traditional medicine. Acupuncture points are stimulated with needles. For effective therapy you need to know the exact location of these points. Acupuncture in the treatment of bulimia is a new direction.

Effects of therapy: normalizes the patient's appetite and energy metabolism. In addition, acupuncture relaxes and helps to get rid of stress.

Bioenergy therapy

The most popular form alternative medicine. This is one of the oldest ways to restore health. Therapy has been known since antiquity in China, India, Egypt, Mesopotamia. Most diseases in the human body begin with thoughts about the disease, and then the disease appears in physical body. In the case of bulimia, the patient is constantly dissatisfied with the proportions of the body, he is worried about increased appetite.

Bioenergy activates the body's natural defenses, puts "order" in the patient's body. When the energy source of the problem is removed, the disease stops. This treatment option is very good if it is not possible to defeat the disease in the classical way.

Forecast

If you or someone close to you has symptoms of bulimia, see your doctor. This disease is dangerous because the patient is absolutely unable to control himself, and eventually bulimia can become severe form. Various violations that have arisen as a result of the disease, with an integrated approach to treatment, are reversible.

In the case of bulimia, the prognosis is related to the effectiveness of the treatment and the psychological mood of the patient. With timely effective medical therapy and high-quality psycho-correction, the prognosis is favorable. Otherwise, complications may arise in the form of a malfunction of cardio-vascular system, problems with the stomach or with a depressed psyche.
In some cases, spontaneous healing may occur. For example, with a powerful positive emotional shock and change psychological state the patient for the better.
In order to prevent the onset of bulimia, prevention is necessary, which is to maintain a healthy psychological climate in the family, instilling proper nutrition skills in the child and developing adequate self-esteem in him. If a teenager is worried about figure flaws and excessive fullness, it is necessary to monitor his diet and eating behavior. Food should not be used as a means of rewarding or punishing children.

Practice shows that attempts to cure this disease on their own do not lead to tangible results: sooner or later, there comes a moment again when you can not restrain yourself and pounce on food. Making progress in this case will be quite difficult. With the help of professionals and the support of relatives, dealing with bulimia will be much easier. The main condition for recovery: do not overeat or starve. Nutrition should be balanced, and positive emotional condition- stable.

Bulimia (bulimia nervosa)- it's serious life threatening mental illness.

People with bulimia may secretly overeat and then induce vomiting, take laxatives, or exhaust themselves with exercise in an unhealthy way to get rid of calories.

Some sufferers can "purify" themselves even after eating a modest amount of food.

Bulimia is a common disease. For example, in the United States, it affects 1 to 3% of adolescent girls and young women. More than 90% of patients with bulimia are women. Average age patients for about 17 years.

Bulimia is divided into two types:

Cleansing bulimia. In this type of bulimia, people try to induce themselves to vomit or abuse laxatives, diuretics, and cleansing enemas.
. Nonpurifying bulimia. With this type of illness, people use other unsafe calorie loss methods, such as starvation, a rigid diet, or strenuous exercise.

Some patients combine these methods, trying to achieve the desired result at any cost. People with bulimia are preoccupied with caring about their weight or body shape, judge their appearance very strictly, and suffer because of it. Bulimia can be very difficult to overcome, but treatment helps sufferers feel better, eat well, and prevent serious consequences.

Causes and Risk Factors for Bulimia

The exact cause of bulimia is unknown. Bulimia is considered a polyetiological disease, in the development of which psychological, sociocultural and family factors play a role.

Bulimia is most common in Western society, where there is a lot of pressure for women to be thin and fit. In those Eastern countries, where fullness is not only not considered a vice, but even praised, the frequency of bulimia is extremely low.

Risk factors for bulimia include:

Female.
. Adolescence.
. The presence of relatives with similar problems. Perhaps these disorders are associated with a deficiency of serotonin in the brain, which is inherited.
. Psychological factors such as low self-esteem, perfectionism, impulsive behavior, anger control problems, obsessive-compulsive disorder (OCD), anxiety disorders.
. Social pressure. Propaganda slim figure as a model for a sexy and successful woman. Pressure on teenagers and ridicule from classmates.
. The need for high achievements in sports. Eating disorders are typical for female athletes (gymnasts, runners, etc.). Coaches and parents can unconsciously contribute to such pathologies, achieving high results from young athletes.

Bulimia Symptoms

The main signs of bulimia are:

Excessive preoccupation with one's body.
. Living in constant fear of gaining weight.
. Inability to control one's behavior.
. Immoderate meals to fullness and pain in the abdomen.
. Inducing vomiting after eating.
. Starvation or a very strict diet.
. Abuse of laxatives.
. Taking diuretics to lose weight.
. Exhausting exercises for weight loss.
. Use of dietary supplements for weight loss.

