A gray bulimia a что это

A gray bulimia a что это

вирусы a.gray.jvptvr.e» и «a.gray.generic.h» чем угрожают устройству?

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A gray bulimia a что это

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What is Bulimia: Symptoms, Complications and Causes

Bulimia Nervosa is a troubling mental illness and eating disorder that can have severe lifetime consequences. For those that struggle with this disorder, overcoming the complicated behaviors of the disorder as well as the misperceptions and stigmas associated with it can be incredibly difficult.

Approximately 1% of individuals with bulimia nervosa will struggle for their lifetime. Increasing awareness of symptoms, causes, and interventions of bulimia nervosa can result in a meaningful reduction of this prevalence.

Bulimia Meaning

The term “bulimia nervosa” refers to an eating disorder characterized by episodes of binge eating that are followed by compensatory behaviors such as purging, fasting, and/or excessive exercise.

Bulimia Definition According to the DSM-5

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) defines the diagnostic criteria that must be met for an individual to be diagnosed with a specific mental illness.

For bulimia nervosa, the DSM-5 specifies the following criteria:

1. Recurrent episodes of binge eating, which are characterized by BOTH of the following

• “Eating, in a discrete period of time (e.g. within any 2-hour period), an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances.
• A sense of lack of control over eating during the episode (e.g. a feeling that one cannot stop eating or control what or how much one is eating).

1. Recurrent, inappropriate compensatory behaviors in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, or other medications; fasting; or excessive exercise.
2. The binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for 3 months.
3. Self-evaluation is unduly influenced by body shape and weight.
4. The disturbance does not occur exclusively during episodes of anorexia nervosa [1].

ICD-10 Code for Bulimia Nervosa

Each culture varies in its medical and mental health diagnostic terminology. For this reason, the International Classification of Disease (ICD-10) designates specific codes that allow diagnoses to be communicated regardless of cultural differences.

The ICD-10 code for Bulimia Nervosa is F50.2

Bulimia Statistics

While many are aware of bulimia, the impact it has on various populations, as well as its prevalence, is less known.

• .3% of the US population will struggle with bulimia in their lifetime [2].
• 4% of females in the US will experience bulimia nervosa, which is 5X that of males [3] [2].
• 78% of those with bulimia nervosa experience daily life impairment and 43.9% experience severe impairment [2].
• Only 43% of those with bulimia nervosa receive treatment [2].
• 3.9% of those with bulimia nervosa will die from their disorder [4].

Types of Bulimia Nervosa

Due to the complexity of Bulimia Nervosa symptoms and behaviors, they are often divided into two subtypes: Purging Type and Non-Purging Type.

Purging Type

Bulimia Nervosa – Purging Type refers to the most commonly understood version of Bulimia Nervosa behaviors. Purging Type involves the individual engaging in the above-mentioned binge eating behaviors followed by purging behaviors such as vomiting and/or laxative/diuretics/enemas.

Non-Purging Type

Bulimia Nervosa – Non-Purging Type does not mean that individuals do not engage in compensatory behaviors intended to “undo” binge-eating behaviors. Those that struggle with non-purging bulimia engage in compensatory behaviors that do not actively involve expelling the food from the body. Instead, these individuals will engage in fasting or exercising behaviors to compensate and do not regularly engage in purging behaviors if they do at all.

Related Reading

Bulimia Nervosa Symptoms

The best way to combat bulimia and increase the likelihood of long-term recovery is early intervention. This begins with early detection through awareness of symptoms and signs of bulimia.

Physical Signs

Bulimia Nervosa is an intensely physical disorder, resulting in apparent changes to the body that can warn an individual is struggling, such as:

• Weight fluctuations.
• Chronically inflamed or sore throat.
• Swollen salivary glands around the neck and jaw.
• Worn tooth enamel/yellowing teeth and tooth sensitivity due to exposure to stomach acid.
• “Acid reflux disorder and other gastrointestinal problems [5].”
• “Intestinal distress and irritation from laxative abuse [5].”
• Severe dehydration due to fluid loss from purging.
• Electrolyte Imbalance.
• Scars on knuckles or hands from self-induced vomiting (also known as “Russell’s Sign”).
• Puffy cheeks.
• Appearing bloated from fluid retention.
• Bright red eyes, bursting of blood vessels in eyes due to vomiting or straining in vomiting.
• Smelling of vomit.

