Bulimia nervosa is an eating disorder that originates from psychological causes, the consequences of bulimia can be very serious without adequate therapy. A bulimic person can be overweight, normal weight or underweight, manifest excessive attention towards food and an exaggerated concern about their weight and physical shape. The therapy for bulimia nervosa is multidisciplinary, it is not only a nutritional diet treatment, it also includes psychological and psychotherapeutic treatments to regain control of one’s life. So let’s see what are the psychological causes of bulimia nervosa, what it is, how it manifests itself and finally the therapy and the consequences, even serious ones, of this insidious eating disorder.
What is bulimia nervosa?
Bulimia nervosa is an eating disorder caused by psychological reasons that lead the bulimic person to binge eat a large amount of food in a short period of time, and then purge it, fearing for their physical shape and weight gain.
Those who suffer from bulimia nervosa can be of normal weight, underweight, or overweight, unlike those who suffer from anorexia nervosa who are always underweight. The total lack of hunger control along with psychological causes is the determining factor in this eating disorder. The desire to binge eat is a constant and unstoppable thought that only stops when the person has binged so much to the point of feeling sick.
Bulimia derives from the Greek words bous and limos, meaning “ox’s appetite,” and bulimia nervosa indicates psychological, not medical, causes at the origin of the problem. A person is considered bulimic if they have binge eating episodes but are unable to digest it and deliberately eliminate the excess food to try to avoid weight gain, being overly concerned about their physical shape and weight.
Bulimia nervosa is a severe eating disorder characterized by the ingestion of excessive amounts of food in a short period of time with loss of control (binge) followed by attempts to avoid weight gain by eliminating what has been consumed (compensation behaviors) and excessive concern for weight and body shape. When we speak of “excessive amount of food” we refer to an amount of food ingested significantly higher than what a person normally consumes during a meal. By “short period of time” we mean a period not exceeding 2 hours, while the loss of control is characterized by the inability to refrain from eating or the inability to stop once started.
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To make a diagnosis of bulimia nervosa, binge eating episodes must occur at least once a week for three months. It is difficult to obtain an early diagnosis because those who have this disorder generally feel ashamed of their eating behavior and try to hide it at all costs. For this reason, binge eating episodes often occur in solitude. Weight and body shape are the main factors on which self-esteem is based for those who suffer from bulimia nervosa.
Bulimia Nervosa: What Are the Psychological Causes Behind the Eating Disorder?
Bulimia Nervosa is an eating disorder where the relationship with food is unhealthy and negatively impacts various aspects of daily life, including relationships with others and self-image. Risk factors for bulimia nervosa, like other eating disorders, are influenced by the individual’s environment and unresolved personal issues.
Obesity or one’s family members’ diet, criticism from friends and relatives about one’s appearance or diet, memories of childhood obesity, being in environments that emphasize thinness (dance, fashion, sports), and traumatic events are all possible causes of bulimia nervosa. These are risk factors, which means they increase the likelihood of someone developing an eating disorder.
In particular, the psychological causes that increase the risk of developing bulimia nervosa include:
- having low self-esteem;
- lacking self-confidence;
- having little awareness of one’s emotions;
- being excessively perfectionistic;
- being extreme in beliefs: “it’s either black or white”;
- not being able to compromise and instead showing impulsive, obsessive behavior;
- tending to place too much importance on weight and body shape.
Psychological, physical, and relational consequences
The main psychological consequences of bulimia nervosa include:
- negative effects on mood, such as sadness, depression, and guilt;
- lack of self-esteem;
- heavy impact on self-image;
- reduced interests, with a focus solely on food;
- detrimental effects on healthy personality development, especially in young people.
The main physical consequences of bulimia nervosa include:
- using self-induced vomiting or improperly using laxatives and diuretics can have severe consequences on the body, including serious electrolyte imbalances resulting in kidney complications, heart arrhythmias, cardiac arrest, and even death;
- difficulty concentrating;
- less likelihood of engaging in recreational or sports activities;
- constant fluctuations in body weight;
- ruptured blood vessels in the eyes;
- enlarged glands in the neck and under the chin;
- trauma to the oral cavity, such as cuts in the mouth and throat;
- chronic dehydration;
- inflammation of the esophagus;
- chronic acid reflux after eating or peptic ulcers;
- infertility.
The main relational consequences of bulimia nervosa include:
- avoiding social situations, especially those involving eating with others, such as work dinners, birthdays, or brunches;
- frequent family arguments;
- problems in relationships in various aspects.
The consequences of bulimia nervosa are directly related to the severity of the eating disorder. Therefore, the more bulimic episodes there are in a week, the more binge eating takes place, the more laxatives, diuretics, and vomiting are used, the more severe the consequences will be. It’s possible to die from bulimia nervosa, so if you suspect you suffer from it, book a medical consultation. The first step in overcoming the disorder is to interrupt the vicious cycles of bulimia, including interrupting binge eating and compensatory behaviors.
Therapy for Bulimia Nervosa: Types of Treatment
The pharmacological treatment involves administering compounds effective in controlling binge eating and antidepressants to generate an overall improvement in mood.
The psychotherapeutic treatment brings about a modification of problematic family relationships, if the family is undergoing treatment, otherwise it focuses on deep psychological distress underlying the disorder. Greater awareness helps to take note of the consequences of one’s disturbed eating behavior.
The cognitive-behavioral rehabilitative treatment involves a joint effort by several specialized figures working in a team: the dietitian-nutritionist, the psychotherapist, and the psychiatrist. The primary goal is to change the mistaken idea that weight and physical shape are the elements on which to estimate one’s worth, thus helping the patient manage the symptoms. Recognizing physiological hunger from “psychological” (or nervous) hunger is a great first milestone, and together with better management of one’s emotions and the restoration of a healthy eating behavior (eliminating the cycle of “binge/compensatory behaviors”), constitutes the rehabilitative treatment of bulimia.
The treatment of bulimia, like other eating disorders, requires a multidisciplinary and specialized team capable of evaluating the numerous elements to be considered during treatment.
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The information provided in the Diet and Italian Recipes articles is for INFORMATION ONLY and does not intend to replace the opinion of professional figures such as a doctor, nutritionist, or dietitian, whose intervention is necessary for the prescription and composition of personalized dietary therapies.