Physical signs that may indicate frequent vomiting include:

Russell's sign: Numerous welts on the arms from cuts on the upper incisors received during induction of vomiting.
. Swelling of the parotid glands.
. Damage to the enamel of the upper teeth.
. Various diseases gums
. Petechial hemorrhages in the palate.
. Petechiae on the skin of the face after vomiting.
. Well developed abdominal muscles.

In patients suffering from bulimia, there may be a complete absence of any signs of exhaustion. They may be in normal physical shape.

When should you see a doctor?

If you notice signs of bulimia in your loved one, contact your medical care As soon as possible. If left untreated, this disease can worsen and lead to a fatal end.

Talk to your family doctor or psychiatrist about your concerns. If the patient resists your attempt to help, find a way to influence him through people whom he considers an authority (girlfriend, teacher, coach). Don't let this disease run its course!

You cannot force a person into treatment, but you can offer them your help and support. You can find a qualified specialist who will be able to help a loved one.

People with bulimia are often normal or overweight, so it's sometimes difficult to suspect something is wrong.

If you live with a person with bulimia, then it will not be difficult for you to notice:

. Frequent complaints about being overweight.
. Negative perception of one's appearance.
. Restless examination of one's body in front of a mirror.
. An unusually large amount of food eaten at one time.
. Unwillingness is in plain sight of other people.
. Going to the bathroom right after eating.
. Too intense exercise.
. Ulcers, cuts or scars on the hands.
. Problems with teeth and gums.
. The appearance of new drugs in the house.

Complications of bulimia

Bulimia causes many dangerous complications:

Severe dehydration that can be life threatening.
. Irregular heartbeat and heart failure.
. Severe diseases of the teeth and gums.
. Absence of menstruation (amenorrhea).
. Digestive problems.
. Anxiety and depression.
. Alcoholism and drug addiction.
. Side effects associated with medication.
. deficit nutrients(proteins, vitamins, minerals).

Diagnosis of bulimia

If you suspect bulimia, your doctor may order the following tests:

Seeing a psychiatrist.
. Complete physical examination.
. General urine and blood tests.
. Analyzes for the level of electrolytes.
. Tests for cortisol, LH and FSH levels.
. X-ray of bones for fractures.
. Electrocardiography (ECG), etc.

For the diagnosis of bulimia, there are special psychiatric guidelines and questionnaires.

The American Psychiatric Association recommends that patients with bulimia meet the following criteria:

. Patients believe that they regularly overeat; they feel they are unable to control their urge to eat.
. Patients get rid of excess calories by vomiting, fasting, exhausting exercise, taking laxatives, diuretics, and cleansing enemas.
. Patients eat and “cleanse” themselves at least 2 times a week for three or more months.
. Patients experience shame and low self-esteem due to the shape of their body and their weight.
. Patients do not have anorexia nervosa (anorexia nervosa) - another disease associated with malnutrition.

But even if a person does not meet all of these criteria, he still may have a violation of eating habits. Do not try to diagnose yourself - seek the help of a specialist.

Bulimia treatment

With bulimia, the patient may need several different treatments: psychotherapy, taking antidepressants, etc. Treatment should include a team approach. Doctors (family doctor, nutritionist and psychiatrist), family and friends of the patient should also participate in it.

Methods for treating bulimia:

1. Psychotherapy.

Psychotherapy for bulimia should last for years. Relatives and friends of the patient must be involved in it. It is necessary to raise the self-esteem of the patient in order to save him from the need to "improve" his body in an unhealthy and dangerous way.

2. Medicines.

Antidepressants can relieve symptoms of bulimia when taken along with psychotherapy. The only antidepressant that has been approved by the FDA for the treatment of bulimia is fluoxetine (Prozac), a member of a group of selective serotonin reuptake inhibitors. They can help with bulimia even if the sufferer is not depressed.

3. Treatment by a nutritionist.

If the patient has a low body weight due to bulimia, then the first goal of treatment is to gain weight and maintain normal nutrition. A nutritionist will help develop the optimal, complete diet. If the patient is overweight, the doctor will suggest a safe weight loss plan.

4. Hospitalization.

Usually, the patient does not need to be hospitalized to treat bulimia. But if a person has a severe form of the disease and there are dangerous complications, he should be treated only in a hospital.

