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Symptoms and Treatment of Bulimia

Bulimia nervosa afflicts many people worldwide. Those who struggle with bulimia will binge, i.e., eat large quantities of food such as whole pizzas, bags of chips, or multiple types of food over a short period of time. They will then compensate for the binge by throwing up, using laxatives, and/or exercising for hours. The binges may result from the patient being hungry due to restricting food intake for too long, or they may be triggered by stress or emotions. Patients may binge and purge a few times a week to several times a day. To have a true diagnosis of bulimia nervosa, a patient needs to have objective (very large) binges and compensate for these binges at least twice a week for a minimum of three months, according to the DSM-IV psychiatric manual. Bulimia cannot be diagnosed in a patient who is struggling with concurrent anorexia symptoms, i.e., weight is less than 85% of ideal body weight. Those patients would be diagnosed with a bingeing and purging subtype of anorexia.

Signs that signal possible bulimia include restricting food intake followed by intake of food in quantities much larger than what would be considered a normal portion size. Patients then sneak away to the restroom or take showers shortly after eating to vomit in secret. Large quantities of missing food, secret stashes of food, or empty food wrappers can be a sign of bingeing. Some patients, especially teens, will hide their vomiting from others by throwing up in trash bags or hiding outside during the process. Empty laxative packages, frequent diarrhea, and over exercising are other things that should also raise suspicion that someone may be struggling with bulimia. Weight may be high, low, or normal in bulimic patients. They may be overly conscious of their weight, or they may be embarrassed to weigh themselves due to increasing weight with ongoing binges.

Physical symptoms may include complaints of feeling lightheaded or having frequent sore throats. Patients may complain of feeling cold, and they may be more depressed or irritable than usual. Females sometimes stop menstruating. Physical examination may reveal cold hands, enlarged saliva glands, damaged enamel on the teeth, and cuts or calluses on the hands.

Those struggling with possible bulimia should be evaluated and treated by a full eating disorder treatment team. Medical professionals will monitor for electrolyte abnormalities, which are common in those who vomit or use laxatives. Potassium

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