Bulimia: what is it and how to deal with it yourself? Bulimia nervosa: symptoms, treatment. Talk about healthy eating and weight gain. Signs of bulimia: what symptoms can accurately tell about the disease bulimia

The most common medical name for the disease caused by the processes of uncontrolled overeating is bulimia or kinorexia.

Signs of the disease can manifest themselves in some pathologies caused by excessive accumulation of adipose tissue (obesity), bulimia nervosa syndrome, or endogenous mental illness. But it can also be an independent pathology in perfectly healthy, normal people.

Bulimia - what is it?

Bulimia is the most common type of eating disorders caused by the manifestation of irrepressible (wolf) hunger. In multiple cases, bulimic pathology may be the result of psychogenic disorders in patients with mental and neurological problems, often adjacent to anxiety and phobias, with syndromes of depressive states.

The manifestation of the disease is characterized by alternation (alternation) of two stages:

An indefatigable feeling of hunger accompanied by excellent appetite with an absent sense of proportion mechanism. As they say in simple terms - "lack of brakes."
The second stage is the maximum disposal of food eaten by any means, even harmful to health.

The duration of each stage can be any, depending on the severity of the abnormal process, manifesting itself in symptoms of varying severity at the behavioral (behavioral) level, or as a result of mental and physiological dependence.

Kinorexic disorders: causes

The genesis of disorders is based on hypothetical variants, since it has not been studied for certain. However, predisposing leading factors initiating the manifestation of kinorexia have been identified, which include:

Genetic inheritance of family mental, somatoform (contrived), depressive and anxiety-phobic pathologies;
Anatomical defects in various functions CNS;
Endocrine and metabolic pathologies;
Failures in the inhibitory function of CNS neurotransmitters;
Hereditary chronic dependence of "ancestors" to alcohol or drugs.

Against the background of even one of these disorders, an unconscious life scenario can be formed in the patient's subconscious, which is expressed by an obsessive need for food. The impetus for creating an anomalous scenario is:

Individual psychological characteristics of the patient (sensitivity, anxiety, timidity);
Low inadequate self-esteem and a sense of insecurity in their abilities;
Strict and harsh methods of education and critical external assessment of parents;
Influence of the informal asocial environment;
Unreasonable self-flagellation and guilt due to the divorce of parents;
Physical, sexual or mental abuse;
Frustration situations (failures, deceit, unfulfilled expectations);
Unfortunate experience of first love and fear of loneliness;

Symptoms of bulimia according to the forms of manifestation

Statistical data indicate the predominant manifestation of symptoms of bulimia in women, fixing the onset and development of the disease at a certain age.

initial form- pubertal kinorexia (bulimia), noted in adolescence(up to 16 years), corresponding to the period of the formation of hormones and the restructuring of the body.

Second form kinorexia nervosa (bulimia). It is characterized by the manifestation on the segment of personal maturation in the first period of maturity. After 35 years, pathology in female patients is very rare. In many cases, addiction to excessive gluttony at this age is manifested by symptoms of bulimia nervosa - signs of neuropsychiatric disorders or neurotic conditions.

The manifestation of the disease in men is very rare. But there are no grounds for asserting such a manifestation as neuropsychiatric disorders. Such a phenomenon as gluttony followed by stomach cleansing is most likely due to the fashion trend among young people - to have an athletically slender figure.

Behavioral eating disorders can be manifested by various clinical symptom complexes - constantly, and manifesting themselves in a paroxysmal course (in the form of seizures), which can provoke - physiological needs for food, psycho-emotional experiences, anxiety states and depression.

Emotional disorders are a typical stereotypical response to affective situations, and overeating is a kind of defensive reaction from their influence.

At the same time, the decrease in mental stress occurs not due to the digestion of food, but due to a decrease in uncomfortable experiences in the process of its absorption. This reaction eventually leads to the development of obesity.

The emotiogenic signs of bulimia include the phenomena of night eating (up to 10% of manifestations) and compulsive (compulsory, anxiety-relieving) overeating (more than 25% of cases), and mood, mental disorders.

Bulimia nocturnal syndrome is caused by dysfunction of the serotonin system of the brain, manifested by three-phase symptoms:

Anorexia in the morning, characterized by lack of appetite and aversion to food;
Evening and nocturnal kinorexia, with a sharp increase in an irresistible need for food, accompanied by a nocturnal zhor - a "belly feast";
Psychophysiological insomnia due to the influence of a stress factor.

This behavior is noted to be advantageous in women prone to mental disorders. Morning food disgusts them, and violent ingestion can cause nausea or vomiting reflex. In the second half of the day, the need for food increases sharply, in the late afternoon, an indefatigable zhor of everything begins in a row. But the feeling of satisfying hunger is very rare.

They justify insomnia with a feeling of hunger, which does not allow them to sleep and wakes them up in the middle of the night. Others justify night eating as a soothing and relaxing method that helps to distract from the sad reality and fall asleep faster, perceiving night gluttony as a sedative sleeping pill.

Numerous examinations of such patients have proven that the main stimulant of wakefulness in them is hunger and satiety.

The main signs of bulimia

Primarily, vivid symptoms bulimia, characteristic of patients, are manifested behavioral signs- they consume great amount food. At the same time, the meal is hurried, poorly chewed and swallowed in large pieces. After the "meal", they quickly rush to get rid of it, retire to cause a gag reflex.

Patients are secretive and closed, differ in non-standard behavior and signs mental disorders. They are overly addicted to the methods of all kinds of diets and the continuous counting of calories in the diet consumed.

They constantly carry with them an extensive arsenal of medicines that help get rid of food (emetics, diuretics, laxatives).

Physiological disorders are caused by:

Loss of strength and general disorders;
Physical weakness and predisposition to ENT pathologies;
Failure and absence of menstrual flow;
Frequent changes in weight;
Violation of metabolic processes;
Pathological processes in the digestive tract, in the salivation system, dental problems;
Depressive states.

The main manifestation of bulimic symptoms is paroxysmal in nature in the form of episodes of forced overeating, during which, for a short time absorbing a lot various food- any one that comes to hand.

Lost full control over the amount of food absorbed in one "sit".

Such an "orgy" can last up to 2 hours in a row. Repeat a couple of times a week, but continue for a long time, stretching for several days. At the same time, the “meal” takes place in “proud solitude” and is carefully hidden from relatives and people around. During and after the attack, the patient experiences stomach pain and nausea, self-contempt, guilt, and despair, but no satiety.

Psychologically, the manifestation of bulimic neurosis is very painful. The patient is well aware of the harmfulness of overeating, realizes how detrimental it will be to his own health, but he is not able to drown out his irrepressible hunger. To avoid painful consequences, the "glutton" tries by any means to get rid of what he has eaten - artificially induce vomiting or take laxatives.

Periods of gluttony are replaced by repentance and depressive states, often turning into neuropsychic anorexia with a complete lack of appetite.

The patient loses the meaning of life, develops mental pathologies of a neurasthenic nature. As a result, addiction to alcohol or drugs may develop.

Treatment of bulimia - methods and drugs

Self-treatment of bulimia is so rare that sooner or later it forces the patient to seek medical help.

Basic diagnostic criterion bulimia is due to a detailed survey, not even of the patient himself, but of his environment. The circumstances preceding the development of the pathology, the symptoms and the patient's well-being are clarified. With personal contact, deviations of a mental nature are clarified. The need for additional research to identify certain disorders, comorbidities:

examination of blood and urine;
measurement of blood pressure;
cardiac monitoring by ECG.