You certainly cannot cure bulimia on your own, but there are several steps you can take to help you along with professional treatment:

Keep a diary of pre-planned meals for each day of the week. You should eat these portions without doubts and worries, about which you will make a note in your diary.
. Stick to your doctor's advice. All recommendations and visits to the doctor should also be recorded. Do whatever you are told to do, even if it makes you uncomfortable. Don't skip doctor visits!
. Enrich your diet with vitamins and minerals. Talk to your dietitian about taking a multivitamin. They will help you overcome nutritional deficiencies, which are common among bulimics.
. Examine your illness. Self-education is the first step towards overcoming illness. You must understand the nature of your disease, its features, possible consequences.
. Don't isolate yourself from loved ones. Maintain good relationships with those around you. It helps to overcome many mental problems, including bulimia.
. Don't be too hard on yourself. Resist the urge to look at your folds in the mirror every hour. You perfectly understand that nothing has changed during this time. Don't let someone put pressure on you and impose on you some kind of "ideal" to strive for. There is no ideal figure, and there cannot be.
. Be careful with loads. Talk to your doctor about the types of exercise you can do. Do not overload yourself, because you can harm your health, especially your heart.
. Beware of dubious dietary supplements. Some people who want to lose weight quickly run the risk of purchasing dubious funds through the Internet or simply from their hands. Remember that there is no healthy and safe way to lose 10 kilograms in a month. Do not use obscure and potentially dangerous agents.

Take care of your health!

Konstantin Mokanov

Bulimia, kinorexia or wolf hunger - serious pathological condition relating to mental disorders. Pathology is indigestion, which leads to various complications. It is noted that much more often the symptoms of the disease are observed in females, especially in those who seek to lose weight.

Causes of pathology

The disease is periodic bouts of binge eating followed by vomiting, intense sports or other manipulations to get rid of excess calories. According to studies, more than 90% of patients with a similar diagnosis are girls and women under 35 years old. Only about 5% are representatives of the stronger sex. To date, the mechanisms for the development of a pathological condition are unknown, but there are predisposing factors that can provoke the development of the disease:

One of the common causes of bulimia is a severe form of schizophrenia with regular periods of exacerbation.

Patients with similar symptoms practically unable to control the amount of food eaten, they almost do not feel the taste and eat food on the machine. However, in most cases they do not feel hungry.

Clinical picture

The first symptom of bulimia in women will be periodic overeating due to stress or another condition. At the same time, in almost 75% of patients, body weight does not go beyond the norm. This is due to the fact that after another bout of gluttony, a woman experiences a painful sense of remorse.

She reproaches herself for her act and tortures her body with physical exertion, makes enemas, takes laxatives in large quantities, provokes vomiting, and stops eating for several days. Often, patients combine several options, which greatly complicates the course of the pathology. The characteristic signs of the disease are as follows:

A characteristic symptom of the pathology will be increased salivation even in the absence of predisposing factors.

These symptoms do not appear immediately. Gradually, attacks occur more often, and clinical manifestations become aggravated.

Possible Complications

As a result of the alternation of hunger and gluttony in the patient's body, the functioning of all organs and systems is disrupted. A person develops severe gastritis, pancreatitis, and in some cases cirrhosis of the liver. Often in advanced stages - a severe form of obesity, heart failure, arterial hypertension.

Since bile stasis is regularly observed due to starvation, a large number of stones form in the gallbladder, which disrupts its work and provokes inflammation of the organ walls. As a result, the food that enters the stomach during the next attack is not digested. The processes of decay in the stomach and intestines provoke the development of pathogenic microflora.

Quite often, patients develop symptoms of enteritis and colitis, since the regular use of cleansing enemas negatively affects the intestinal walls. The inflammatory process provokes constant pain and spasms in the intestines.

Prolonged fasting leads to depletion of the body, deficiency of vitamins and minerals. A person often begins to get sick with various catarrhal pathologies, which complicates the course of the underlying disease. Breaks between meals provoke the appearance of small ulcers on the mucous membrane of the stomach and intestines, which, as the pathological process progresses, turn into ulcers.

In this case, the risk of perforation of the walls of the stomach and intestines increases significantly with the development internal bleeding. This condition often leads to death. The condition of a woman's teeth, hair, nails, and bones also deteriorates. Increased risk of accidental fracture. Hair falls out diffusely, and new ones do not grow. Nails exfoliate, tooth enamel darkens, becomes sensitive.

Quite often in women it is violated hormonal balance, menstruation becomes rare or disappears altogether, because the body is exhausted. Such a condition often provokes development when the patient, after another overeating, does not eat anything for a long time. As a result, bulimia becomes more severe, when a woman is unable to take food and even fluids.

The disease also refers to mental disorders and requires immediate treatment.

As a result of fasting, the patient gradually reaches the point where she is not even able to perform simple household manipulations. Her consciousness is confused, delirium and hallucinations can be observed. Dehydration is considered a danger to life and health. In such a situation, the risk of death increases several times.

Diagnostic methods

Treatment of bulimia is impossible without a comprehensive examination. Most often, a woman or a man does not recognize the problem, especially at the initial stage. That is why the first step will be an appointment with a psychotherapist. An experienced doctor will determine tactics that will help in a particular case and find out the causes, stage of pathology.

As a rule, this will require several sessions. The doctor must enter into the patient's confidence, become his friend. Only in this case, a person will be able to tell him about the true causes of overeating. Identification of them is very important, since further treatment will be closely related to the root cause.