Behavioral Warning Signs

Behavioral red flags of bulimia are not as easily identifiable as the physical listed above; however, it is still possible to recognize behavioral changes that could indicate a problem, for example:

• Engaging in binge eating episodes.
• Distress over body shape/weight/size and/or negative body image.
• Expressing shame or guilt around eating.
• Frequently going to the bathroom during or immediately after meals.
• Increased irritability.
• Increased depression and suicidal ideation or self-harming behaviors.
• Withdrawal from family and friends, particularly in situations related to food or during/after meals.
• Uncomfortable eating food around others.
• Buying/hoarding diuretics/laxatives.
• Hiding food.
• Drinking excessive amounts of water.

What are the Long-Term Effects of Bulimia?

The body is created to consume food, absorb the necessary nutrients, and then get rid of what is not needed for optimal body functioning. It is not surprising then that bulimic behaviors result in serious long-term consequences to the physical functioning of the body, which include:

• Digestive Issues.
• Irregular Heartbeat/Cardiovascular issues/heart attack or failure.
• Cardiomyopathy.
• Coronary heart disease.
• Gum disease and tooth decay/tooth loss.
• Mental health disorders such as anxiety, depression, substance use issues, etc.
• Dehydration and organ issues/failure.
• Increased suicidal ideation.
• Irregular menstrual cycles and fertility issues.
• Low bone density.
• Osteopenia.
• Osteoporosis.
• Ulcers in the lining of the intestine.
• Irritable Bowel Syndrome (IBS).
• Bowel perforation.
• Possible colon resection.
• Use of a colostomy bag.
• Damage to esophageal sphincter and esophagus.
• Chronic Acid Reflux disease.
• Esophageal cancer.
• Death due to the physical impacts mentioned above or increased suicidal ideation.

What are the Causes of Bulimia?

As with most mental illnesses and eating disorders, there is no one cause of bulimia nervosa. Numerous factors related to one’s genetic make-up, environmental and social upbringing, and psychological history can lead to bulimia nervosa behaviors.

Biological Factors

There are a few genetic and biological factors that are associated with the development of bulimia nervosa, such as:

• Family history of eating disorders/bulimia nervosa.
• Family history of mental illness/substance use.
• Predisposition to impulsivity/impulse control difficulties.
• Predisposition to binge eating.
• Neural sensitivity to rewards, particularly food reward systems.

Psychological Factors

Bulimia nervosa is associated with specific behavioral pathology, including:

• Prior mental health diagnosis.
• Tendency for impulsivity.
• History of abuse or trauma.
• Negative body image or self image.
• Impaired emotion regulation and distress tolerance capabilities.
• Poor self-esteem.
• Engaging in a career or hobby focused on physical appearance.

Dieting Factors

Development of bulimia nervosa is closely associated with a history of dieting and engagement in diet culture behaviors, some of which include:

• Dissatisfaction with body weight/shape/size.
• Negative self-view related to appearance.
• Any history of dieting behaviors.
• Any history of engaging in restricting and bingeing cycles.
• Overvaluation of eurocentric beauty ideals.
• Core beliefs equating fulfillment with appearance.

Bulimia Nervosa Treatment Options

There are various therapeutic modalities recommended to treat bulimia nervosa that are proven to be effective. One of these is Cognitive Behavioral Therapy (CBT), which focuses on the limiting and unhelpful beliefs one might have that fuel bulimic behaviors and supports the individual in replacing these with beliefs that support recovery. Family-based therapy is also particularly helpful in treating eating disorders in adolescents and young adults. Additionally, many individuals with bulimia nervosa struggle with co-occurring disorders that might perpetuate bulimia behaviors, therefore, seeking out information regarding psychiatric medication may provide mood stabilization that results in behavior reduction.

