Bulimia nervosa is an eating disorder characterized by recurrent binge eating, followed by compensatory behaviors, referred to as “purging”.^[1] The most common form—practiced more than 75% of people with bulimia nervosa—is self-induced vomiting; fasting, the use of laxatives, enemas, diuretics, and over exercising are also common.^[2]

The word bulimia derives from the Latin (bulimia) from the Greek (boul?mia; ravenous hunger), a compound of ???? (bous), ox + ????? (l?mos), hunger.^[3]

Diagnosis for Bulimia nervosa

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV TR) published by the American Psychological Association, the criteria for diagnosing a patient with bulimia are:

• Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
  • Eating, in a fixed period of time, an amount of food that is definitely larger than most people would eat under similar circumstances.
  • A lack of control over eating during the episode: a feeling that one cannot stop eating or control what or how much one is eating.
• Recurrent inappropriate compensatory behavior to prevent weight gain, such as: self-induced vomiting; misuse of laxatives, diuretics, or other medications; fasting; excessive exercise.
• Self-evaluation is unduly influenced by body shape and weight.
• These symptoms occur at least twice a week on average and persist for at least 3 months.
• The disturbance does not occur exclusively during episodes of Anorexia Nervosa.^[4]

There are two sub-types of Bulimia Nervosa: purging and non-purging.

• Purging Type: the patient uses self-induced vomiting (which may include use of emetics such as syrup of ipecac) and other ways to rapidly remove food from the body before it can be digested, such as laxatives, diuretics, and enemas.
• Non-purging Type: occurring in approximately 6%-8% of cases, in which the patient uses excessive exercise or fasting after a binge to offset the caloric intake after eating. Purging-type bulimics may also exercise or fast, but as a secondary form of weight control.^[4]

The onset of Bulimia Nervosa is often during adolescence (between 13 and 20 years of age), with many sufferers relapsing in adulthood into episodic binging and purging even after initially successful treatment and remission.^[5]

Bulimia Nervosa can be difficult to detect, compared to Anorexia Nervosa , because bulimics tend to be of average or slightly above or below average weight. Many bulimics may also engage in significantly disordered eating and exercising patterns without meeting the full diagnostic criteria for Bulimia Nervosa.^[6]

Prevalence

The collection of data on the incidence of bulimia nervosa in the general population is limited. Most studies conducted thus far have been on convenience samples from hospital patients, high school or university students. These have yielded a wide range of results: between 0% and 2.1% of males, and between 0.3% and 7.3% of females.^[7] A more recent study indicates that 10% of adolescent girls and 3% of adolescent boys binge eat and purge at least once weekly. ^[8]

Although bulimia is overwhelmingly a disease of young women, it can affect others. Former British Deputy Prime Minister John Prescott says he developed bulimia in his 60s ^[15].

Effects of Bulimia nervosa

These cycles often involve rapid and out-of-control eating, which may stop when the bulimic is interrupted by another person or the stomach hurts from overextension, followed by self-induced vomiting or other forms of purging. This cycle may be repeated several times a week or, in more serious cases, several times a day^[16], and may directly cause:

• Chronic gastric reflux after eating.
• Dehydration and hypokalemia caused by frequent vomiting.
• Electrolyte imbalance, which can lead to cardiac arrhythmia, cardiac arrest, and even death
• Esophagitis
• Oral trauma, in which repetitive insertion of fingers or other objects causes lacerations to the lining of the mouth or throat.
• Pancreatitis^[17]
• Peptic ulcers
• Perimolysis, or the erosion of tooth enamel by gastric acids.
• Swollen salivary glands.^[18]
• Tearing or rupture of the esophagus caused by repeated forced vomiting.
• Severe caries (‘cavities’) as the stomach acid lowers the pH of the oral environment making the teeth far more susceptible to demineralization.

Causes for Bulimia nervosa

Bulimia is related to deep psychological issues and feelings of lack of control. Sufferers often use the destructive eating pattern to feel in control over their lives.^[19] They may hide or hoard food and overeat when stressed or upset. They may feel a loss of control during a binge, and consume great quantities of food (sometimes over 20,000 calories).^[20] After a length of time, the sufferer of bulimia will find that they no longer have control over their binging and purging. The binging becomes an addiction that seems impossible to break. Recovery is very hard, and often, in the early stages of recovery, the patient will gain weight as they rehydrate and obtain electrolytes that they have lost during the purging process. There are higher rates of eating disorders in groups involved in activities that emphasize thinness and body type, such as gymnastics, modeling, dance, cheerleading, running, acting, rowing(lightweights/coxwains) and figure skating.^[21] Bulimia is more prevalent among Caucasians. In one study, diagnosis of bulimia was correlated with high testosterone and low estrogen levels, and normalizing these levels with combined oral contraceptive pills reduced cravings for fat and sugar.^[22]

