Diagnosis
The diagnostic criteria for Bulimia Nervosa, according to the DSM-IV-TR (2000), is as follows: |
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A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following: 1. Eating, in a discrete period of time…an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances. 2. A sense of lack of control over eating during the episode. |
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B. Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as: • self-induced vomiting • misuse of laxatives, diuretics, enemas, or other medications • fasting • excessive exercise C. The bing eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for 3 months. |
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D. Self-evaluation is unduly influenced by body shape and weight. E. The disturbance does not occur exclusively during episodes of Anorexia Nervosa (p.589). |
Complications
Treatment
The primary goal of treatment for bulimia is to reduce or stop binge eating and purging behavior. Nutritional education, psychotherapy, family intervention, and medication are often used. The goals of treatment usually include: • the establishment of regular, non-binge meals • improvement in attitudes related to the eating disorder • encouragement of healthy but not excessive exercise • resolution of co-occurring conditions such as mood or anxiety disorders |
Therapy: Individual psychotherapy (especially cognitive-behavioral or interpersonal psychotherapy), group psychotherapy that uses a cognitive-behavioral approach, and family or marital therapy have been reported to be effective. |
Medications: Psychiatric medications, primarily antidepressants such as the selective serotonin reuptake inhibitors (SSRIs), have been found helpful for people with bulimia, particularly in patients with depression or anxiety, or those who have not responded adequately to psychotherapy alone. These medications also may help prevent relapse. |
Prevention
Although there is no concrete preventive measure for Bulimia Nervosa or other eating disorders, many studies have developed suggestions as to how to minimize this issue.Some of these suggestions include:
• denouncing the ultra-thin ideal propagated by current mainstream Western culture while implementing a healthier, more realistic female physical ideal
• a de-emphasis on appearance as a determinant of female value and a stress on other indicators of worth that are attainable and maintainable (e.g., intelligence, relationships, spiritual connection) is critical
• parents need to limit their children’s exposure to media, promote healthy eating and moderate physical activity, and encourage participation in activities that increase mastery and self-esteem
• funding for high-quality, visible advertising campaigns promoting healthy life styles may increase awareness
Dove's Campaign For Real Beauty
http://www.campaignforrealbeauty.com/
References
Barr, T.C. (2006). The adverse effect of negative comments about weight and shape from family and siblings on women at high risk for eating disorders. Pediatrics, 118(2), 731-738.Brain Physics: Mental Health Resource. (2006). Bulimia nervosa: eating disorder overview, 1-3. Retrieved March 15, 2007, from http://www.brainphysics.com/bulimia-nervosa.php
Danskey, B., Brewerton, T, Kilpatrick, D & O’Neil, P. 1997. The national women’s study: Relationship of victimization and posttraumatic stress disorder to bulimia nervosa. International Journal of Eating Disorders, 21(3), 213-228.
Derenne, J. (2006). Body image, media, and eating disorders. Academic Psychiatry, 30(3), 257-261.
Diagnostic and statistical manual of mental disorders. (4th ed.). (2000). (Rev. ed.). American Psychiatric Association.
Dichter, J., Cohen, J. & Connolly, P. (2002). Bulimia nervosa: Knowledge, awareness, and skill levels among advanced practice nurses. Journal of the American Academy of Nurse Practitioners, 14(6), 1-7.
Green, M., Scott, N., Diyankova, I. & Gasser, C. (2005). Eating disorder prevention: An experimental comparison of high level dissonance, low level dissonance, and no-treatment control. Eating Disorders, 13(2), 157-169.
Kiziltan G. (2006). Prevalence of bulimic behaviors and trends in eating attitudes among Turkish late adolescents. Adolescence, 41(164), 677-689.
Kneisl, C., Wilson, H. & Trigoboff, E. (2004). Contemporary psychiatric-mental health nursing. Pearson: New Jersey.
MayoClinic. (2006). Mental health: Bulimia nervosa. Retrieved March 15, 2007, from http://www.mayoclinic.com/health/bulimia/DS00607/DSECTION=4
Mensigner, J. (2005). Disordered eating and gender socialization in independent-school environments: A multilevel mediation model. Journal of Ambulatory Care Management, 28(1), 30-40.
Striegel-Moore R. (2006). Caffeine intake in eating disorders. Eating Disorders, 39(2), 162-165.
Warren, C., Gleaves, D., Cepeda-Benito, A., Fernandez, M. & Rodriguez-Ruiz, S. (2005). Ethnicity as a protective factor against internalization of a thin ideal and body dissatisfaction. International Journal of Eating Disorders, 37(3), 241-249.
Wikipedia. (2006). Bulimia nervosa, 1-8. Retrieved March 15, 2007, from http://en.wikipedia.org/wiki/Bulimia_nervosa
Additional Resources:
National Eating Disorder Information Centrehttp://www.nedic.ca/index.shtml
National Eating Disorders Association
http://www.edap.org/p.asp?WebPage_ID=294
The Center for Eating Disorders at Sheppard Pratt
http://www.eatingdisorder.org/
The Federal Government Source for Women's Health Information
http://www.4woman.gov/faq/Easyread/bulnervosa-etr.htm
Women's Health Zone
http://www.womenshealthzone.net/eating-disorders/bulimia-nervosa/effects/