It is true that the behaviors and potential consequences of bulimia nervosa are frightening, however, do not forget that this disorder is treatable. It is possible to receive meaningful and life-changing support that allows you or your loved one to become free of this disorder and live a fulfilled and joyful life of recovery.

Resources

Author: Margot Rittenhouse, MS, LPC, NCC
Page Last Reviewed By: Jacquelyn Ekern, MS, LPC on June 30, 2020

What Is Bulimia?

Rachel Goldman, PhD FTOS, is a licensed psychologist, clinical assistant professor, speaker, wellness expert specializing in eating behaviors, stress management, and health behavior change.

What Is Bulimia?

Bulimia, also known as bulimia nervosa, is an eating disorder characterized by binge eating following by compensatory purging or other methods to avoid weight gain or to relieve the physical symptoms that a person feels after binging. Purging usually involves vomiting, but it may also include the use of laxatives, excessive exercise, or fasting.

Like other eating disorders, people who have bulimia are often secretive about the condition due to feelings of shame or guilt about their behaviors. They may go to great lengths to hide their symptoms, which may result in family and friends missing the signs that there is a problem.

Symptoms

The signs and symptoms of bulimia can be physical, behavioral, and emotional.

Physical Symptoms

Dentists are often the first to notice signs of self-induced vomiting in patients with bulimia nervosa because of the tell-tale pattern of dental erosion primarily on the internal surface of the teeth.   But oral health concerns aren’t the only physical symptom linked to bulimia. People may also experience:

• Bloodshot eyes
• Calluses on the back of the hand
• Chest pains
• Chronic bouts of constipation (resulting from laxative abuse)
• Electrolyte imbalances and dehydration
• Frequent sore throat
• Headache
• Heart palpitations
• Lightheadedness or loss of balance (may experience fainting)
• Mouth ulcers
• Stomach aches
• Swelling of hands and feet
• Swollen glands and roundness in the jaw area
• Tooth cavities
• Tooth sensitivity
• Vomiting blood

Puffy cheeks among people whose purging include vomiting are one of the other noticeable physical signs. Calluses on the hand from inserting it in the mouth to cause vomiting may also be visible and are known as Russell's sign.   Later in the illness, this sign may not even be visible as the person may be able to vomit without mechanical stimulation.

Behavioral Symptoms

The following behavioral symptoms are those that are most often noticed outwardly by family members and friends.

• Creation of schedules or rituals that allow for binging and purging
• Desperation to exercise even when it gets in the way of other activities
• Evidence of binge eating including stashing food, stealing food, and eating large amounts in one sitting
• Evidence of purging such as always needing to go to the restroom or showering after meals or packages of laxatives or diuretics
• Exercising a specific amount to "burn off" the calories that have been taken in
• Extreme eating habits (strict dieting followed by overeating)
• Fatigued appearance
• Frequent trips to the bathroom
• Large amounts of food that are missing from the cabinets or pantry; large amounts of food packaging in trashcans or vehicles
• Talks about dieting, calories, food or weight so much that it gets in the way of regular conversation
• Uses drugs or detox teas as a way to suppress appetite
• Withdrawal from friends, families, and usual activities

Emotional Symptoms

Although more difficult to notice than behavioral symptoms, emotional symptoms are also often recognized by family members and friends, even when they don’t know about the binging and purging behaviors. These emotional issues are not unique to bulimia nervosa but may raise concerns.  

• Depression
• Extreme irritability
• Extremely self-critical
• Feeling out of control
• Mood swings
• Self-esteem, self-worth, or attractiveness determined by appearance and weight
• Strong need for approval

Diagnoses

Most of the symptoms and signs associated with bulimia nervosa are reversible with treatment. If you don't have a doctor who specializes in mental health, feel free to start with speaking with your primary care physician.

A doctor or mental health professional will ask questions about physical health, mental health, behaviors, and medical history. A physical examination will also be performed and lab tests may be ordered to help rule out other conditions or diseases. Diagnosis can be complicated by the fact that many people with eating disorders hide their behaviors.