Diagnosis is confirmed based on characteristic symptoms when the act of overeating in combination with cleansing the stomach is noted at least twice a week, for several months (3 months or more).

The tactics of treating bulimia (kinorexia) is determined in accordance with the severity of pathological manifestations.

The healing process begins with the patient's readiness to recognize the existence of the disease and to reveal a voluntary desire to cope with it. Treatment is long and complicated, sometimes you need to change a lot in life.

According to statistics, a complete cure is observed only in 50% of patients. Consistently positive results psychological treatment in tandem with drug therapy antidepressant drugs.

Psychotherapeutic treatment of bulimia

Today it is based on the principles and methods of treatment used in many countries - ("Cognitive Behavioral Treatment"), due to a series of communication between the patient and the psychotherapist. Such meetings help the patient to assess the problem at the level of emotions and independently find new scenario her decisions.

In the process of learning, the task of the doctor is to convey to the patient that his gluttony is nothing more than a defensive reaction from psychological problems and external dependence. Awareness of this will enable the patient to independently build a line of his behavior. The patient is offered to keep a food diary, which will clearly help him analyze the situations that affect the attacks of uncontrolled eating.

The next applied psychotherapeutic technique is Interpersonal Therapy, due to the importance of social contact, influence on the patient and his connections with the surrounding reality. The doctor determines the factor that supports the patient, dear to him, which would reduce the super-significance of food as a central factor in his life.

Drugs and treatments for bulimia

Most often, in the treatment of bulimia with drugs, multicyclic antidepressant drugs of the SSRI group are used - Fluoxytin, Paroxetine, or Citalopram, and Sertraline, Fluvoxamine, or Dapaxetine. Their action is due to the cumulative nature and manifests itself after some time. Contribute to the correction of eating disorders, mental disorders and phobias.

AT healing process includes consultative visits to a nutritionist who teaches the right attitude to food with an individual selection of a diet and a detailed plan for therapeutic nutrition.

Complications of kinorexia

Permanent cleansing procedures and reception various drugs causing the gag reflex leads to the development of various pathologies.

The work of the intestines and stomach is disturbed, sometimes with the processes of internal hemorrhages. Due to salt and alkaline imbalance, functional disorders in the brain and heart structures can occur. As for the secondary consequences, they can manifest themselves:

alopecia - baldness and baldness;
yellowness of the skin;
premature appearance of wrinkles;
the development of muscle atrophy;
pulmonary pathologies;
problems with teeth.

The processes of dehydration and electrolyte deficiency can lead to disruption of many functions in the body. The most dangerous is the rupture of the esophagus or stomach due to severe overeating. The consequences of bulimia can turn into a disability "glutton".

In the 21st century, diseases associated with disorders have become more frequent eating behavior. This is due to factors such as the imposition of social stereotypes, increased levels of stress and the spread of fast food.

From the screens and covers of magazines, certain standards of beauty are promoted, which people strive to meet. Sometimes, against the background of constant nervous breakdowns, this becomes an obsession and develops into a real phobia. One such case is bulimia, which, according to statistics, affects about 7% of the population.

The figure is still small, but tends to constantly grow. Many suffer from it without even realizing it and having no idea what kind of disease it is. Therefore, it is so important to familiarize yourself with the basic information: forewarned means forearmed.

What it is?

If many have heard about anorexia, then information about this disease pops up much less often, although these diseases are similar. According to medical reference books Bulimia is an unhealthy eating behavior that is characterized by bouts of overeating and an obsessive desire to correct the figure and lose weight, although in most cases it does not exceed the norm.

People suffering from this disorder have very low self-esteem, they are mentally unstable and often abuse laxatives to cleanse the body again and again, causing diarrhea or vomiting by any means. Such stresses lead not only to numerous health problems, but also to alcohol addiction and even suicide.

To date, this disease has overtaken anorexia and compulsive overeating in its prevalence. Many patients do not even realize that they suffer from bulimia. For them, the picture looks like this: they lead a healthy lifestyle (go in for sports, constantly cleanse the body, diet), but at the same time, nature has deprived them of ideal body proportions. They are guided not by their BMI, but by the parameters of beauty that flicker in the media, and their own reflection in the mirror, which they cannot objectively evaluate.

Bulimia is a cyclic disease, as the patient has to move again and again in the same circle that he is unable to break: an attack of overeating - cleansing the body (through vomiting, enemas or laxatives) - - a new breakdown.

In connection with this situation, psychotherapists and nutritionists today are trying to convey to the masses as much information as possible about bulimia: how to identify it and how to get rid of it. The American National Association for Anorexia Nervosa and Related Disorders (ANAD) has called it a fatal mental condition.

Etymology. The term "bulimia" comes from two Greek words: "βοῦς" means "ox" and "λῑμός" means "hunger".

The reasons

In each case, the reasons may be different. Their identification and elimination is the main task of therapy. this disease. Without getting rid of the provoking factor, it is impossible to cure the patient. All of them are divided into 3 large groups.

Organic:

disturbed metabolism;
metabolic syndrome;
diabetes, insulin resistance;
lesions (toxic, tumor) of the brain in the hypothalamus;
hypothalamic-pituitary insufficiency (hormonal disorder);
genetics, heredity;
lack of nutrients as a result of constant hunger strikes.

Social:

desire to meet the standards of beauty imposed by society;
internal complexes come from childhood and adolescence (bullying from classmates and relatives about being overweight at 10-16 years old);
constant comparison of oneself with someone from the environment, unhealthy rivalry with a thin and slender girlfriend (colleague, neighbor ...);
dependence on social networks, in which acquaintances constantly publish pictures with flat tummies, a wasp waist and a pumped-up booty;
careless and tactless remarks, jokes, comments from acquaintances, parents, coaches, friends about the figure or weight.

Psychogenic:

psychological trauma received in childhood, and these include not only fullness in adolescence, due to which relations with peers did not develop, but also the starvation of the newborn, and the lack of parental love;
constant nervous breakdowns;
depression;
prolonged depression;
low self-esteem associated with shortcomings in appearance;
inferiority complex;
negative attitude towards life;
high anxiety.

Moreover, bouts of overeating can be triggered by both negative stress (due to the loss of a loved one, divorce, failures at work), and positive ( new novel, promotion at work). In the first case, food becomes the only pleasure that helps to calm down. In the second, it acts as a reward for merit.

Most often, a bulimic sufferer is not able to independently realize the true cause of overeating attacks. But finding the trigger is very important so that you can take the appropriate steps to curb your appetite.

Other names. Bulimia is also called wolf hunger or kinorexia.

Kinds

There are several classifications.

Clinical and pathogenetic approach

bulimia nervosa- develops against the background of mental disorders when comparing oneself with others.
Hereditary.
Depressive - begins after serious stress or psychological trauma.
Emotional - bouts of overeating for a person are a method of emotional discharge, such patients are characterized by irritability, irascibility and sudden mood swings.
Dietary - develops against the background of too long a hunger strike in order to correct the figure.

According to the mechanism of occurrence

Reactive - a surge in the disease occurs at 20-25 years, the provoking factor is unbearable psychological stress, the main manifestation is the constant struggle between the desire to eat tasty and a lot and the need to limit and control nutrition.
Autochthonous - begins in adolescence, is characterized by frequent attacks, an irresistible craving for tasty and forbidden food, a lack of understanding of the presence of a disease, and a lack of satiety.