Related disorders

Bulimics are much more likely than non-bulimics to have an affective disorder, such as depression or general anxiety disorder: A 1985 Columbia University study on female bulimics at New York State Psychiatric Institute found 70% had suffered depression some time in their lives (as opposed to 25.8% for adult females in a control sample from the general population), rising to 88% for all affective disorders combined.^[23] Another study by the Royal Children’s Hospital in Melbourne on a cohort of 2000 adolescents similarly found that those meeting at least two of the DSM-IV criteria for bulimia nervosa or anorexia nervosa had a sixfold increase in risk of anxiety and a doubling of risk for substance dependency.^[24]

Treatment for Bulimia nervosa

There is no approved or generally accepted treatment for bulimia. Generally treatment is predicated on a real or hypothetical relationship to other disorders, Some researchers have hypothesized a relationship to mood disorders. In consequence, clinical trials have been conducted with tricyclic antidepressants, MAO inhibitors, mianserin, fluoxetine, lithium carbonate, nomifensine, trazodone and bupropion. ^[25] Research groups who have seen a relationship to seizure disorders have attempted treatment with, phenytoin,carbamazepine and valproic acid. A third group has viewed bulimia as an addiction disorder, The opiate antagonist naloxone and naltrexone which also block cravings for gambling have been used.^[26] There has also been limited use of Topamax which blocks cravings for opiates, cocaine, alcohol and food.,^[27] Some researchers also report positive outcomes when bulimics are treated in an addiction-disorders inpatient unit. ^[28]. None of these approaches have been consistently effective.

Homeopathy Treatment for Bulimia nervosa

Keywords: homeopathy, homeopathic, treatment, cure, remedy, remedies, medicine

Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines are selected after a full individualizing examination and case-analysis, which includes the medical history of the patient, physical and mental constitution, family history, presenting symptoms, underlying pathology, possible causative factors etc. A miasmatic tendency (predisposition/susceptibility) is also often taken into account for the treatment of chronic conditions. A homeopathy doctor tries to treat more than just the presenting symptoms. The focus is usually on what caused the disease condition? Why ‘this patient’ is sick ‘this way’. The disease diagnosis is important but in homeopathy, the cause of disease is not just probed to the level of bacteria and viruses. Other factors like mental, emotional and physical stress that could predispose a person to illness are also looked for. No a days, even modern medicine also considers a large number of diseases as psychosomatic. The correct homeopathy remedy tries to correct this disease predisposition. The focus is not on curing the disease but to cure the person who is sick, to restore the health. If a disease pathology is not very advanced, homeopathy remedies do give a hope for cure but even in incurable cases, the quality of life can be greatly improved with homeopathic medicines.

The homeopathic remedies (medicines) given below indicate the therapeutic affinity but this is not a complete and definite guide to the homeopathy treatment of this condition. The symptoms listed against each homeopathic remedy may not be directly related to this disease because in homeopathy general symptoms and constitutional indications are also taken into account for selecting a remedy. To study any of the following remedies in more detail, please visit the Materia Medica section at Hpathy.

None of these medicines should be taken without professional advice and guidance.

Homeopathy Remedies for Bulimia nervosa :

Arg-n., carc., ign., iod., med., nat-m., phos., puls., staph.