Bulimia nervosa is characterized by:

• Repeated episodes of binge eating, which is eating a large amount of food in a short period of time and feeling out of control while doing so
• The use of compensatory behaviors such as vomiting, fasting, using laxatives or diuretics, or engaging in extreme amounts of exercise in order to offset eating.
• Self-evaluation is unjustifiably influenced by body shape and weight.

Because many people who have bulimia are of average weight, physical symptoms of bulimia may not be noticeable to others until the disorder has become extremely severe. It is important for anyone experiencing associated symptoms to be assessed by a physician.

In addition to these diagnostic criteria, the binging/purging must occur at least once a week for the last three months. and the behavior must not be caused by anorexia.

If you or someone you know is showing signs of bulimia nervosa, please seek out or encourage your loved one to seek out professional help. Simply having a conversation about your behaviors toward food, eating, stress, and more can give your doctor valuable insight to help you.

Bulimia vs. Other Eating Disorders

Sometimes, people with anorexia nervosa will also use binging or purging behaviors. However, the distinction between bulimia nervosa and anorexia nervosa is that people struggling with anorexia nervosa have significantly low body weight.   Additionally, people who binge but do not purge may meet the criteria for binge eating disorder.

Bulimia Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Causes

The exact causes of bulimia are not known, but there are a number of factors that may play a role:

• Biological factors
• Distorted body image
• Genetics
• Having family members with eating disorders
• Media influences and exposure to unhealthy role models
• Negative thought patterns
• Learned behaviors

It is also not uncommon for people with bulimia to have co-occurring mental health conditions including depression, anxiety, obsessive-compulsive disorder (OCD), and substance use disorders.

Treatment

Treatment for bulimia focuses on changing binging-purging behaviors and replacing distorted thought patterns. A treatment plan will often involve psychotherapy, medications, and nutritional education. Because treatment addresses many different life areas, it often involves a treatment team that may include doctors, mental health professionals, and dietitians.

Psychotherapy

Three forms of psychotherapy that are often helpful in the treatment of bulimia include:

: This type of therapy focuses on identifying and changing the negative underlying thoughts and attitudes about weight and shape. People learn to change these thoughts and adopt healthier behaviors. People also develop coping mechanisms and learn how to delay purging behaviors. : This approach incorporates CBT and focuses on improving relationships, practicing mindfulness, increasing distress tolerance, and learning emotional management skills. : This approach is family-focused and initially involves parents or caregivers taking complete control of the individual’s eating. Eventually, the individual is able to gradually regain control of meal planning and eating until they achieve healthy independence.

Medications

Treatment for bulimia may also include the use of antidepressant medications including:

• Selective serotonin reuptake inhibitors (SSRIs) such as Zoloft (sertraline), Prozac (fluoxetine), and Paxil (paroxetine)
• Selective norepinephrine reuptake inhibitors (SNRIs) such as Effexor (venlafaxine) and Cymbalta (duloxetine)

Coping

Getting appropriate treatment is essential, but there are also things you can do to take care of yourself during your recovery.

• Treat yourself kindly. Avoid criticizing yourself or expecting immediate results. It takes time to establish new ways of thinking and healthy habits.
• Stick to your plan. Even when you are tempted to stray from your therapy or eating plan, focus on sticking with it. It’s normal to feel uncomfortable at times, so be sure to talk to your doctor or therapist about the difficulties you are dealing with.
• Use relaxation techniques. Find ways to cope with feelings of distress such as visualization, deep breathing, or progressive muscle relaxation.
• Rely on your support system. Talk to the people you are closest to and discuss the kind of support you need. Reach out to these people during times when you need extra help or a safe space.
• Use positive self-talk. In addition to addressing negative thoughts and self-perceptions in therapy, work on using positive self-talk in your daily life. If you find yourself dwelling on negative thoughts, look for ways to reframe those thoughts in a more realistic, positive way.

If you or a loved one are coping with an eating disorder, contact the National Eating Disorders Association (NEDA) Helpline for support at 1-800-931-2237.