Structural psychopathological analysis of seizures

Obsessive - the patient constantly struggles with himself, with his own attacks, often he manages to control overeating for weeks and even months, but then a powerful breakdown occurs, and he cannot stop, absorbing food in exorbitant quantities.
Dysthymic - the patient is emotionally worried that he is drawn to food, but is unable to fight the attacks, so they happen almost daily.
Impulsive - a person does not understand what is happening to him, therefore he does not particularly worry about attacks, although there are internal complexes about the imperfection of his own figure.

Way to lose weight

Medicinal - uncontrolled intake and.
Vomiting - artificial induction of vomiting several times a day.
Sports - grueling workouts.

Bulimia classifications apply in medical practice to clarify the diagnosis, identify the underlying causes and prescribe the optimal treatment.

Statistics. 10% of those suffering from bulimia are men. 10% of adolescent girls between the ages of 12 and 16 are diagnosed with this disease. In 10% of cases, the disease ends in death due to cardiac arrest, exhaustion or suicide.

Clinical picture

The main signs of bulimia:

overeating, when a person cannot control the amount of food eaten, and it exceeds the daily allowance;
permanent use various methods fight against overweight: cleansing the body through emetics and laxatives, hunger strikes, exhausting training programs;
excessive dependence of self-esteem and mood on body weight and figure parameters.

Bulimia often develops against the background of mental disorders, diseases of the central nervous system and the endocrine system. For each individual, it manifests itself in different ways:

self-harm, where a person suffers from the fact that his body does not meet the standards of beauty imposed by society;
appetite that leads to absorption a large number food can be sudden (most often this happens at night) and constant (a person always chews something without ceasing);
seizures are accompanied strong weakness, excruciating hunger, dizziness and pain in the stomach.

Some symptoms are simultaneously the result of the measures taken by the patient and his lifestyle. They relate to his mental and physical health:

prostration;
predisposition to ENT pathologies;
failure of the menstrual cycle up to amenorrhea;
fluctuations in weight;
violation of metabolic processes;
pathology of the gastrointestinal tract;
depression;
self-hatred, constant guilt for bouts of overeating;
painful need for approval from other people;
muscle pain;
dental problems;
too frequent talk about diets, models, nutrition, weight;
stool disorders caused by overeating;
dry skin, poor condition of nails and hair.

At the same time, the majority have normal weight, i.e. the idea extra pounds- invented, obsessive, not corresponding to reality.

Since bulimia is a mental disorder, a person cannot objectively evaluate either his own behavior or the parameters of his body. It seems to him that he is doing everything right (starves, goes in for sports, cleanses the body), but he is so imperfect that even this does not lead to the desired result (sizes 90/60/90, cubes on the press, wasp waist, etc. ). This provokes constant bouts of irritability, and internal complexes quickly develop into real self-hatred.

On a note. The age peaks for outbreaks of the disease are adolescence (13-16 years old) and young girls (22-25 years old).

Diagnostics

The disease is not diagnosed by conventional tests, as it belongs to the category psychological disorders. There is a test for bulimia - this is EAT-26: it stands for Eating Attitudes Test (test for attitude to food). It was developed in 1979 in Toronto at the Clark Institute of Psychiatry. Already based on it, other similar tests were released. They can be found on the Internet and go online, but the interpretation of the results and the final diagnosis should be carried out exclusively by a doctor.

If you suspect bulimia, you should contact a psychotherapist. To confirm the diagnosis, consultations with a gastroenterologist, therapist and nutritionist are also required. To identify concomitant diseases traditional tests are given: blood, urine, ECG, ultrasound of internal organs that could be affected.

For comparison. Many experts believe that bulimia is akin to drug addiction, only food acts as a drug. Signs of addiction are obvious: the patient cannot independently break out of the cyclical circle. Over time, the feeling of satiety is lost, so you have to increase portions and the number of meals.

Treatment

For treatment to be effective, comprehensive examination body and collect the conclusions of various specialists. But the main course of therapy will be conducted by a psychotherapist.

Medical

You can treat bulimia with medication - in some cases, antidepressants are prescribed. They are effective when:

overt depressive disorder;
neuroses;
obsessive-compulsive disorder.

In the course of ongoing research, the effectiveness of the following antidepressants has been scientifically proven:

selective inhibitors: fluoxetine, sertraline, paroxetine, citalapram, escitalopram;
tricyclic: Amitriptyline, Imipramine, Clomipramine, Maprotiline, Mianserin, Trazodone;
monoamine oxidase: Moclobenide, Pirlindol.

Most other drugs are prescribed (tablets), since tricyclic drugs, for example, in 30% of cases cause multiple side effects, due to which therapy is forced to be interrupted.

It is believed that the treatment of bulimia with antidepressants alone is not effective, since it only eliminates mental disorders, against which the underlying disease develops. Therefore, they are most often prescribed in conjunction with cognitive behavioral therapy.

Cognitive Behavioral Therapy

To cure bulimia, you need to seek help from a psychotherapist or psychiatrist. Hospitalization is required only in the most extreme cases, so that most often patients are observed by a doctor on an outpatient basis. The most effective treatment method is CBT, Cognitive Behavioral Therapy. It includes the following work with patients.

The goal is to teach the patient to control his diet.
Tools to achieve this goal: patients write down how much they ate at each meal, and then try to identify factors that provoke binge attacks.
Work to eliminate these factors.
Reducing Eating Restrictions: Instilling Proper, Healthy Eating Habits.
Development of skills to counter attacks.
Identification and change of dysfunctional thoughts and attitudes about the figure and body weight.
Fighting negative emotions.

How effective CBT is in treating bulimia can be seen from the following facts:

in 50% - complete relief from the disease;
in 80% - reduction of seizures;
results can last for a year or more;
the patient is registered for about 6 years after undergoing CBT, which is an excellent prevention of further development of the disease;
the frequency of seizures decreases after 3-4 sessions.

Neither antidepressants nor other psychotherapeutic methods give such an effect. The latter include:

behavioral therapy;
psychodynamic therapy;
family psychotherapy;
analysis of experiences;
the Twelve Steps program (adapted from the system for treating substance dependence disorders);
interpersonal therapy (interpersonal) is one of the most promising methods after CBT, which also gives good results.

The treatment program is drawn up in each individual case individually, as it depends on the presence of mental disorders, against which the underlying disease develops.

Additional measures

In some cases, diet helps. It is not a panacea and is prescribed purely individually. Most often it concerns a strict schedule of meals and exact dimensions portions, as well as exclusion from the diet of fast food and sweets.
Reception of multivitamin complexes is needed only in the presence of a lack of certain trace elements and vitamins.
Treatment of concomitant diseases.

To cope with bulimia, the patient must learn to accept himself as he is, to lead normal life. Restoring health (both physical and psychological) takes a lot of time, the results manifest themselves gradually, so you need to be patient. The positive attitude of the patient himself and the professionalism of the doctor are the main components of successful therapy.

Folk remedies

Many are interested in how to get rid of bulimia on their own, without the involvement of antidepressants and CBT. You can try, but no one will give a guarantee of a complete cure, since it is very difficult to cope with a mental disorder.

