Question

1. What is Bulimia Nervosa?

2. Explain the main treatments for Bulimia Nervosa.

Answer 1

1. Bulimia nervosa is characterized by uncontrollable binge eating and efforts to prevent resulting weight gain by using inappropriate behaviors such as self-induced vomiting and excessive exercise.  The word bulimia comes from the Greek bous (which means “ox”), and limos (“hunger”). It is meant to denote a hunger of such proportions that the person “could eat an ox.” Bulimia typically begins with restricted eating motivated by the desire to be slender. During these early stages, the person diets and eats low- calorie foods. Over time, however, the early resolve to restrict gradually erodes, and the person starts to eat “forbidden foods” such as potato chips, pizza, cake, ice cream, and chocolate. Of course, some patients binge on whatever food is available, including such things as raw cookie dough. During an average binge, someone with bulimia nervosa may consume as many as 4,800 calories. After the binge, in an effort to manage the breakdown of self-control, the person begins to vomit, fast, exercise excessively, or abuse laxatives. This pattern then persists because, even though those with bulimia nervosa are disgusted by their behavior, the purging alleviates the fear of gaining weight that comes from eating.

2. Treatments for Bulimia Nervosa:
a. Medications: It is quite common for patients with bulimia nervosa to be treated with antidepressant medications. Researchers became interested in using these medications after it became clear that many patients with bulimia nervosa also suffer from mood disorders.

b. Cognitive Behavioral Therapy: The leading treatment for bulimia nervosa is CBT. The “behavioral” component of CBT for bulimia nervosa focuses on normalizing eating patterns. This includes meal planning, nutritional education, and ending binging and purging cycles by teaching the person to eat small amounts of food more regularly. The “cognitive” element of the treatment is aimed at changing the cognitions and behaviors that initiate or perpetuate a binge cycle. This is accomplished by challenging the dysfunctional thought patterns typically present in bulimia nervosa, such as the “all-or-nothing” or dichotomous thinking described earlier. For instance, CBT challenges the tendency to divide all foods into “good” and “bad” categories. This is done by providing factual information, as well as by arranging for the patient to demonstrate to herself that ingesting “bad” food does not inevitably lead to a total loss of control over eating.