Bulimia is not a fad, nor a phase. It is a serious mental health disorder, which affects both men and women of all ages. On the surface, it can appear to be associated solely with food or body image. But bulimia is beyond that.
It is a double-edged sword. The disorder is characterized by a cycle of binge eating followed by compensation behaviors, such as self-induced vomiting or taking laxatives (also known as purging). Episodes of binging can become obsessive, much like smoking or taking drugs. Contrary to popular belief, binge-eating is not a conscious choice, but rather, exists to fill a void – serving as a coping mechanism for underlying issues and internal struggles.
What follows? Low self-esteem, guilt, a need for control and a deep fear of gaining weight, bringing an urge to undo what has been done.
Bulimia becomes a vicious cycle of mixed feelings including shame, fear, and relief.
Causes
A range of genetic, social and environmental factors can predispose someone to bulimia. There is no black and white answer that points to its cause, or how someone should be treated for it.
Psychological: Bulimia often overlaps with other mental health disorders such as anxiety, depression, and OCD. As bulimia is associated with feelings of low self-esteem, self-worth, and hopelessness, it is no surprise that depression and anxiety sometimes occur together with it.
Trauma: We all face trauma to some degree. Life is full of ups and downs, and everyone’s tolerance to traumatic events differs. For example, a negative event to one person may be perceived as neutral or positive to someone else. These differences are what make us all interesting and unique, but unfortunately, trauma may increase one’s likelihood of developing bulimia. Triggers may include past sexual abuse, violence, starting a new job, relationship breakdowns or death of a loved one.
Personality: Some people are more sensitive than others. And on the other hand, some of us experience difficulty expressing or understanding our emotions. When we struggle to manage our emotions, we may seek unhealthy methods, such as binge eating and purging (in the case of bulimia) as a strategy to find relief and feel in control of our lives.
Genetics & upbringing: Genes may play a role in predisposing some people to bulimia. Research suggests that physical problems in the brain, involving serotonin and altered brain circuitry may play a role. Family history may increase your likelihood of experiencing bulimia as well. Parents who are overly critical of their children, or who emphasize the importance of dieting and physical appearance may be more likely to have a child with bulimia.
Culture: Our culture emphasizes an unrealistic need to have ‘the perfect body’ and always look good, which, unsurprisingly, can trigger bulimia along with a plethora of other health conditions.
Harmful Myths About Bulimia
The cultural stereotypes and air of secrecy surrounding bulimia make it one of the least understood of mental health conditions. Let’s replace the myths with a better understanding of this disorder.
Myth 1: Bulimia is caused by a need to stay thin and a fear of gaining weight.
This misconception is understandable but false. Overeating may lead to the fear of gaining weight – true. However, the act of binging itself is often used as a coping mechanism for trauma or stressful life events. Some people turn to food for comfort on occasion, but for others, it becomes a significant and regular part of their lives, a way to manage unwanted emotions – an addiction. When people reach this stage, they likely have a binge eating disorder. When there’s a need to purge, rid of previously ingested food or ‘work it off,’ they likely have bulimia.
Myth 2: Bulimia doesn’t make sense. Why overeat when you’re concerned with weight gain?
Bulimia makes sense when considering how these behaviors work hand-in-hand. Binge eating becomes addictive, much like a drug. Some people with bulimia eat until it hurts, and this behavior may stem from feeling like they are unable to stop or perhaps even as a form of self-punishment. When the binge subsides, feelings of guilt often result, and the person may feel like they have lost control. No one likes to feel out of control. So many people with bulimia will resort to purging or restricting food intake to gain that control back – or to ensure they remain slim; to feel good; or perhaps all three. Unfortunately, the good feelings are temporary, and health issues often result over time.
Myth 3: Bulimia is gender specific.
Some people assume that bulimia is only prevalent among women due to a pressure for females to always look good and maintain a slim figure. This is false. Men are also susceptible, and it is dangerous to assume otherwise.
