FAT LOSS – EATING DISORDERS: BULIMIA

The desire to maintain a sub-optimal weight also frequently underlies the condition of bulimia, although bulimia sufferers are usually dose to normal weight for height. Bulimia is defined as a behaviour involving a variety of techniques for purging after binge-eating. Unlike those who suffer from obesity or anorexia with associated body size, there are few clues to the condition of bulimia for the observer. For this reason its prevalence is probably much higher than estimated, and its diagnosis is more difficult. Its prevalence (1-3 per cent amongst adolescent and young females) is thought to have significantly increased during the last 20 years, with surveys in the US indicating possibly as many as 15 per cent of college aged women experiencing some form of bulimia. Many bulimia sufferers seek treatment only after years of binge-eating and vomiting, feeling both responsible for and guilty and ashamed of their disorder. On the other hand, clients may seek help for weight loss without ever disclosing the underlying condition.

Diagnostic criteria.

The following symptoms are considered to be characteristic of bulimia:

• usually normal weight-for-height—but may be slightly over or under weight

• morbid fear of fatness

• extreme sensitivity to weight gain

• recurrent episodes of bingeing (characterised by the feeling of loss of control over eating) followed by self-induced vomiting—at least twice a week for three months

• purgative abuse—may be in addition to vomiting

• excessive exercise or fasting

• depressive symptoms.

Non-purging type bulimia may also occur, involving bingeing together with inappropriate compensatory behaviours such as fasting or excessive exercise, but not vomiting or laxative abuse. Possible medical complications of bulimia include dehydration, electrolyte abnormalities, salivary gland swelling, possible kidney disease, gastrointestinal problems, possible endocrine abnormalities, dental caries and erosion of tooth enamel.

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