First, you need to try:

Eat fractionally: organize 5-6 meals a day, portion sizes should be no more than 250-300 g.
Get up from the table with a slight feeling of hunger.
Drink at least 2 liters of plain water daily.
Food should be light, low-fat, low-calorie, so that the stomach digests it quickly.
You need to have breakfast before 9 am, lunch - before 14.00, dinner - around 18-19.00.
Between the main meals, you need to arrange light snacks from fruits, nuts, smoothies, berries, dairy products.
Give up soda, fast food, sugar, coffee and alcohol.
Try to lead a healthy lifestyle.
Spend a lot of time outdoors.
Sleep (but don't oversleep) optimal amount time for sleep individually, but on average is 7-8 hours.
Do not be nervous.
Walks must be on foot.
Intense sports ( gym, swimming, running) are not recommended, as they lead to the burning of a large number of calories, which is fraught with an increase in appetite, exhaustion of the body, up to anorexia.
As soon as you feel another attack, drink kefir, green tea or the usual one.

The hardest part is choosing the right products. After learning that it is recommended to abandon a certain list, many fall into extremes, which entail new breakdowns and attacks. Therefore, if you can’t wake up in the morning without coffee, you don’t need to force yourself in any case: once a day, 150 ml of your favorite drink without sugar can be afforded. The same goes for chips or a hamburger. Once a week, a small pack or a small portion will not cause serious harm. Make indulgences, otherwise the more you restrict yourself in food, the more powerful and dangerous then attacks occur.

Secondly, at home, you can try to use folk remedies to dull the appetite.

Garlic

Grind 3 cloves of garlic, pour a glass of warm water, leave for a day, drink a tablespoon daily before bedtime. Garlic infusion has a beneficial effect on the valve that unites the esophagus and stomach. If there are problems with the gastrointestinal tract, this recipe is contraindicated.

Linseed oil

Before each meal (both main and snacks), drink 20 ml.

Mint and parsley

An infusion of mint and parsley has a calming effect. They need to be dried, crushed, mixed in equal proportions (a teaspoon), pour a glass of boiling water. Strain after half an hour. Drink as soon as the attack begins. It dulls the feeling of hunger for 2-4 hours.

Wormwood

Pour 20 g of dried and chopped grass with a glass of boiling water, leave for half an hour, strain. Drink a tablespoon 30 minutes before meals three times a day.

Plum and fig

Take 250 g of plums and figs. Fruits are crushed, mixed and filled with 3 liters of water. Put on fire and boil down to 500 ml. Drink 4 times a day for half a glass, regardless of meals.

Celery

Pour 20 g of fresh celery stalks with a glass of boiling water. Keep on fire for 15 minutes, strain. The resulting volume should be drunk 1 day in 3 doses 10 minutes before meals.

Corn silk

Pour a glass of boiling water 10 g corn silk, steam in a water bath for 20 minutes. Take a tablespoon before meals.

Collection of herbs

Mix 40 g of dried herbs of lemon balm, couch grass, chamomile, yarrow, dandelion, St. John's wort, horsetail. Pour 500 ml of boiling water. Insist 2 days. Drink a glass twice a day for a month.

St. John's wort

Mix 30 g dried St. John's wort, 10 ml concentrated lemon juice, 50 ml cold water, a teaspoon. Beat thoroughly with a whisk, drink a tablespoon before meals for a month.

Baths with lavender

Them main function- soothing. Put a few drops in the bath essential oil lavender. Take twice a week before bed.

Motherwort

Pour a tablespoon of dry chopped motherwort with a glass of boiling water. Keep for 20 minutes in a water bath. Strain. Drink 50 ml before meals three times a day.

If you have taken all possible measures to eliminate bouts of overeating, but they return again and again, it is better to start medical or psychotherapeutic treatment as soon as possible.

Data. Bulimics tend to prefer sweets and starchy foods. Scientifically, this is quite understandable. Firstly, such products deliver maximum pleasure and contribute to the production of a large amount of endorphins. Secondly, they are high in calories, increase blood sugar levels, which allows you to feel full for at least some time.

Forecasts

Can bulimia be completely cured? Many sources claim that even after passing full course therapy, the disease still comes back. Indeed, the risk of such a development of events is very high for two reasons. Firstly, the main trigger is stressful situations that lie in wait for modern man at every step. Secondly, the disease belongs to mental disorders, and it is extremely difficult to overcome problems with the central nervous system even with the help of medications.

Here are the experts' predictions:

complete deliverance is not guaranteed by any technique known today;
the main symptoms and consequences are eliminated by CBT for a sufficiently long period, subject to the implementation of all medical recommendations;
there are cases of spontaneous disappearance of signs of bulimia in the absence of treatment after a strong mental shock, which was of a positive nature, but they are extremely rare;
attempts at self-treatment rarely end in recovery;
in the absence of psychotherapeutic and drug treatment the prognosis is extremely unfavorable - complications begin to develop, the risk of death due to heart failure, gastrointestinal bleeding, and suicide is high;
with the support of relatives and the immediate environment, the chances of recovery increase.

An unfavorable prognosis is if the patient does not realize the presence of a problem for a very long time and refuses treatment.

Complications

Unfortunately, most patients do not even know how dangerous bulimia is. In the absence of proper treatment, the consequences for the body can become irreversible and lead to death. The most common complications are:

neurasthenia;
various forms of addiction: drug, alcohol, narcotic;
suicide;
acute heart failure;
antisocial behavior, isolation, cessation of communication up to autism;
irritation of the pharynx and mucosa of the esophagus (due to constantly induced vomiting);
violation of water-salt balance;
proctological disorders due to the frequent use of enemas;
severe dehydration;
caries, bleeding gums due to repeated vomiting (acid gastric juice destroys tooth enamel and irritates the oral mucosa);
inflammation of the esophagus;
electrolyte imbalance leads to muscle cramps;
intestinal disorders;
disorders in the liver and kidneys;
internal bleeding;
amenorrhea;
heart disease.

Such serious and severe consequences of bulimia once again indicate that it poses a danger to human life and health and requires timely medical attention.

Prevention

Prophylaxis is necessary if such a diagnosis has already been made in the past, after a recent course of CBT, if there is similar diseases from one of the relatives. It is aimed at acquiring and consolidating normal eating habits and maintaining psychological health. What measures need to be taken for this?

Avoid any stressful situations whenever possible.
Find something non-food related that will give you pleasure: hobbies, work, family, etc.
Do not abuse drugs.
Temper your character.
Take a multivitamin twice a year.
If you have low self-esteem, sign up for training.
Do not close in yourself, expand the circle of communication.

A very large responsibility in the prevention of bulimia falls on the shoulders of parents. The risk of its development in the future may depend on their upbringing. To protect the child from this problem in the future, it is necessary:

maintain a comfortable psychological microclimate in the family;
to form the correct self-esteem in the child;
do not use food in educational measures: you can not use it as a reward or punishment;
to instill in the child the right attitude to food as a normal physiological need, and not as a way to get emotional and physical pleasure;
form the right eating habits: eat according to the regimen, eliminate (or minimize) harmful foods.

The support of family and friends plays a huge role. Their help is a guarantee that a person will never encounter this disease, and if this happens, it will be much easier to recover.

Useful information

Bulimia is a disease that is not yet so common, but doctors are sounding the alarm. It is assumed that the number of people suffering from it will increase several times every year. The massive use of the Internet, which describes all kinds of diets and methods of cleansing the body, leads people (most often young and inexperienced girls) to a stressful state when they want to achieve an ideal figure by any means, even to the detriment of their own health.

Not everyone is in a hurry to consult a doctor with this disease, even if they suspect it in themselves. A block of useful information will dispel some of the doubts.

What movies about bulimia can you watch?

Starving.
Maledimiele.
Sharing the Secret.
Kate's Secret.
When friendship kills (When friendship kills).

How does bulimia affect pregnancy?