The next step will be to identify comorbidities. mental nature in order to separate their clinical manifestations from the underlying disease. After that, it is carried out general examination. This is necessary to accurately determine the stage of pathology. If the patient has many complications from the internal organs, the disease has been developing for more than a year and requires immediate treatment. General analysis blood and urine, x-ray examination, magnetic resonance imaging, cardiogram - all this is necessary to determine the stage of the pathology and possible complications.

A mandatory item will be a blood test for hormones, glucose levels, liver tests.

It would be useful to conduct fibrogastroduodenoscopy in order to determine the presence of ulcers on the mucous membrane of the stomach and duodenum. An additional method will be sigmoidoscopy, during which the doctor will determine the degree of damage to the intestinal mucosa.

Medical treatment

The symptoms and treatment of bulimia are closely related. For the relief of acute clinical manifestations, medications are used. They are selected individually after receiving the results of a diagnostic examination. Most commonly used in therapy the following groups of medicines:

Apart from special means, symptomatic therapy is also used to alleviate the symptoms of complications that have already appeared on the part of organs and systems. The most commonly used drugs are:

An obligatory moment in therapy will be the appointment of a vitamin complex in order to make up for the deficiency of valuable components.

This is necessary, since it will not be possible to quickly make up for the deficiency with food, and the body needs enough useful substances for the successful fight against the disease.

It should be noted that any medicine should be prescribed only by a specialist in medical institution. Self-administration stops the symptoms, but if the dosage is incorrect or the instructions are violated, it does not help in the treatment, but only exacerbates the problem.

Treatment with psychotherapy

The use of medications alone will not help to completely eliminate the problem, and after completing the course, it is likely that the patient will return to their old habits again. Only the combination of psychotherapy with taking medications will bring results and allow you to get rid of the disease forever. Usually, sessions with a psychotherapist significantly increase the effectiveness of medications.

As a rule, in cases of timely access to a specialist, the patient needs 2 sessions of psychotherapy per week. After 2-3 months, complete recovery occurs. In advanced cases, therapy takes at least a year with trips to a specialist at least 3 times a week.

Any memory or an unpleasant incident can become a provoking factor, which as a result will become the beginning of development mental disorder. If the doctor is able to convince the patient that the problem has existed for a long time, it will be much easier to normalize his condition.

An important point will be programming the patient to refuse bouts of gluttony and awareness of their danger to life. A person must set a goal and strictly follow it, understand the need for healing through awareness and acceptance of oneself in the present. This moment is considered the most significant and necessary in the psychotherapy of bulimia.

Usually, good effect has a single therapy, but in some cases the patient needs the company of other people with a similar problem. Usually group sessions are held after several weeks of single therapy, when the patient is already fully aware of the need to get rid of the problem.

Group classes allow you to feel that a person is not alone, that there are many other people with similar disabilities. As a rule, in a group, patients talk in detail about the onset of their illness, about their feelings and changes in the body. Everyone shares their experience and successes that have already been achieved. Often this inspires beginners, stimulates them to recovery.

Usually 4-6 weeks of group sessions thrice a week are sufficient for recovery. If this method did not bring the desired result, you should return to single lessons and carry them out until full recovery.

In some cases, the patient on therapy requires the support of relatives.

Prevention of violation

There are no special measures to prevent the disease, since it is quite difficult to prevent psychological disorders. But it is recommended to avoid stress, overeating and the formation of dependence on food.

Products should not be taken as a way to relieve stress or enjoy. They should serve only as a means to saturate the body and the normal functioning of all systems. If you understand and accept this position, it is possible to avoid the disease.

Bulimia is a serious pathological condition from the group of psychological disorders that significantly complicates life and requires qualified assistance. With timely initiation of therapy, the risk of complications is significantly reduced.

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, elevated level stress and the spread of fast food.

From the screens and covers of magazines, certain standards of beauty are promoted, which 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 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 means forearmed.

What it is?

If many have heard about anorexia, then information about this disease pops 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 correct the figure and lose weight, although in most cases it does not exceed the norm.

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

To date, 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 (go in for sports, constantly clean the body, go on diets), but at the same time, nature has deprived them perfect proportions body. They are guided not by their BMI, but by the parameters of beauty that flicker in the media, and their own reflection in the mirror, which they cannot objectively evaluate.

Bulimia is a cyclic disease, as the patient has to move again and again in the same circle that 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 for Anorexia Nervosa and Related Disorders (ANAD) has called it a fatal mental condition.

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

The reasons

In each case, the reasons may be different. Their identification and elimination is the main task of therapy. 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:

disturbed 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:

desire to meet the standards of beauty imposed by society;
internal complexes come from childhood and adolescence (bullying from classmates and relatives about being overweight at 10-16 years old);
constant comparison of oneself with someone from the environment, unhealthy rivalry with a thin and slender girlfriend (colleague, neighbor ...);
dependence on social networks, in which acquaintances constantly publish pictures with flat tummies, a wasp waist and a pumped-up booty;
careless and tactless remarks, jokes, comments from acquaintances, parents, coaches, friends about the figure or weight.