References

1. ^ Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR (4th ed.). American Psychiatric Association. 1994. ISBN 0890420629.
2. ^ Fairburn, Christopher (1995), Overcoming Binge Eating, Guilford, ISBN 0898621798
3. ^ Douglas Harper (November 2001). “Online Etymology Dictionary: bulimia”. Online Etymology Dictionary. https://www.etymonline.com/index.php?search=bulimia&searchmode=none. Retrieved on 2008-04-06.
4. ^ ^{a b} Barlow, David H; Durand, V Mark (July 2004), Abnormal Psychology: An Integrative Approach, Thomson Wadsworth, ISBN 0534633625
5. ^ Agras, W S (2004), “Disorders of eating: anorexia nervosa, bulimia nervosa and binge eating disorder”, in Shader, R I, Manual of psychiatric therapeutics, Lippincott Williams & Wilkins, ISBN 0781744598
6. ^ Walsh, J M E; Wheat, M.E; Freund, K (2000), “Detection, evaluation, and treatment of eating disorders”, Journal of General Internal Medicine (Springer) 15 (8): 577–590, doi:10.1046/j.1525-1497.2000.02439.x, PMID 10940151, https://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1495575
7. ^ Makino, M; Tsuboi, K; Dennerstein, L (2004). “Prevalence of eating disorders: a comparison of Western and non-Western countries”. Medscape General Medicine 6 (3): 49. PMID 15520673. https://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1435625.
8. ^ AE Fields. Archives of Adolescent and Pediatric Medicine. 162:574-579,2008.
9. ^ Pemberton, A R; Vernon, S W; Lee, E S (2005), “Prevalence and Correlates of Bulimia Nervosa and Bulimic Behaviors in a Racially Diverse Sample of Undergraduate Students in Two Universities in Southeast Texas”, American Journal of Epidemiology (Oxford University Press) 144 (5): 450–455, PMID 8781459, https://aje.oxfordjournals.org/cgi/content/abstract/144/5/450
10. ^ Heatherton, T F; Nichols, P; Mahamedi, F; Keel, P (1995), “Body weight, dieting, and eating disorder symptoms among college students, 1982 to 1992”, American Journal of Psychiatry 152 (11): 1623–9, https://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&uid=7485625&cmd=showdetailview
11. ^ Götestam, K G; Eriksen, L; Hagen, H (1995), “An epidemiological study of eating disorders in Norwegian psychiatric institutions”, The International journal of eating disorders (Wiley) 18 (3): 263–268, doi:10.1002/1098-108X(199511)18:33.0.CO;2-O, https://cat.inist.fr/?aModele=afficheN&cpsidt=3704897
12. ^ Hay, P, “The epidemiology of eating disorder behaviors: An Australian community-based survey”, International Journal of Eating Disorders 23 (4, pages = 371-382, year = 1998), https://www3.interscience.wiley.com/cgi-bin/abstract/34755/ABSTRACT
13. ^ Garfinkel, P E; Lin, E; Goering, P; Spegg, C; Goldbloom, D S; Kennedy, S; Kaplan, A S; Woodside, D B (1995), “Bulimia nervosa in a Canadian community sample: prevalence and comparison of subgroups”, Americal Journal of Psychiatry 152 (7): 1052–1058, PMID 7793442, https://ajp.psychiatryonline.org/cgi/content/abstract/152/7/1052
14. ^ Suzuki, K; Takeda, A; Matsushita, S (1995), “Coprevalence of bulimia with alcohol abuse and smoking among Japanese male and female high school students”, Addiction (Blackwell Synergy) 90 (7): 971–976, doi:10.1046/j.1360-0443.1995.90797110.x, https://www.blackwell-synergy.com/doi/abs/10.1046/j.1360-0443.1995.90797110.x
15. ^ by the BBC
16. ^ Let’s Talk Facts About: Eating Disorders, American Psychiatric Association, 1999, ISBN 0-89042-352-0 (pamphlet)
17. ^ Health Consequences of Eating Disorders, Copyright 2006 by the National Eating Disorders Association, neda.org
18. ^ McGilley, Beth M; Pryor, Tamara L (June 1998), “Assessment and Treatment of Bulimia Nervosa”, American Academy of Family Physicians, https://www.aafp.org/afp/980600ap/mcgilley.html
19. ^ BBC – Health – Conditions – Eating disorders
20. ^ Bulimia
21. ^ Bulimia Nervosa
22. ^ Bulimia May Result from Hormonal Imbalance – Startpage – ki.se
23. ^ Walsh, B T; Roose, S P; Glassman, A H; Gladis, M; Sadik, C (1985), “Bulimia and depression” (PDF), Psychosomatic Medicine 47 (2): 123–131, https://www.psychosomaticmedicine.org/cgi/reprint/47/2/123.pdf
24. ^ Stark, Jill (2008-04-28), [theage.com.au/news/national/anorexia-a-pointer-to-later-depression/2008/04/27/1209234656201.html Anorexia a pointer to later depression], The Age, theage.com.au/news/national/anorexia-a-pointer-to-later-depression/2008/04/27/1209234656201.html, retrieved on 28 April 2004
25. ^ Hsu, LKG.
26. ^ J.E. Mitchell,G. Christensen, J. Jennings, M. Huber, B. Thomas. A placebo-controlled , double-blind crossover study of naltrexone in outpatients with normal weight bulimia Journal of Clinical Psychopharmacology, 9:94-97, 1989.
27. ^ A.J. Giannini, A.E. Slaby. The Eating Disorders. NY, Springer-Verlag, 1993. ISBN 0-387-94002-2
28. ^ A.J. Giannini, M.J. Keller, G.L. Colapietro, S.M. Melemis, N. Leskovac, T. Timcisko. Comparison of alternative treatment techniques in bulimia: The chemical dependency approach. Psychological Reports. 82:451-456,1998.