It is important to prevent bulimia and pregnancy from occurring at the same time. The disease depletes strength and resources maternal organism, and this is fraught with numerous complications in the development of the fetus and further labor activity. In most cases, this leads to caesarean section, miscarriage or stillbirth. Babies born to mothers suffering from severe bulimia are weak, they are often diagnosed with:

developmental delay;
low level blood sugar;
increased level of red blood cells;
weakened immunity;

As practice shows, in the future, such children have an increased risk of cardiovascular diseases, type II diabetes, and hypertension. Given the seriousness of the situation, when diagnosing bulimia in a pregnant woman, timely and comprehensive assistance from doctors of various specializations is necessary. The chances of a successful birth of a healthy child in this case increase several times.

How is bulimia different from anorexia?

Which famous people suffered from bulimia?

Princess Diana - fell ill when she found out about her husband's infidelity and became depressed. The treatment took 10 years.

Elvis Presley - became the saddest and most famous example of a fatal outcome in bulimia, which the singer constantly aggravated by drug use.

Diane Keaton (actress) - fell ill after losing weight for one of her roles.

Jane Fonda is an actress who was one of the first to admit that she had been treated for an illness for almost 30 years. She even founded a foundation to help women with this diagnosis.

Lindsay Lohan also made an official admission that she had been suffering from the disease for several years.

Nicole Scherzinger hid her illness for a long time not only from the public and doctors, but even from her family and friends.

famous in the 70s. of the last century, the fashion model Twiggy was very fashionable, as she resembled a reed girl, but after another bout of overeating, her heart failed, she was in a state of clinical death, but they managed to save her.

Elton John - fought not only with drug addiction and prolonged depression, but also with bulimia.

Kate Moss - used to be constantly starving in order to be the owner of a flat, almost childish figure. But when she started eating, she often couldn't stop. She underwent long courses of treatment in many prestigious clinics in the world.

Nicole Kidman - suffers a lot serious illness- Anorexia nervosa on the background of bulimic attacks.

Bulimia is a very serious and dangerous disease, often leading to death. Most people are not even aware that they suffer from this disease. Therefore, you need to carefully monitor your eating habits and any changes in weight. As soon as there are any doubts, it is better to seek medical help so that it does not come to complications and hospitalization.

An unhealthy increase in appetite may be a sign of developing dangerous disease- bulimia.

Bulimia is a disease in which frequent attacks uncontrolled tricks food necessarily end with the speedy disposal of what was eaten by artificial induction of vomiting.

This disease is insidious and multifaceted. A person who quickly and indiscriminately “swallows” the food that has come to hand is not aware of what is happening and cannot stop. The situation is aggravated by pain in the stomach, weakness of the body, the presence of a very strong appetite and the psychological dependence of the patient. Concomitant diagnoses in bulimia are often CNS disorders and endocrine pathologies.

Bulimia: symptoms of the disease: photo

Bulimia is extremely difficult to diagnose, because its signs can not always be recognized. You can suspect bulimia in a person who is characterized by:

Frequent overeating, "swallowing" food in pieces
obvious changes in weight either up or down
depression or sudden mood swings
taking laxatives and diuretics
diseases and defects of the teeth, damage to the enamel
too frequent visits to the toilet
unhealthy skin
burrs on the fingers and swollen cheeks due to the constant induction of vomiting
desire for food in solitude
lack of energy, fatigue
hoarseness

IMPORTANT: If treatment is not started on time, bulimia will quickly gain momentum and lead to irreparable consequences.

bulimia after diet

People who are dissatisfied with their appearance, namely their weight, usually sit on diets. To reduce body weight, they go to exhausting daily workouts and severe food restrictions.

A healthy body experiences severe stress from this lifestyle. Suffer not only internal organs digestion, but also the human psyche. Innocent, at first glance, attempts to comply strict diets lead to major breakdowns.

A person pounces on the food that he has denied himself for so long, and receives great satisfaction from the process of eating food. The euphoria does not last long. After realizing how many “forbidden” foods have been eaten, there comes a fear of gaining the kilograms shed earlier and the need to empty the stomach as soon as possible.

At this moment, a terrible disease is born - bulimia.

Over time, the need for the process of eating and feeling full becomes more and more. It becomes impossible to control food intake. Accordingly, trips to the toilet to get rid of "unnecessary" food are becoming more frequent.

IMPORTANT: If you do not detect this addiction in time and do not try to change your lifestyle, a person suffering from bulimia falls into vicious circle which is very difficult to get out of.

Nervous (psychological) bulimia

Bulimia nervosa occurs on the basis of low self-esteem, experienced stress and mental trauma, depression, depression, fear of gaining weight. It is easiest for a person to get rid of oppressive psychological states with the help of food, so the so-called “jamming” of problems occurs.

You can distinguish developing bulimia nervosa from simple overeating by the following signs:

Lovers of good food are picky eaters and have certain culinary preferences. Developing bulimia does not leave the patient the right to choose - he eats everything with the same appetite
when overeating satiety occurs, and when bulimia - no. Only stomach pains and cramps can stop a bulimic from eating.
a person who is prone to overeating does not experience sudden mood swings. The nature of people suffering from bulimia is characterized by apathetic traits, loss of interest in their usual life.

IMPORTANT: Women with bulimia nervosa are more likely to suffer from the weaker sex. Men are less predisposed to such diseases.

Bulimic attacks

Bulimia attacks can be compared to coughing or asthma attacks. They are uncontrollable and beyond the will and desire of the patient. During each attack of bulimia, a person eats about two and a half kilograms of food.

The absorption of food ends with the onset of heaviness in the stomach, increased heart rate, the appearance of drowsiness, sweating and weakness. The patient has feelings of guilt and shame, which push him to the desire to empty the stomach of what he has eaten as soon as possible. After artificially induced vomiting, hunger sets in again and everything starts anew.

IMPORTANT: At the beginning of the development of the disease, the patient may experience 2-5 attacks per month, in severe advanced cases- 5 - 7 attacks per day.

Consequences of bulimia

Bulimia can quickly destroy the entire body. This happens gradually and begins with the development of diseases of the stomach, pancreas and intestines. Then there are problems with the circulatory system.

At the same time, the condition of the patient's skin, nails and teeth deteriorates sharply. Tooth enamel suffers greatly, regularly experiencing the action of gastric acid. Then comes the turn of the excretory system. Kidney diseases develop, the liver ceases to cope with the load.

IMPORTANT: In women during this period, the menstrual cycle is disturbed, premature menopause may begin.

Constipation becomes a constant companion of a bulimic. There may be bleeding from cracks in the mucous membranes of the esophagus. The endocrine system is severely affected. And these are not all the troubles that lie in wait for those who are in pursuit of perfect figure chose bulimia. Severe cases of bulimia do not respond to treatment and are fatal.

Can there be anorexia after bulimia?

Although anorexia is the exact opposite of bulimia, both are complex eating disorders and share a common goal: strict weight control. Both of these diseases are inherent in people who are obsessed with thinness, who have a distorted idea of \u200b\u200bthe beauty of the body.

Those who suffer from bulimia lose weight slowly or not at all. They may even weigh a little overweight, which is not in line with their desires. If, in his desire to lose weight, the patient decides to extreme measures and completely refuses to eat, his weight will begin to decrease rapidly, and bulimia will gradually turn into anorexia.

Food for bulimia

To fight bulimia, you need to learn how to control the urge to vomit. This requires specific nutrition, because the “wrong” food will quickly bring all attempts to get rid of bulimia to “no”.