Psychogenic:

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

Moreover, bouts 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, 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 bulimic sufferer is not able to independently realize true reason bouts of overeating. But finding the trigger is very important so that you can take the appropriate steps to curb your appetite.

Other names. Bulimia is also called wolf hunger or kinorexia.

Kinds

There are several classifications.

Clinical and pathogenetic approach

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

According to the mechanism of occurrence

Reactive - a surge in the disease occurs at 20-25 years, the provoking factor is unbearable psychological stress, the main manifestation is the constant struggle between the desire to eat tasty and a lot and the need to limit and control nutrition.
Autochthonous - begins in adolescence, is characterized by frequent attacks, an irresistible craving for tasty and forbidden food, a lack of understanding of the presence of a disease, and a lack of satiety.

Structural psychopathological analysis of seizures

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.
Dysthymic - the patient is emotionally worried that he is drawn to food, but is unable to fight the attacks, so they happen almost daily.
Impulsive - a person does not understand what is happening to him, therefore he does not particularly worry about attacks, although there are internal complexes about the imperfection of his own figure.

Way to lose weight

Medicinal - uncontrolled intake and.
Vomiting - artificial induction of vomiting several times a day.
Sports - grueling workouts.

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

Statistics. 10% of those suffering from bulimia are men. 10% of adolescent girls aged 12 to 16 put this diagnosis. In 10% of cases, the disease ends in death due to cardiac arrest, exhaustion or suicide.

Clinical picture

The main signs of bulimia:

overeating, when a person cannot control the amount of food eaten, and it exceeds the daily allowance;
permanent use various methods fight against overweight: cleansing the body through emetics and laxatives, hunger strikes, exhausting training programs;
excessive dependence of self-esteem and mood on body weight and figure parameters.

Bulimia often develops against the background of mental disorders, diseases of the central nervous system and the endocrine system. Everyone has it individual person it manifests itself in different ways:

self-harm, where 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 a large amount of food, can be sudden (most often this happens at night) and constant (a person always chews something without stopping);
seizures are accompanied strong weakness, excruciating hunger, dizziness and pain in the stomach.

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

prostration;
predisposition to ENT pathologies;
failure of the menstrual cycle up to amenorrhea;
fluctuations in weight;
violation of metabolic processes;
pathology of the gastrointestinal tract;
depressive state;
self-hatred, constant guilt for bouts of overeating;
painful need for approval from other people;
muscle pain;
dental problems;
too frequent talk about diets, models, nutrition, weight;
stool disorders caused by overeating;
dry skin, bad condition nails and hair.

At the same time, the majority have a normal weight, i.e. the idea extra pounds- invented, obsessive, not corresponding to reality.

Since bulimia is a mental disorder, a person cannot objectively evaluate either his own behavior or the parameters of his body. It seems to him that he is doing everything right (starves, goes in for sports, cleanses the body), but he is so imperfect that even this does not lead to the desired result (sizes 90/60/90, cubes on the press, wasp waist, etc. ). This provokes constant bouts of irritability, and internal complexes quickly develop into real self-hatred.

On a note. Age peaks, which account for bursts of the disease, are - teenage years(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 (test for attitude to food). It was developed in 1979 in Toronto at the Clark Institute of Psychiatry. Already based on it, other similar tests were released. They can be found on the Internet and go online, but the interpretation of the results and the final diagnosis should be carried out exclusively by a doctor.

If you suspect bulimia, you should contact 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 could be affected.

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

Treatment

In order for the treatment to be effective, a comprehensive examination of the body is carried out and the conclusions of various specialists are collected. But the main course of therapy will be conducted by a psychotherapist.

Medical

You can treat bulimia with medication - in some cases, antidepressants are prescribed. They are effective when:

overt 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 oxidase: Moclobenide, Pirlindol.

Most 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 the 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 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.

The goal is to teach the patient to control his diet.
Tools to achieve this goal: patients write down how much they ate at each meal, and then try to identify factors that provoke binge attacks.
Work to eliminate these factors.
Reducing Eating Restrictions: Instilling Proper, Healthy Eating Habits.
Development of skills to counter attacks.
Identification and change of dysfunctional thoughts and attitudes about the figure and body weight.
Fighting negative emotions.

How effective CBT is in treating bulimia can be seen from the following facts:

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

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

behavioral therapy;
psychodynamic therapy;
family psychotherapy;
analysis of experiences;
the Twelve Steps program (adapted from the system for treating substance dependence disorders);
interpersonal therapy (interpersonal) is one of the most promising methods 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

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 from the diet of fast food and sweets.
Reception of multivitamin complexes is needed only in the presence of a lack of certain trace elements and vitamins.
Treatment of concomitant diseases.