Myth 4: Bulimia always involves purging.
Purging is a stereotypical aspect of bulimia. This doesn’t mean that every person with bulimia will resort to purging. Alternative behaviors to purging include hoarding food, fear of public eating, excessive exercise, and restricting food intake to make up for binging episodes.
Myth 5: Bulimia, anorexia & binge eating disorder are the same thing.
There are overlapping characteristics between each of these disorders, but they are not the same. In short, bulimia is characterized by binge eating, following by compensation. Binge eating disorder does not involve compensation, and therefore, diseases such as obesity, heart disease, and diabetes are of concern. Anorexia does not involve binge eating, but instead, compensation on its own. A person with anorexia may restrict calorie intake and/or exercise excessively to avoid weight gain.
Myth 6: You can tell who has an eating disorder by the way they look.
People often assume that someone with an eating disorder will look a certain way, usually extremely thin, or in the case of binge eating disorder, morbidly obese. This is not always the case. Often, someone with bulimia will look completely healthy, or of normal weight. Also, the behaviors associated with bulimia are often paired with guilt or shame, and therefore, may occur behind closed doors. It’s important to be vigilant if you notice any changes or associated behaviors in a loved one. Don’t assume you will always see red flags or notice warning signs.
Myth 7: Bulimia can cause health issues but isn’t deadly.
Bulimia can and does cause health issues such as worn tooth enamel and tooth decay due to increased exposure of stomach acid, kidney issues, extreme dehydration, acid reflux disorder, a chronically inflamed throat, and intestinal distress. Bulimia can also be deadly in severe cases or if left untreated.
Myth 8: Bulimia is a phase.
It is important to understand that bulimia, along with other eating disorders, is not a phase. It has a direct cause, it can be chronic, and treatment is available – just like any other physical disease. One does not simply ‘grow out’ of bulimia. It can be chronic; it can come and go. Either way, it’s important to seek appropriate treatment and support if you’re suffering. It is equally important to offer empathy and understanding if you’re supporting a loved one.
Final Thoughts
Bulimia has unique characteristics from other eating disorders and should be treated as a separate disease with a unique treatment plan. It can co-occur with other mental health disorders such as anorexia, depression or anxiety, but not always. Most importantly, bulimia is manageable and does not have to be forever.
On June 2, 2018 rtor.org will observe the third annual  World Eating Disorders Action Day (#WeDoAct), a grassroots movement to expand global awareness of eating disorders as genetically linked, treatable illnesses that can affect anyone. You can help by reading these 9 Truths About Eating Disorders and Take the Pledge to break down stigma. Be a part of the movement on social media with the hashtags #WorldEatingDisordersDay #WeDoAct2BreakStigma
If you or someone you know experiences mental health issues, it is important to seek help from a qualified professional. Our Resource Specialist can help you find expert mental health resources to recover in your community. Contact us now for more information on this free service to our users.
Author Bio:Â Emma Deriu is an editor and content manager at Health Insurance Comparison. She writes about a range of health & lifestyle topics including fitness, mental health, food and general wellbeing. Visit their blog at healthinsurancecomparison.com.au/
The opinions and views expressed in this guest blog do not necessarily reflect those of www.rtor.org or its sponsor, Laurel House, Inc. The author and www.rtor.org have no affiliations with any products or services mentioned in this article or linked to herein.
References:
- Kaye WH, Wagner A, Fudge JL, Paulus M. Neurocircuitry of eating disorders. Curr Top Behav Neurosci. 2011;6:37-57.
- Kaye W. Neurobiology of anorexia and bulimia nervosa. Physiol Behav. 2008;94(1):121-135.
- Bailer UF, Kaye WH. Serotonin: imaging findings in eating disorders. Curr Top Behav Neurosci. 2011;6:59-79.
- Lee Y, Lin PY. Association between serotonin transporter gene polymorphism and eating disorders: a meta-analytic study. Int J Eat Disord. 2010;43(6):498-504.
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