Mental health articles

Features of bulimia nervosa

For a person to be diagnosed with bulimia nervosa, they usually have the following features:

• persistent preoccupation with eating and irresistable craving for food

• irresistible craving for food

• ‘binges’ (episodes of overeating) and attempts to counter the effects of food• morbid fear of fatness with imposed low-weight threshold.

Persistent preoccupation with eating and irresistible craving for food

The person with bulimia nervosa will wish to avoid eating; however, they will be preoccupied with thoughts of food and calorific content. Effectively, they have aprofound loss of control over their eating and may refer to themselves as ‘failed anorexics’ as they are unable to starve themselves.

‘Binges’ and attempts to counter the effects of food

During these episodes, large amounts of food are consumed rapidly, usually foodssuch as bread, cakes or other sweet foods. This can be very costly and some peoplewith bulimia nervosa are caught shoplifting food. Usually, the person eats alone.After eating, there is initial relief but rapidly this turns into guilt and disgust.These episodes may have been precipitated by a stressful event, sad mood or bydeciding to break a period of self-starvation. The person isnot necessarily hungry but sees food as a comfort.

After the binge eating, the person may then induce vomiting, take laxatives,endure periods of starvation or use drugs (e.g. appetite suppressants) to rid the bodyof the food in the hope that they will not gain weight. These episodes of binge eating and then purging may occur several times a day.

Louise Roche in her biography Glutton for Punishment describes an episode of binge eating:

I close the curtains and sit on the floor surrounded by the food. I turn on the bedsidelamp, shut the door and begin to eat. First the toast. I cut thick slices from the still-hardbutter and lay them on the toast. I ram piece after piece into my mouth, feeling thebutter cold and greasy against the warm, dry toast. I eat piece after piece until it isall gone and then start to eat the chocolate _ _ _ and begin to eat mechanically throwingsome pieces to the back of my throat without even tasting them, putting some pieces inslowly and pressing them against the roof of my mouth before scraping them off andpushing them down my throat..

Morbid fear of fatness with imposed low-weight threshold

Like the person with anorexia nervosa, the person with bulimia nervosa has a fearof being fat, and they constantly set themselves an unrealistic weight target toachieve. They also have overvalued ideas on what being slim represents and feelif they could reach and maintain their unrealistic ideal weight then life would bemuch better. They are very self-critical and, like people with anorexia nervosa, areperfectionists in their own standards of behaviour.

 

Tags: bulimia, bulimia nervosa