Bulimia Nervosa Disease.pptx Eating Disorder

People with bulimia binge eat. This means people feel like they've lost control over their eating. They eat large amounts of food in one sitting. This often occurs in secret, and they often feel very guilty and shameful. Then they try to get rid of the food and extra calories in an unhealthy way, such as vomiting or misusing laxatives. This is called purging.
If you have bulimia, you probably focus on your weight and body shape even when you're trying to think about other things. You may judge yourself severely and harshly for what you see as flaws in your appearance and personality. Bulimia is related to how you see yourself — not just about food. It can be hard to overcome, and it can be dangerous.
It's important to remember that an eating disorder is not something you choose. Bulimia is a complex illness that affects how your brain works and how you make decisions. But effective treatment can help you feel better about yourself, eat healthier and reverse serious complications.

1. Prepared by Dr . Rahul Sharma

2. Definition of Bulimia Nervosa : Bulimia nervosa is an eating disorder characterized by episodes of binge eating, where a person consumes an excessive amount of food in a short period of time, followed by behaviors to prevent weight gain. These behaviors can include self-induced vomiting, excessive exercise, or misuse of laxatives or diuretics. .

3. Aetiology: Genetic Factors : There is evidence suggesting a genetic component to bulimia nervosa. If someone has a family history of eating disorders, they may be at a higher risk of developing bulimia . Psychological Factors : Low self-esteem : People with bulimia often struggle with a negative self-image, which may lead to unhealthy coping mechanisms like binge eating and purging. Perfectionism : A desire for control and perfection in various areas of life, including body image, may contribute to the development of bulimia.

4. Aetiology: Emotional distress : Bulimia can be a way to cope with feelings of anxiety, depression, or stress . Trauma or abuse : Past experiences of trauma, such as physical or emotional abuse, can be risk factors for developing eating disorders . Sociocultural Factors : Cultural pressure : Societal emphasis on thinness and idealized body images can contribute to unhealthy dieting behaviors and a preoccupation with weight and appearance. Peer pressure : Adolescents and young adults may feel influenced by peers or social media to conform to certain beauty standards, increasing the risk of developing disordered eating patterns.

5. Aetiology : Biological Factors : Changes in brain chemistry, particularly in areas related to mood and appetite regulation, can contribute to bulimia. Imbalances in neurotransmitters like serotonin and dopamine may play a role in the disorder's development. Environmental Factors : Dieting and weight control : Frequent dieting or extreme efforts to control weight can trigger unhealthy eating behaviors. This is particularly true for those who have a history of chronic dieting. Family dynamics : Family relationships, especially those involving criticism of appearance or weight, may contribute to the development of eating disorders.

6. Symptoms: 1. Physical Symptoms: Frequent weight fluctuations : People with bulimia may maintain a normal weight, but there can be dramatic changes in weight due to cycles of bingeing and purging. Swelling in the face or cheeks : This can result from frequent vomiting, leading to inflammation of the salivary glands. Gastrointestinal issues : Persistent constipation, bloating, or abdominal pain may result from excessive use of laxatives or diuretics.

7. Symptoms: 1. Physical Symptoms: Dehydration : Caused by vomiting, laxative use, and over-exercising, leading to dry skin, dizziness, or even fainting. Erosion of tooth enamel : Repeated vomiting can cause stomach acid to erode dental enamel, leading to tooth decay . Menstrual irregularities : Disordered eating behaviors can lead to missed periods or changes in menstrual cycle regularity

8. Symptoms : 2. Behavioral Symptoms: Binge eating : Engaging in episodes of consuming an excessive amount of food in a short time, often with a feeling of loss of control. Purging behaviors : This includes self-induced vomiting, misuse of laxatives, diuretics, or enemas, or excessive exercising to "counteract" the calories consumed. Secrecy around eating : Individuals may hide food, eat in private, or avoid eating around others to conceal their behavior.

9. Symptoms : 2. Behavioral Symptoms: Preoccupation with food and weight : A constant focus on dieting, weight loss, and body image, often leading to rigid eating patterns or extreme restriction when not bingeing . 3. Emotional Symptoms: Low self-esteem : A distorted self-image, where the person places a great deal of value on body shape and weight. Intense guilt or shame : After a binge episode, individuals often experience overwhelming feelings of guilt, self-loathing, or shame.

10. Symptoms : 3. Emotional Symptoms: Anxiety or depression : Many individuals with bulimia also experience symptoms of depression or anxiety, particularly linked to their body image concerns or the stress of managing the disorder . Obsessive thoughts : Constant worry about weight, food, calories, or appearance, which can lead to a distorted perception of the body.

11. Symptoms : 4. Other Potential Signs: Excessive exercise : Often as a compensatory measure after a binge to try to burn off the calories consumed. Frequent trips to the bathroom after meals : This may be a sign of purging behaviors such as vomiting.