To cope with bulimia, the patient must learn to accept himself as he is, to lead 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 are interested in how to get rid of bulimia on their own, without the involvement of antidepressants and CBT. You can try, but no one will give a guarantee of a complete cure, since it is very difficult to cope with a mental disorder.

First, you need to try:

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

The hardest part is choosing desired products. After learning that it is recommended to abandon a certain list, many fall into extremes, which entail new breakdowns and attacks. Therefore, if you can’t wake up in the morning without coffee, you don’t need to force yourself in any case: once a day, 150 ml of your favorite drink without sugar can be afforded. The same goes for chips or a hamburger. Once a week, a small pack or a small portion will not cause serious harm. Make indulgences, otherwise the more you restrict yourself in food, the more powerful and dangerous then attacks occur.

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

Garlic

Grind 3 cloves of garlic, pour a glass of warm water, leave for a day, drink a tablespoon daily before bedtime. Garlic infusion has a beneficial effect on the valve that unites the esophagus and stomach. If there are problems with the gastrointestinal tract, this recipe is contraindicated.

Linseed oil

Before each meal (both main 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), pour a glass of boiling water. Strain after half an hour. Drink as soon as the attack begins. It dulls the feeling of hunger for 2-4 hours.

Wormwood

Pour 20 g of dried and chopped grass 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. Fruits are crushed, mixed and filled with 3 liters of water. Put on fire and boil down to 500 ml. Drink 4 times a day for half a glass, 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 stigmas with a glass of boiling water, steam in a water bath for 20 minutes. Take a tablespoon before meals.

Collection of herbs

Mix 40 g of dried herbs of lemon balm, couch grass, chamomile, yarrow, dandelion, St. John's wort, horsetail. Pour 500 ml of boiling water. Insist 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. Beat thoroughly with a whisk, drink a tablespoon before meals for a month.

Baths with lavender

Their main function is soothing. Put a few drops in the bath essential oil lavender. Take twice a week before bed.

Motherwort

Pour a tablespoon of dry chopped motherwort with a glass of boiling water. Keep for 20 minutes in a water bath. 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 start medical or psychotherapeutic treatment as soon as possible.

Data. Bulimics tend to prefer sweets and starchy foods. Scientifically, this is quite understandable. Firstly, such products deliver maximum pleasure and contribute to the production of a large amount of endorphins. Secondly, they are high in calories, increase blood sugar levels, which allows you to feel full for at least some time.

Forecasts

Can bulimia be completely cured? Many sources claim that even after completing the full course of therapy, the disease still returns. Indeed, the risk of such a development of events is very high for two reasons. First, the main trigger is stressful situations that lie in wait modern man at every step. Secondly, the disease belongs to mental disorders, and it is extremely difficult to overcome problems with the central nervous system even with the help of medications.

Here are the experts' predictions:

complete deliverance is not guaranteed by any technique known today;
the main symptoms and consequences are eliminated by CBT for a sufficiently long period, subject to the implementation of all medical recommendations;
there are cases of spontaneous disappearance of signs of bulimia in the absence of treatment after a strong mental shock, which was of a positive nature, but they are extremely rare;
attempts at self-treatment rarely end 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 the immediate environment, the chances of recovery increase.

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

Complications

Unfortunately, most patients do not even know 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, narcotic;
suicide;
acute heart failure;
antisocial behavior, isolation, cessation of communication up to autism;
irritation of the pharynx and mucosa of the esophagus (due to constantly induced vomiting);
violation of water-salt balance;
proctological disorders due to frequent use enemas;
severe dehydration;
caries, bleeding gums due to repeated vomiting (gastric acid destroys tooth enamel and irritates the oral mucosa);
inflammation of the esophagus;
electrolyte imbalance leads to muscle cramps;
intestinal disorders;
disorders in the liver and kidneys;
internal bleeding;
amenorrhea;
heart disease.

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 a recent course of CBT, in the presence of such diseases in one of the relatives. It is aimed at acquiring and consolidating normal eating habits and maintaining psychological health. What measures need to be taken for this?

Avoid any stressful situations whenever possible.
Find something non-food related that will give you pleasure: hobbies, work, family, etc.
Do not abuse drugs.
Temper your character.
Take a multivitamin twice a year.
If you have low self-esteem, sign up for training.
Do not close in yourself, expand the circle of communication.

A very large responsibility in the prevention of bulimia falls on the shoulders of parents. The risk of its development in the future may depend on their upbringing. To protect the child from this problem in the future, it is necessary:

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

The support of family and friends 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.