Most of the mistakes patients make at the moment when it seems to them that bulimia has receded. They start eating high-calorie foods and eat food in large quantities. The body cannot accept such food and, according to the usual pattern, rejects it.

IMPORTANT: After bulimia, you should not eat fatty, spicy and starchy foods until the basic functions of the body are restored.

A diet that helps cure bulimia should consist of the following foods:
vegetable soups and purees
chicken broths
oatmeal on the water
Rye bread
fresh and steamed vegetables
kefir, fat-free cottage cheese

IMPORTANT: At the beginning of treatment, the body will not accept hot, cold, flaky, sour, sweet foods.

At first, all food will have to be chewed very slowly and thoroughly. When your stomach gets used to it a little, you can try adding new dishes to the diet, as well as experiment with the taste and temperature of food.

IMPORTANT: The correct diet for complete recovery from bulimia can be compiled by a doctor. He will also give advice on recovery. metabolic processes and work of the gastrointestinal tract.

How to deal with bulimia? How to treat bulimia?

IMPORTANT: Treatment of bulimia is complex, simultaneously in three directions: psychological, medication and food.

To cope with bulimia on your own, you must first get rid of guilt. For this you need:
calm down, try to understand the causes of "hungry" dissatisfaction
make a promise to yourself to do everything possible to fight the disease
repeat as often as possible: “I am safe. I'm not in danger"
respect and allow yourself any emotions, including negative ones
realize that fictional ideals are far from real life
try to love your body
find a new hobby
visit interesting places, go on vacation
get pets and plants
seek help from a specialist

IMPORTANT: The favorable outcome of the treatment of bulimia largely depends on the psychological mood of the patient.

Drugs for the treatment of bulimia

For the treatment of bulimia, antidepressants and antipsychotics are used, which help fight attacks, resist the acute need for food.

The first drug your doctor will prescribe is fluoxetine (60 mg/day). This drug works both as an antidepressant and a stimulant. Applied in daytime and has few contraindications. The minimum duration of treatment is 6 months
Another drug widely used in the treatment of bulimia is Phenibut. It has a good sedative effect. Taken at night
Ondansetron reduces the frequency of overeating and self-purging. Has a number of serious side effects such as abdominal pain, migraines, constipation. It is prescribed at the beginning of treatment at a dose of 25 mg / day. At the end of treatment daily dose can reach 400 mg/day

IMPORTANT: Drugs such as Bupropion and Trazodone, despite their high efficiency, yet should not be used to treat bulimia due to serious side effects.

Bulimia and pregnancy

For women with bulimia, pregnancy becomes a difficult test, because the life of the mother and child is at risk. Overeating attacks and the need to cleanse the body in pregnant women are no different from similar processes in ordinary women, however, they have different consequences.

Bulimia in pregnant women leads to the birth of premature, underweight children with immature organs and tissues, miscarriages, and premature births.

IMPORTANT: Even birth healthy child, born by a bulimic mother, does not exclude the appearance of serious problems in the baby in the near future.

the only positive moment in pregnancy with bulimia is the possibility of a quick cure for the disease. Future mother who cannot love and accept herself and her body in any way, it is enough to seriously think about the health of her unborn baby. Understanding that the life of a child is at stake is often enough for a woman to take decisive action.

Bulimia in children

Bulimia in children is quite common. The causes of this phenomenon may be psychogenic and physiological factors. Psychogenic include:

IMPORTANT: Parents who notice signs of bulimia in their child should definitely seek medical advice.

Treatment of children from bulimia takes place only under the supervision of specialists and consists of several stages:

1. Psychoanalysis, with the help of which the cause of an eating disorder is clarified
2. Changing erroneous behavior patterns at the subconscious level
3. Drawing up a new menu, prescribing medications
4. Increasing self-esteem, learning to communicate with others
5. Elimination of psychological factors that provoke the development of the disease.
6. Group therapy

IMPORTANT: Hospitalization is carried out extremely rarely, in very advanced cases.

Despite the fact that bulimia is a dangerous and intractable disease, if desired and active action the patient can still be defeated. And so that the disease does not return, it is enough to strictly follow the recommendations of the doctor.

Video: Bulimia. How to recover from bulimia

In a disease such as bulimia, symptoms and treatment require special attention. Bulimia is a process of eating disorders caused by disorders mental health person. To a greater extent, it is women who are predisposed to this disease.

Bulimia nervosa has symptoms that are hard to miss. The manifestation of bulimia begins with an increase in hunger and uncontrolled eating. Moreover, the patient prefers the fattest and most appetizing pieces of food, after which the next stage begins, when he deliberately provokes the cleansing of the stomach, causing vomiting. by artificial means. Having noticed signs of bulimia in someone close to you, you need to immediately provide assistance to the patient, primarily psychological.

With more advanced stages of the disease, people actively begin to use diuretics and laxatives to speed up the process of cleansing the stomach. Patients are often tormented by doubts and remorse due to the fact that at some point they lose control of themselves. Their behavior in many ways converges with patients with anorexia. The only difference is that bulimics can leave others in the dark about their problems for a long time, and their weight can stay within the normal range. In patients with anorexia, it begins to decline sharply. Anorexia and bulimia are two diseases that have a common origin.

Causes of bulimia

The following reasons are possible:

low self-esteem, psychological disorders;
lack of serotonin in the body, without which the patient has a constant depressive state, as a result of which he begins to “seize” problems;
constant dieting, breakdowns;
excessive perfectionism (striving for perfection);
public concepts of harmony as a standard (like certain singers, models, actresses), because of which there is an urgent need for drastic changes in appearance;
results from diets push patients to even greater efforts in an effort to achieve the best;
the presence of depressive disorders, high anxiety, obsession with thoughts and actions.

Bulimia Symptoms

The main symptoms and signs of bulimia are:

damaged gums and tooth enamel;
depletion of the body;
damage to the fingers, due to which the patient provokes vomiting;
inflamed esophagus due to frequent vomiting;
uncontrollable convulsions and constant spasms;
indigestion due to the abuse of laxatives;
the occurrence of discomfort in the kidneys and liver;
disturbed menstrual cycle;
occurrence of heart disease;
neurasthenic diseases.

Consequences of bulimia

If you run and do not do emergency treatment patient, the consequences of bulimia can be the most terrible, even fatal. In less advanced cases, the patient eventually develops heart failure, disorders of the general mental state, the appearance of dependence on various kinds narcotic drugs, lack of incentive to life, relationships with all loved ones begin to deteriorate.

The most common effects of bulimia are:

destruction of tooth enamel;
caries;
periodontal disease;
increase salivary glands;
irritation of the throat mucosa due to frequent vomiting;
violation of the menstrual cycle;
disruption of the gastrointestinal tract;
endocrine disorders;
sudden weight gains.

Irreversible effects of bulimia:

chronic dehydration;
metabolic disease;
gastritis, gastric ulcer and esophagus;
deterioration in the condition of the hair, their thinning;
disorders in the work of the nervous and cardiovascular systems.

Varieties of bulimia

In medicine, there are two types of bulimia, it is nervous and pubertal. Bulimia nervosa most commonly affects people between the ages of 25 and 30. The causes of this disease can be a constant stressful lifestyle, constant psychological stress, depression. Food in these cases becomes a means of dealing with stress for the patient, and soon such a habit imperceptibly begins to develop into an uncontrollable process.

Very often, bulimia begins its development due to such factors:

failures in personal life;
dissatisfaction with personal life;
rejection of their external data;
very low self-esteem.

