Addiction and Bulimia Nervosa
What is Bulimia Nervosa?
Bulimia, or bulimia nervosa, is an eating disorder related to anorexia and compulsive overeating. Sufferers overeat in a short time span (binge) and then force the body to get rid of the food (purge), so that they don’t gain weight. Binging commonly involves eating a large amount of foods that are rich in calories, fat, and sugar in one sitting.
Purging involves throwing up or taking laxatives right after eating. This behavior creates medical problems in bulimia sufferers. Purging may also involve diuretic abuse, in order to decrease one’s weight through the loss of water stores.
Bulimics tend to have a distorted body image, believing that they are fat and otherwise undesirable. Purging food gives a false sense of control in the face of daily stress and anxiety. Faced with an uncontrollable outside world, bulimics binge and then seek control through purging. Ironically, binging and then purging only worsens feelings of guilt, shame, self loathing, and being out of control.
The binging and purging cycles can deliver a “high” to the person engaged in such behaviors. Various neurotransmitters are released during the consumption of large amounts of sugary foods that contain high amounts of fat. Through the binging process, the bulimic can induce a “chemical high”. Subsequently, in order to prevent the absorption of calories, the bulimic will purge the food through either vomiting or diarrhea.
Bulimia mostly affects young women. According to the National Institutes of Mental Health (NIMH), 85% to 90% of people with this condition are female. And though onset can happen at any age, bulimia usually begins around age 20 (NIMH). Overall, 2-3 in 100 women in the US have bulimia (State of South Carolina Department of Mental Health, SCDMH) and less than half of sufferers receive treatment in their lifetimes (NIMH).
Bulimia doesn’t have one clear cause. Multiple factors contribute to the disorder. Some triggers might be:
- Cultural expectations
- Family or cultural expectations
- Stressful events and major life changes
- Low self-esteem or poor self image
- Depression, anxiety, or repressed anger
- Dysfunctional or chaotic family of origin
Signs and Symptoms of Bulimia Nervosa
Long term bulimia nervosa takes a toll on the body. Throwing up regularly deprives a bulimic of much needed nutrients, stresses the digestive system, and creates chaos throughout the body. Frequent binging and purging causes:
- Anemia
- Dehydration
- Low magnesium, potassium, and sodium
- Ulcers and stomach pain
- Irregular or missing periods
- Kidney problems
- Cavities
- Loss of tooth enamel
- Constipation, bloating, diarrhea, or cramps
- Heart failure
- Dizziness and fatigue
- Severe problems in the esophagus
Without bulimia nervosa treatment, bulimia can lead to death. “Eating disorders have the highest mortality rate of any mental illness” in the US. (SCDMH)
Some of the warning signs of bulimia nervosa include:
- Using diet pills daily and/or for long periods of time
- Consistently using laxatives or pills to urinate
- Regularly going to the bathroom (to throw up) right after a meal
- Exercising too much
- Clear looking teeth
- Dry mouth and swollen cheeks from vomiting
- Broken blood vessels in the eyes
- Rashes and pimples
Bulimia and Addiction
There is a link between bulimia and addiction. It’s common for bulimics to also suffer from alcoholism and alcohol addiction. Researchers think that an underlying impulsive behavior pattern in bulimia contributes to impulsively using drugs or alcohol to cope with negative emotions. Negative emotions lead the bulimic to seek drugs and alcohol for relief. Bulimics may also use drugs and alcohol to assist with controlling weight and some become addicted to these substances.
When an individual is practicing the self-destructive pattern of bulimia coupled with alcoholism and/or drug addiction, they are considered to have a dual diagnosis and are in need of addiction treatment which will address both issues simultaneously.
In order to fully recover from bulimia nervosa and an alcohol or drug addiction, dual diagnosis treatment is necessary. In this type of program, both disorders will be concurrently treated. Until one is able to develop coping skills that address self-esteem, life stressors, family problems, and self-image, they are likely to seek an outlet, such as binging and purging or excessive intake of alcohol or drugs.
Bulimia Treatment
Although Lakeview Health does not provide bulimia treatment, it’s important to know when seeking treatment for bulimia nervosa that a quality dual diagnosis treatment program will offer a combination of group therapy, individual therapy, medical evaluations, nutritional counseling, family therapy and social activities with trained, licensed medical and psychiatric staff. The individual who attends treatment with a dual diagnosis track will be able to learn healthier coping skills for uncomfortable feelings and work towards eliminating unhealthy coping patterns.
There are medications that can help substance abusers and bulimics recover, such as antidepressants and atypical antipsychotic agents. Medication management should be part of any comprehensive dual diagnosis program.
Some specific inpatient bulimia treatment programs offer 24-hour medical and psychiatric care. Every meal is supervised in a structured setting. Outpatient bulimia treatment programs offer similar services, but through scheduled appointments. Patients live at home while receiving therapy and other services at a clinic.