Useful information

Bulimia is a disease that is not yet so common, but doctors are sounding the alarm. It is assumed that the number of people suffering from it will increase several times every year. The 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 is in a hurry to consult a doctor with this disease, even if they suspect it in themselves. A block of useful information will dispel some of the doubts.

What movies about bulimia can you watch?

Starving.
Maledimiele.
Sharing the Secret.
Kate's Secret.
When friendship kills (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 activity. In most cases, this leads to caesarean section, miscarriage or stillbirth. Babies born to mothers suffering severe form bulimia, are weak, they are often diagnosed with:

developmental delay;
low blood sugar;
increased level of red blood cells;
weakened immunity;

As practice shows, in the future, such children have an increased risk cardiovascular disease, type II diabetes, and hypertension. Given the seriousness of the situation, when diagnosing bulimia in a pregnant woman, timely and comprehensive assistance from doctors of various specializations is necessary. Chances of a safe birth healthy child in this case, they increase several times.

How is bulimia different from anorexia?

Who from famous people suffered from bulimia?

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

Elvis Presley - became the saddest and most famous example of a fatal outcome in 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. of the last century, the fashion model Twiggy was very fashionable, as she resembled a reed girl, but after another bout of overeating, her heart failed, she was in a state of clinical death but they managed to save her.

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

Kate Moss - used to be constantly starving in order to be the owner of a flat, almost childish figure. But when she started eating, she often couldn't stop. She underwent long courses of treatment in many prestigious clinics in the world.

Nicole Kidman - suffers a lot serious illness- Anorexia nervosa on the background of 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 there are any doubts, it is better to seek medical help so that it does not come to complications and hospitalization.

Bulimia is a mental disorder associated with eating disorders. In medical practice, as an independent disease, it began to be considered relatively recently. The main manifestation of bulimia is bouts of overeating, in which a person is able to consume a large amount of food without feeling full. After a breakdown, bulimics feel guilty and try to get rid of what they have eaten in various ways, such as taking a laxative or making themselves vomit. Such behavior inevitably leads to exhaustion of the body and the development of many complications from various internal organs.

As statistics show, the ailment in question is more common in young girls and women under the age of thirty-five. Among all patients, only 5% are males. A person with bulimia has two obsessions: food and weight loss. Even very thin women may consider themselves overweight, which forces them to adhere to the strictest diets.

The person is essentially in vicious circle, is in a constant state. At some point, a nervous breakdown occurs - an attack of compulsive (uncontrolled) overeating. Absorbing food in large volume, the patient experiences euphoria, which after is replaced by strong feeling guilt and panic that this will entail an increase in body weight. Again there is stress, hunger strike, etc.

Bulimics themselves do not consider themselves ill, do not seek help from specialists. Such people perceive violations of their eating behavior, rather, as a bad habit, which they are ashamed of. This explains the fact that all patients try to hide their overeating and “cleansing” of the body from others.

Bulimia is almost always accompanied by other disorders, such as sexual disorders, severe, etc. As shows medical practice, only about 50% of people achieve a complete recovery, but even they can relapse. The success of treatment depends not only on the right tactics, but also on the desire and willpower of the patient himself.

Causes of bulimia

At the heart of the development of the considered mental disorder is, as a rule, a psychological trauma that caused a disruption in the functioning of the food center in the brain. Such injuries can occur even in infancy and childhood due to lack of nutrition and parental attention. In adolescents, the development of the disease may be facilitated by unsettled relationships with peers.

Important: experts note that the risk of pathology increases in children who are encouraged by their parents with food for good study and behavior. This contributes to the fact that the child begins to consider food the main source of positive emotions.

Other possible reasons bulimia:

low self-esteem due to any existing or far-fetched external flaws, the desire for the ideal appearance of the model;
increased anxiety, stress;
nutritional deficiencies in the body caused by strict diets;
hereditary predisposition.

Most bulimics are not able to independently understand what exactly pushes them to overeat. The trigger mechanism of the disease can be found with the help of specialists and measures can be taken to control one's own eating behavior.

Doctors identify three main symptoms that characterize bulimia:

uncontrollable craving for food, which pushes the patient to eat a large amount of food in a short time;
taking measures that, in the opinion of the bulimic, will help to avoid obesity: taking diuretics and laxatives, artificial induction of vomiting, cleansing enemas, exhausting physical exercises;
fluctuations in body weight;
self-esteem of the patient is based on the state of his figure.