Bulimia nervosa most often occurs in girls and women. Men suffer from this disease 10 times less often. Bulimia nervosa is a disease that is difficult to treat, but with a timely and comprehensive approach, it is still possible to get rid of it. In advanced cases, anorexia and bulimia require immediate hospitalization.

Pubertal bulimia occurs mainly in children in adolescence, when due to hormonal changes in the body, the child is very sensitive and emotional. Bulimia in this case is associated with discontent and rejection of their appearance, as a result of which children (especially girls) resort to the most severe methods to achieve their ideal. It can be grueling physical exercises, rigid diets, or even prolonged hunger strikes and the deliberate rejection of certain foods.

The result is usually the same for most: due to the stress that the body endures, breakdowns and uncontrolled absorption of food occur.

Currently, many experts are increasingly mentioning such a phenomenon as sleepy bulimia, when people who do not get enough sleep for the entire working week, decide to sleep off over the weekend, resulting in half of Saturday and Sunday being spent in bed. In today's world, sleepy bulimia is assuming epidemic proportions. The saddest thing is that this sleep pattern is pure water self-deception. It is physically impossible to sleep in advance, as well as to eat. To an ordinary person You need about 8 hours of sleep per day.
If sleep deprivation becomes chronic, the body releases cortisol, the stress hormone. Stress leads to fatigue, low working capacity and a state of depression.
How to beat bulimia
For the treatment of the disease, a complex of procedures is used, which consist of psychological help and the use of medications. To get rid of the underlying causes, individual or group psychotherapy is used, because only a psychologist can accurately determine the true cause of this disorder.
Unfortunately, without your own desire to overcome the disease, it will be quite problematic to treat it.

Therefore, if you or your loved ones suspect that you have symptoms of the disease, then the most basic thing to do is to immediately consult a doctor.
During a conversation with a doctor, it is important to honestly and in detail tell about your own lifestyle, about your diet, up to how much food is eaten per day, and it is also necessary to mention how much and how often the feeling of hunger visits. At this point, the doctor will analyze and try to identify the main cause of bulimia, after which he will prescribe a specific course of treatment.
After a detailed examination and test results, the doctor will also be able to determine whether the patient needs hospitalization or not. Typically, inpatient treatment options are offered to a bulimia sufferer, which include:
restoration and treatment of all organs that may have suffered as a result of the disease;

psychotherapy sessions;

drawing up a special diet;

prescribing certain antidepressants;

physiotherapy.

Self-management of bulimia
AT rare cases a person suffering from this disease is able to admit that he is really sick and needs treatment, which means that he cannot cope with it without someone's help.
In order to protect yourself from the risk of this disease, you must:
strive to maintain a healthy lifestyle;

learn to accept yourself and your appearance as it is;

do not fight stress with food;

know the measure in the use of alcohol;

do not use laxatives and diuretics unless prescribed by a doctor.

It is important to know that the first step that a sick person can take on the road to recovery is to admit that he is really sick. After accepting this fact, it will be much easier for the patient to help both relatives and doctors.

Regular eating with a gradual reduction in the amount of easily digestible, carbohydrate-rich meals helps prevent episodes of bulimia. The menstrual cycle usually returns to normal after the signs of bulimia disappear.
For a complete cure, it may take quite a long time in some cases. Treatment can be delayed for a couple of months, or up to several years. But the most important thing on the path to recovery is a stable mental state of the patient. Sometimes, during the treatment, the patient may have thoughts that he has long since recovered, or vice versa, that recovering from an illness is something impossible and insurmountable. However, this is not at all the case. If the patient's desire to recover from the disease is serious enough, then it is quite possible to defeat bulimia, and even in the future relapses can be avoided. The main thing is to realize and remember that happy life and good health worth fighting for.
Pregnancy and bulimia
The female body for the normal bearing of a child requires a certain amount of energy. With the appearance of any eating disorders, health problems arise for both the mother and the child. When overeating, a woman increases the load on the digestive organs, and getting rid of what she has eaten with the help of vomiting, deprives the body of the intake necessary vitamins and trace elements, dehydrates.
In addition, the emotional state of the expectant mother has a huge impact on the child. Depression and neurosis, which accompany bulimia, provoke the appearance of unforeseen complications during pregnancy. Most dangerous consequences- miscarriage, premature birth, development congenital pathologies The child has.
Bulimia has a very bad effect on reproductive system It is very difficult for women with this diagnosis to become pregnant.
But if this happens, the body of the expectant mother is faced with a great burden. An emaciated woman may face the following ailments:
osteoporosis;

disorder of the gastrointestinal tract;

loss of teeth;

diseases of the cardiovascular system;

disorders in the work of the kidneys;

liver diseases.

Bulimia nervosa is an eating disorder characterized by intermittent bouts of binge eating preceded by feelings of extreme and acute hunger. Such episodes are usually caused by some negative (failure at work or school, quarrels with loved ones, feelings of loneliness, etc.) or positive (holiday, promotion, the prospect of meeting a new guy, etc.) factors. Against the background of such experiences, a person develops an uncontrollable appetite, and in order to alleviate his anxiety, he begins to absorb food in unlimited quantities. After such an attack of gluttony, there is a feeling of guilt, shame and fear of gaining extra pounds, and to “cleanse” the body, attempts are made to get rid of what has been eaten: an artificial induction of vomiting, taking diuretics and laxatives, intermittent fasting or exhausting physical activity.

In this article, we'll walk you through the possible causes, signs and symptoms, prognosis, diagnosis, and treatment for bulimia nervosa. This information will help you suspect the occurrence of this eating disorder, and you will make the right decision about the need for treatment from a specialist.

Individuals prone to bulimia nervosa are much more difficult to identify than those with anorexia. They can maintain a completely normal weight, arrange “revels” of gluttony in secret from others, and their behavior may not differ from normal in any way. Usually such people do not tell anyone about their problem for many years and then only one or two family members or the closest friend can find out about it.

On the contrary, they lose weight so much that others cannot but notice it, and even at the beginning mental disorder their behavior changes: they are looking for the ideal diet, they are overly fond of studying the principles of proper nutrition, they take regular measurements of body volumes or weighing, and often refuse food, allegedly due to lack of appetite, etc.

According to statistics, bulimia nervosa is detected more often than anorexia nervosa. Most of these patients are adolescent girls and women under 35 years of age.

The reasons

Anxiety, stress, low self-esteem, personal problems - all these factors can provoke the development of bulimia nervosa in a girl.

Bulimia nervosa can be caused by various physiological and psychological causes.

Such a violation of eating behavior can be provoked by the following physiological factors:

hormonal disorders (hypothalamic-pituitary disorders);
organic damage to the food center of the cerebral cortex and functional lesions of the central nervous system (, epilepsy);
insulin resistance, metabolic syndrome and other metabolic abnormalities.

According to many experts, bulimia nervosa is more often caused by various psychological factors:

problems of a personal nature;
low self-esteem;
increased anxiety;
stress;
the habit of "jamming" problems and nervous experiences;
tendency to perfectionism;
long-term adherence to diets, leading to disruptions in eating;
active sports;
imposing the canons of success and beauty, expressed in harmony;
mental illness (psychopathy, schizophrenia, obsessive-compulsive disorder).

As a rule, bulimia nervosa, not associated with physiological reasons, begins due to the misconception that with the help of vomiting, taking laxatives and other methods, you can easily restrain weight gain and indulge in nothing when eating. And attempts to eliminate life's troubles with the help of food indicate a lack of willpower and an inability to solve their own problems. In such cases, eating becomes an attempt to get away from the difficulties that arise, in this way a person corrects his unfavorable emotional state according to the principle “ate and enjoyed”.