12. Diagnostic Evaluation : 1. Clinical Interview The healthcare provider will ask detailed questions about: Eating patterns : Frequency of binge eating episodes and purging behaviors (e.g., vomiting, misuse of laxatives, excessive exercise). Body image and self-esteem : How the individual views their body, concerns about weight, and any distress related to appearance. Psychological symptoms : Feelings of guilt, shame, or anxiety related to eating and body image. Health history : Any previous eating disorders, mental health conditions (e.g., depression, anxiety), or family history of eating disorders or mental health issues .

13. Diagnostic Evaluation : 2 . Diagnostic Criteria (DSM-5 ) : The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) outlines specific criteria for diagnosing bulimia nervosa. For a diagnosis, the following conditions must be met: Recurrent episodes of binge eating : A period of excessive food intake in a short period of time, accompanied by a feeling of lack of control. Recurrent compensatory behaviors : Engaging in purging (vomiting, misuse of laxatives, diuretics) or other compensatory actions to prevent weight gain.

14. Diagnostic Evaluation : 2. Diagnostic Criteria (DSM-5) Self-evaluation based on weight and shape : A distorted body image where weight and shape play a central role in self-esteem. Binge and purge behaviors occurring at least once a week for three months . Exclusion of anorexia nervosa : Bulimia nervosa is distinct from anorexia nervosa, as individuals with bulimia are typically at or near a healthy weight, whereas those with anorexia have significant weight loss.

15. Diagnostic Evaluation : 3. Physical Examination: Vital signs (e.g., heart rate, blood pressure, temperature). Dental health : Signs of tooth erosion or cavities due to frequent vomiting. Signs of dehydration or malnutrition . Body mass index (BMI) : While people with bulimia often maintain a normal or near-normal weight, extreme fluctuations in weight may be observed.

16. Diagnostic Evaluation : 4. Laboratory Tests: Blood tests : To check for electrolyte imbalances (e.g., potassium, sodium), kidney function, or liver function, which may be impacted by purging behaviors or laxative abuse. Electrocardiogram (ECG) : To check for any heart irregularities, which can be a concern in people with bulimia due to the potential for electrolyte imbalances affecting heart function.

17. Diagnostic Evaluation : 5. Psychological Assessment: Co-occurring mental health conditions : Many people with bulimia also experience other mental health disorders, such as depression, anxiety, or substance abuse. Identifying these conditions is important for comprehensive treatment planning. Eating behavior patterns : Specific questions about how often bingeing and purging occur and the emotional state surrounding these behaviors.

18. Diagnostic Evaluation : 6. Assessment of Severity: Mild : An episode occurs on average once a week. Moderate : An episode occurs on average 2-3 times a week. Severe : An episode occurs on average 4-7 times a week. Extreme : An episode occurs more than once a day.

19. Treatment: 1. Pharmacotherapy : Antidepressants: ex . Fluoxetine, carbamazepine and lithium. Anti-anxiety medications : Benzodiazepines, Alprazolam, Clonazepam, Sertraline, Propranolol.

20. 2 . Psychotherapy: Cognitive Behavioral Therapy (CBT) : This therapy helps individuals identify and challenge distorted thoughts related to body image, food, and weight. It focuses on changing unhealthy eating behaviors, like bingeing and purging, and improving coping skills for managing stress, emotions, and body image issues.

21. Treatment: Interpersonal Therapy (IPT) : IPT focuses on improving relationships and addressing any interpersonal issues, which may be contributing to the eating disorder. It can be especially helpful if difficulties in relationships are a significant source of stress .

22. Treatment: Dialectical Behavior Therapy (DBT) : DBT is a form of therapy that focuses on helping individuals manage intense emotions and develop healthier coping strategies. It may be used if emotional dysregulation is a significant issue .

23. Treatment: Family-Based Therapy (FBT) : Often used with adolescents, FBT involves the family in the treatment process to support the individual and improve family dynamics. It helps the family learn how to help the person avoid behaviors like bingeing and purging and promotes healthier communication patterns.

24. Treatment: 3. Nutritional Counseling: Restore healthy eating patterns : Learn about balanced, nutritious eating and establish regular meal routines to prevent cycles of binge eating and purging . Normalize eating behaviors : Help to reduce extreme dieting and restrictive eating that may contribute to binge episodes . Promote a healthier relationship with food : Help individuals separate emotions from eating and address any fears of weight gain or specific foods.

25. Treatment: 4. Medical Monitoring and Support: Regular check-ups : Monitoring vital signs, electrolyte levels, kidney function, and overall health. Hospitalization : In cases of severe bulimia (e.g., life-threatening physical complications or significant medical concerns), hospitalization may be necessary to provide intensive care, stabilize health, and address medical complications.

26. Treatment: 4. Medical Monitoring and Support: Ongoing health monitoring : As treatment progresses, ongoing medical support may be needed to track the recovery process, manage any complications, and adjust the treatment plan accordingly.