- Bulimia nervosa is an eating disorder where individuals experience cycles of bingeing AND purging behaviors in an attempt to “undo” bingeing behaviors with a significant focus on shape and weight. It can impact individuals of different cultures and ethnicities, shapes and sizes, identities and orientations, cognitive and physical abilities, and socioeconomic levels.
- What is a binge?
- Eating unusually large amounts of food over a short period of time (around 2 hours) AND feeling out of control or that one can’t stop eating.
- What is purging?
- Repeated engagement in behaviors in an attempt to lose weight/”undo” calories consumed. These behaviors can be in response to multiple types of feelings including guilt, shame, and embarrassment.
- Types of purging:
- The most common is self-induced vomiting (could be with a finger, toothbrush, on one’s own or other object, or by inducing vomiting with ipecac).
- Excessive exercise
- Not using insulin as prescribed (withholding it or taking too much)
- Thyroid hormone misuse
- Individuals with bulimia nervosa often experience:
- Cycles of bingeing and purging
- Frequent trips to the bathroom during or after meals
- Restriction and/or fasting between bingeing and purging
- Preoccupation with how one’s body looks and feels
- Patterns of hiding or hoarding food or food wrappers
- Engaging in behaviors alone or in secret
- Withdrawal and disinterest in values driven activities, changes in mood, periods of isolation, impacts on focus and concentration
- As bingeing and purging behaviors increase in frequency and/or intensity, individuals may experience physical symptoms that impact their functioning. Often, the physical symptoms may be dependent upon the type of purging.
- With self induced vomiting individuals may experience acid reflux, nausea, throat irritation, broken blood vessels in eyes, increased nosebleeds, blood in vomit, dental complaints including teeth sensitivity, staining or discoloration of teeth, enamel erosion, increased cavities, swollen cheek or jaw areas, calluses on the back of hands or knuckles, cracks in corners of mouth.
- With misuse of diuretics or enemas individuals may have increased urination or diarrhea respectively.
- With any form of purging individuals can develop dangerous and sometimes lethal electrolyte abnormalities, dehydration, and heart rhythm changes.
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Thank you so much for all of your help, understanding, wisdom and patience. Some of the most helpful advice I got (in treatment) was from you. I am so grateful for your brain. You’re an incredible psychiatrist and I’m stoked we have people like you in this field.
I want to thank you for working with me and not walking away. I know I was not easy to work with but I appreciate how willing you were to keep me informed and allowed me to remain an active participant in my plan of care. You are so caring, thoughtful, insightful, and ‘real’. I would not be where I am right now without you.
Thank you for always being there for me. If you ever would consider a career change, you would be a great therapist. You know how to push for answers but also encourage positive thoughts. Thanks again for everything.
I dont think I could even write enough words to express how grateful I am for you. Though our time together was relatively brief, you had a profound positive impact on my life, most of which was due to the unconditional regard and often tough love you provided more so than any ‘medical’ care you provided. You saw me as a person, a whole person, not for my eating disorder but for the potential person I can become when healthy. That is always what I wanted more than anything, to be seen and be known. Thank you for believing in me when I didn’t believe in myself. Thank you for caring for me and putting up boundaries when all I wanted to do was self destruct. Thank you for the unconditional positive regard. You were a light in a dark time of my life and made an impact I will always carry with me.
I never had a psychiatrist who treated me with kindness, dignity and honesty the way you have from the moment we met. I came in feeling guarded and afraid but you helped me find hope again. I will forever be grateful to you for your support and help in fighting this eating disorder. Thank you so very much.
Thank you so much for all of the hard work and time you put into taking care of me. The insight and wisdom you provided me will be something I carry with me throughout my recovery and beyond.
I’m really going to try to express my gratitude even though it will be exceptionally difficult because you have helped me with something as important as my life. Here’s the thing. I know some people who really dislike their treatment team. That is not the case with me. From the get-go, I absolutely loved the team that I had. Not only that, but you’re an exceptionally settling presence and you've made it easier to be open and honest with the people that want to help me.
Thank you for providing support, words of wisdom and care- even when I didnt want it.
I felt like you heard and understood me! I appreciated all your metaphors; they helped put things into perspective. Thank you for taking time with the medication and always listening to my concerns and issues. Your support means the world to me and I always felt a little better after seeing you.
You’re so funny, validating and kind and also brutally honest, which I life. I always loved having meetings with you because we always talk about random stuff after all the doctor things and it give me such happiness. I know it seems small but just having normal and funny convos with you always made my day. Also thank you for being so validating whenever I had a sucky day because most people try to fix it but you’d just validate what I was saying and suggest ways to help me with my distress around it. Thanks for being an amazing person and changing my life!
I’m so lucky to have had you as my doctor and I’ve really enjoyed getting to know you. You have really helped me and somehow always give me these motivating lectures whenever I see you. What you’ve taught me will stay with through and it has made me wiser and stronger. THank you for the kindness and empathy you have shown me and for supporting me through my recovery.