According to statistics, bulimia nervosa occurs more often in wealthy families with ambitious family settings. Children in them often experience their own inferiority and fear of not meeting the expectations of their parents.

Women 13-35 years of age are most susceptible to this eating disorder, and the peak of symptoms occurs at the age of 15-16, 22-25 or 27-28 years. Sometimes the fact of the disease is recorded in women of a more mature age. Mild forms of bulimia nervosa can occur in people of either gender.

Symptoms

As a rule, patients with bulimia nervosa hide their illness from others for many years. Relatives of such patients may suspect an eating disorder for the following signs:

hasty absorption of food;
swallowing large pieces of food;
eating large amounts of food;
the habit of leaving after eating in the toilet (where the patient secretly causes artificial vomiting);
there may be scratches on the fingers from the teeth that occur when trying to provoke vomiting;
the appearance in the house of laxatives or diuretics.

Conditionally bulimia nervosa can occur in two forms:

classical - the patient copes with gluttony by inducing vomiting, holding cleansing enemas taking diuretics or laxatives;
stage of anorexia - the patient compensates for his behavior with periods of fasting or excessive physical exertion.

In addition, such an eating disorder can be primary or secondary (i.e., occurs as a complication of anorexia).

With bulimia, the patient often feels periods of constant, painful and prolonged hunger, after which he cannot restrain himself when eating food and does not limit its volume. For food, he can choose the most favorite dishes or the most beautiful and largest pieces of food. Many patients are very fond of sweet or starchy foods, while others have an irresistible need for certain products nutrition.

Often episodes of excruciating hunger and uncontrolled overeating occur at night. After an attack of gluttony, patients begin to feel remorse and try to get rid of food taken in one way or another.

Almost always, people with bulimia nervosa try to carefully hide their excessive meal from others and spend it alone. They prepare for it like a ritual and make bulk purchases and preparations. If they are unexpectedly caught during gluttony, then bulimics try to shyly and quickly hide or stop eating. In the same "secret" they try to get rid of the ingested food by vomiting or other methods.

Patients with bulimia nervosa are preoccupied with their weight and try to diet. They can often be weighed and measure the volume of their figures. As a result, their life turns into an endless "fight with diets" and alternating periods of control and its loss. As a rule, bulimics rarely develop obesity, and their weight is within the normal range or slightly increased.

People suffering from bulimia try not only to hide episodes of overeating, but also in every possible way deny the fact of the present problem. They are unable to be critical of their condition, and often only their relatives can help them realize the need for treatment by a specialist.

Against the background of such changes in eating behavior and the experiences arising from them, patients may become emotionally unstable, experience depression, voluntarily refuse to communicate with friends or hobbies. In the advanced stages of the disease, such changes in the psyche can lead to complete social isolation and thoughts of suicide. In the absence of timely qualified assistance patients may commit suicide.

In bulimia nervosa, poor nutrition leads to the following symptoms:

discoloration and destruction of tooth enamel, gum lesions, throat irritation and enlargement of the parotid salivary glands under the jaw, caused by frequent vomiting;
increased salivation;
ruptures of small blood vessels on the proteins of the eyeball;
dullness and brittleness of hair and nails;
dehydration of the skin;
unhealthy skin color;
pain in the stomach;
stool changes (diarrhea,);
violations;
muscle cramps and twitching;
signs of dysfunction of the kidneys and liver.

Such changes in physical condition lead to the fact that a patient with bulimia nervosa looks weak, his ability to work decreases, and he feels unhealthy. Patients have sharp fluctuations in weight - from 5 to 10 kg plus or minus.

Later, such physiological abnormalities can lead to more severe consequences of bulimia:

dental diseases: caries, periodontitis, periodontal disease;
inflammation of the esophagus;
and enteritis;
rupture of the stomach (in rare cases);
pathology of the heart and blood vessels;
gynecological diseases (up to amenorrhea);
problems with the onset and bearing of pregnancy;
endocrine pathologies:, diabetes mellitus,;
a tendency to alcoholism or drug addiction on the background of prolonged depression.

Diagnostics

The main method for diagnosing bulimia is a doctor's conversation with the patient or her relatives, conducting a series of special tests.

The main goal of diagnosing bulimia nervosa is to identify the facts of systematic bouts of overeating. To do this, the doctor talks with the patient and may offer him various tests. Sometimes, in the presence of circumstances that do not allow direct communication, the conversation is carried out only with the patient's relatives.

During these conversations, it turns out:

all the circumstances that contributed to the development of the eating disorder;
symptoms;
peculiarities appearance, mental state and general well-being patient.

Additionally, the necessary laboratory tests and instrumental research, allowing you to determine the changes in the physiological state caused by bulimia.

The diagnosis is made in cases where the doctor reveals the facts of overeating and signs of "cleansing" procedures (vomiting, enemas, taking laxatives and diuretics, fasting and debilitating physical activity) occurring at least 2 times a week for 3 or more months.

Treatment

The tactics of treating bulimia nervosa is determined by the causes of its occurrence. In organic forms of such an eating disorder, to get rid of the disease, the main pathology (hormonal disorder, tumor, consequences of trauma, mental illness etc.), and if the violation is caused by changes psychological nature, then therapy is aimed at correcting such disorders.

Treatment for bulimia nervosa should begin as early as possible and be comprehensive. The most effective is a combination of individual and family psychotherapy, diet therapy and drug therapy.

Depending on the complexity clinical case the course of treatment can be carried out on an outpatient basis or in a specialized hospital.

Psychotherapy

For the treatment of bulimia nervosa, the patient may be recommended individual, family or group therapy. The treatment plan is drawn up depending on the characteristics of the patient's personality, and its main goal is to get rid of psychological barriers that lead to the desire to "jam" uncomfortable psychological condition, and compiling right attitude to food.

In addition to working on the behavior of the patient in the treatment of bulimia nervosa, cooperation with the patient's close environment (relatives and friends) is of great importance. The doctor gives them recommendations that could eliminate the appearance of thinking pathologies in the patient, teaches them adequate tactics for communicating with the bulimic and proper monitoring of his food intake.

Group psychotherapy is usually recommended for patients in the recovery phase. In such groups, people suffering from bulimia nervosa can share their experiences, achievements and ways to overcome the disease. Such communication allows them to feel the hopelessness of the current situation and learn about the existence of ways to solve the problem. In addition, helping other people increases the self-esteem of the patient himself.

Usually for patients with bulimia nervosa, one psychotherapeutic course is not enough to cure. Such therapy should be long-term and canceled only after the onset of complete elimination of the wrong diet. After achieving the desired result, some patients may be recommended regular follow-up with a psychotherapist to completely exclude relapses of bulimia nervosa.

diet therapy

An important role in the treatment of bulimia nervosa is given to correct compilation daily menu. When selecting individual plan nutrition, the dietitian takes into account the personality and health status of the patient. In addition, the specialist develops in the patient such an attitude towards food: "Food is not only a pleasure, but also a necessary source of energy, the receipt of which must be carefully planned."

Medical therapy

Taking medications for bulimia nervosa is prescribed to eliminate both the causes (for example, prolonged depression) and the consequences of eating disorders (lack of vitamins, macro- and microelements, treatment of gastritis and other complications). For this, potassium and magnesium preparations, multivitamin complexes and dietary supplements, drugs for the treatment certain diseases and antidepressants (Prozac or Fleokstin), supplementing the effectiveness of psychotherapy.