There are a number of signs by which bulimia can be suspected in loved one:

frequent talk about proper nutrition, newfangled diets and excess weight;
patients can recover dramatically, and then also dramatically lose weight using fairly radical methods;
increased fatigue, depression, decreased concentration and memory, daytime sleepiness and insomnia at night - all these symptoms are a direct consequence of a lack of nutrients in the body;
the presence of diseases of the oral cavity, deterioration of the teeth, susceptibility to frequent tonsillitis and pharyngitis, the presence of scratches on the fingers, heartburn - these signs of bulimia indicate that a person often causes himself to vomit. Hydrochloric acid contained in vomit corrodes the oral mucosa, provokes an inflammatory process in the oropharynx;
another sign frequent vomiting may become burst due to a sharp rise blood pressure vessels in the eyeballs;
bulimics often suffer from stool disorders caused by overeating;
deficiency of nutrients leads to convulsions, impaired functioning of the kidneys, liver, cardiovascular system;
dryness skin, signs of premature aging, unsatisfactory condition of nails and hair;
women are often disturbed menstrual cycle up to amenorrhea. This is because one of the main reasons hormonal disruptions is a violation of metabolic processes in the body.

Attention! Having found signs of bulimia in a loved one, one should realize that the patient himself is not able to help himself, so the only right decision in such a situation will be to see a doctor.

An attack of bulimia is characterized by an uncontrollable feeling of hunger, which can appear even with a full stomach. Arise intrusive thoughts about specific dishes, dreams about food. All this prevents a person from concentrating on study or work, leading a full life.

When the bulimic is left alone, he literally pounces on food. With the rapid absorption of food, the patient does not even feel its taste. Many people consume completely incompatible products together. As a rule, bulimics prefer high-calorie foods, such as sweets.

After a breakdown, a full stomach puts pressure on the diaphragm and adjacent internal organs, breathing becomes difficult, there are pains and spasms in the intestines. The feeling of euphoria is replaced by remorse, guilt, fear of being overweight. The patient has an irresistible desire to get rid of calories, which causes him to induce vomiting or take a laxative.

Important! In the early stages of the disease, such breakdowns occur infrequently, only after stressful exposures. Over time, the situation worsens, and the person suffers from bouts of bulimia already several times a day.

Consequences of bulimia

Being serious illness nervous system, bulimia leads to severe complications, among which are:

decline blood pressure, provoking fainting;
and other pathologies of the cardiovascular system;
renal failure, which develops due to a deficiency of potassium salts;
reproductive problems: miscarriages early dates, fetal development disorders, infertility;
diseases of the oropharynx and digestive system generally;
chronic inflammation of the lungs;
decrease in working capacity;
irritability;
severe depression, attempts.

In an effort to hide the disease from others, bulimics often lose social connections, move away from relatives and friends, which only exacerbates their emotional state.

Diagnosis of the disease

There are several diagnostic signs, on the basis of which the diagnosis of "bulimia" can be made.

These diagnostic symptoms include:

recurring episodes of binge eating (at least twice a week for three months);
obsessive thoughts about food
constant struggle with excess weight;
frequent vomiting or spitting out food without swallowing;
low self-esteem.

An experienced doctor must distinguish between ordinary binge eating and compulsive overeating - bulimia. To common features These conditions include eating a large amount of food at a fast pace, usually alone. Both disorders are caused by disturbances in the emotional sphere and entail a sense of shame. Features of bulimia are that its attacks occur as a kind of reaction to stress, sadness, sadness or other emotions. Overeating in this case is not spontaneous, but is planned by the patient, who has a negative attitude towards food and is ashamed of the very fact of eating it.

Bulimics always compensate for overeating with artificially induced vomiting, laxatives, exhausting physical training. At the same time, taste properties and the type of products used are absolutely not important to patients.

The problem of bulimia is in the competence of a psychotherapist or psychiatrist. In advanced cases, a person may be referred for inpatient treatment if he has signs severe exhaustion and dehydration, severe depression with suicidal tendencies. Pregnant women suffering from bulimia are also treated in a hospital, as the disease poses a direct threat to the life of the child.

The best results are obtained by complex treatment of bulimia, which combines psychotherapeutic and medical methods. Psychotherapeutic treatment is always selected on an individual basis. As a rule, the course consists of ten to twenty sessions, which are held twice a week for several months.

The main areas of psychotherapy used in the treatment of bulimia:

note! Psychotherapy should be supported by regular physical activity. If the bulimic has comorbidities, such as obesity or gastrointestinal disease, consultation with narrow specialists and appropriate treatment is necessary.

As for drug treatment for bulimia, at the discretion of the attending physician, it may include taking the following groups of drugs:

antidepressants, contributing to the improvement of the conductivity of signals of nerve cells
selective serotonin reuptake inhibitors- contribute to the elimination depressive states, as well as improving the conductivity of signals from the cerebral cortex to the food center;
tricyclic antidepressants, which increase the concentration of serotonin and adrenaline in the nerve conductors, which have a pronounced sedative effect
antiemetics to suppress the gag reflex- they may be recommended in the initial stages of treatment before antidepressants begin to work.

Patients and their relatives need to remember that the treatment of bulimia is always a complex and long process, the success of which is directly proportional to personal desire and effort. Having learned to control one's own eating behavior and enjoy not only food, a person will begin to lead a full, versatile life.