Bulimia nervosa

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Introduction0:00–0:35

Bulimia, nervosa or simply bulimia is a condition characterized by rapid out of control binge eating beyond the point of fullness or comfort, followed by compensatory behaviors to prevent weight gain.
These include self-induced vomiting, fasting, excessive exercise, or misuse of laxatives or diuretics to fit the diagnosis.
Cycles of binge eating and inappropriate compensatory behaviors must repeat consistently at least once a week for three months.
Though they can occur several times per day. Bulimia usually begins in adolescence or young adulthood.

Onset of Bulimia Nervosa 0:35–0:56

Usually in individuals with low self esteem who focus heavily on their body shape and weight when evaluating themselves.
Often they experience poor emotional regulation as well as traits of impulsivity, perfectionism or compulsivity which contribute to the condition.
Now, in bulimia, nervosa, you can think of binge eating as an unhealthy way of coping with stress and overwhelming emotions.

Symptoms 0:56–2:27

After binge eating, individuals use inappropriate compensatory behaviors to fix what they've done and prevent weight gain.
Most commonly, they turn to self-induced vomiting, which is also known as purging. Additionally, they may try to control their weight in other ways like taking stimulants following calorie, restrictive diets, fasting or exercising too much.
However, when a person reduces calorie intake, they trigger feelings of hunger, increasing the likelihood of additional binge eating episodes, which in turn trigger compensatory behaviors and further caloric restriction.
In other words, instead of fixing the problem, these behaviors only keep the cycle going. Now it's important not to confuse bulimia, nervosa with another eating disorder, anorexia, nervosa.
The main distinction between the two is that people with anorexia, nervosa have an intense fear of gaining weight. So they end up restricting their energy intake to the point of significant weight loss.
Eventually, this leads to an abnormally low body weight compared to other people of the same age and sex. On the other hand, people with bulimia are usually normal weight or overweight because of this, these individuals can more easily hide the fact that they are struggling with an eating disorder.
Finally keep in mind that in some cases, a person might start with bulimia nervosa and over time eventually develop anorexia, repeated unhealthy behaviors to avoid weight gain can result in a number of serious side effects.

Complications of Bulimia Nervosa 2:27–4:32

Repeated vomiting can cause erosions of dental enamel, sialadenosis, which is swelling of the parotid gland and halitosis or very bad breath.
The back of the knuckles can get callused from using the hand to induce vomiting, which is called Russell sign. Additionally, forceful vomiting and retching can damage the mucosal lining of the lower esophagus and upper stomach causing abdominal pain and blood to come up in the vomit known as heat and when the person is not vomiting, the blood reaches the stomach where red blood cells break down and hemoglobin gets oxidized.
Eventually. This process results in extremely black tarry stools called Melina.
This tear in the esophageal lining due to vomiting or retching is also known as mallory Weiss syndrome. Over time.
Vomiting can cause dehydration and lead to hypertension. A BP below 90/60 as well as tachycardia or fast heart rate, over 100 heartbeats per minute.
Frequent self-induced vomiting can also cause a depletion of electrolytes, which leads to a low level of sodium chloride, magnesium phosphate and potassium as well as a general metabolic alkalosis below potassium or hypokalemia is particularly worrisome because it can lead to muscle weakness and even cardiac arrhythmias.
The latter of which can lead to death. Bulimia can also lead to endocrine changes.
The most common of which is menstrual irregularities like amenorrhea where either the normal menstrual cycle stops or menstruation doesn't start by age 15.
In addition, individuals with bulimia are at a higher risk of developing diabetes, mellitus, which makes for a particularly dangerous combination.
And that's because the compensatory behaviors that maintain the bulimia cycle are a form of calorie restriction that causes a starvation state for the body's cells.
And on top of that, diabetes makes it more difficult for glucose to enter the body cells at a cellular level, which worsens that starvation state as far as risk factors for bulimia go it's been shown to have a genetic component based on twin and adoption studies.

Risk Factors for Bulimia Nervosa 4:32–5:24

In addition, though there's also evidence for a strong social component, bulimia typically begins in teen years or in young adulthood, which is a time when individuals usually start to pay attention to the media and rates of bulimia are higher in cultures and settings where thinness is valued also.
Although bulimia is more common in women, it's worth mentioning that people of all genders can develop this condition. It can often be seen among athletes and professionals who are keenly focused on their body weight and present body fat like with dancers, models and wrestlers.
Finally, bulimia is also commonly associated with other conditions like obsessive compulsive disorder, depression and anxiety, all of which have overlapping symptoms and risk factors.
Medical treatment with careful nutrition and weight management is important, but it's also important to use tools like psychotherapy and cognitive behavioral therapy to help the individual and their family structure.

Treatment 5:24–6:00

A new relationship around food. For example, teaching a person to eat just a small amount of a forbidden food.
And then consciously noticing the absence of severe consequences. Bulimia is sometimes also treated with antidepressant medications like SSRI S or selective serotonin reuptake inhibitors.
And typically a combination of therapy with the medication works best for severe cases. All right.

Review 6:00–6:26

As a quick recap bulimia nervosa is an eating disorder characterized by out of control binge eating beyond the point of fullness followed by inappropriate compensatory behaviors to prevent weight gain, to meet the diagnosis.
A person must have these cycles at least once a week for three months. In contrast to anorexia, nervosa, which is associated with extremely low body weight.
Individuals with bulimia nervosa are typically at a normal weight or overweight.