#bulimia - causes, symptoms, diagnosis and treatment.

Bulimia is a psychiatric disorder that belongs to the group of the Eating Disorders (anorexia is in this same group), which is characterized by recurrent and uncontrollable episodes of eating large amounts of food, usually high in calories, followed by inappropriate reactions to avoid weight gain, such as induced vomiting, use of laxatives and diuretics, fasting and exhaustive physical activity. After some time of sickness, vomiting becomes a spontaneous reaction to high caloric intake, ie, induction is no more needed. 

In patients with bulimia, it is not the thinness that brings attention. In general, they are young women with obsessively sculpted body, who follow strict diets and practice exagerated physical exercises. Suddenly, they lose control and eat enormous amounts of food, in most cases, hiden from others. They are taken by feelings of remorse and guilt. The efforts used for not gaining weight cause many complications. For example: destruction of teeth enamel, sore throat, bleeding, gastrointestinal problems, heart arrhythmias, dehydration, etc.. 

The main difference between anorexics and bulimics is the serious state of malnutrition seen in patients with anorexia; this state is unusual in bulimic patients. 

Causes 

Several factors favor the onset of the disease: 1) genetic predisposition, 2) current fashion concept which determines the absolute thinness as the standard of beauty and elegance, 3) pressure of family and social groups and 5) brain neurochemical alterations, especially in the concentration serotonin and noradrenaline. 

Symptoms 

* Overeating in short periods of time without a corresponding increase in body weight; 

* Self-induced vomiting by placing the finger in the throat; 

* Indiscriminate use of laxatives and diuretics; 

* Strict diets alternate with sudden loss of control leading to compulsive food intake; 

* Depressive disorders, anxiety, obsessive-compulsive behavior, self-mutilation; 

* Large fluctuations in body weight; 

* Distortion of self-image and low self esteem. 

Diagnosis 

The diagnosis is not always easy due to denial of symptoms by the patient. Therefore, the survey's history, eating habits and the constant concern with weight must be carefully observed. According to the manuals for diagnosis in psychiatry, two episodes per week of uncontrolled food intake followed by vomiting for three months at least are needed to classify a patient as suffering from bulimia. 

Treatment 

Treatment requires a multidisciplinary team consisting of physicians, psychologists, psychiatrists and nutritionists. Antidepressant medications can be helpful, especially if disorders such as depression and anxiety occur. Similarly, cognitive-behavioral therapy has shown good results in the long term, especially when associated with the use of antidepressants and mood stabilizers. 

Unfortunately, there are no known effective methods to prevent diseases such as bulimia and anorexia. Certainly, the commitment of society to change certain aesthetic values ​​attached to the cult of the thin body would bring important health benefits. 

If a relative or friend is affected, remember that criticism does not help; instead, it serves to further undermine the self-esteem of the patient. Often, the whole family may need therapy monitoring.