Awareness, Prevention, and Early Intervention for Bulimia Nervosa

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Contributor: Courtney Howard, BA, writer for Eating Disorder Hope

Bulimia nervosa can affect anyone, regardless of age, sex, or ethnicity. Increased awareness on the realities and dangers of bulimia nervosa can help those who are struggling gain better access to care. This also reduces the stigma attached to eating disorders and those affected by them.

As a complex mental health disorder, it is not likely that bulimia nervosa will be eradicated entirely. However, raising awareness is an important first step and does have the potential to reduce its prevalence.

Prevention efforts can also be implemented by families and schools to educate children and teens on coping mechanisms they can implement instead of turning to disordered eating and related behaviors.

The Facts Behind Bulimia Nervosa

The National Eating Disorders Association defines bulimia nervosa as “a serious, potentially life-threatening eating disorder characterized by a cycle of bingeing and compensatory behaviors such as self-induced vomiting designed to undo or compensate for the effects of binge eating.”

Young woman - happy in natureIn other words, those with bulimia nervosa typically binge on large quantities of food, then purge in varying ways to reduce anxiety and guilt associated with the bingeing episode. This is a highly isolative disorder that can affect an individual’s work, school, and interpersonal relationships.

Bulimia nervosa often co-occurs with other mental health conditions and behaviors, such as depression, anxiety, self-harm, and substance abuse.

Individuals with bulimia nervosa often have a normal body mass index (BMI), and do not appear underweight. Though this is not always true, it can contribute to a misdiagnosis or denial that an eating disorder is present.

A 2003 meta-analysis [1] of data conducted by researchers from Parnassia Psychiatric Institute in the Netherlands found that “prevalence rates for bulimia nervosa were 1% and 0.1% for young women and young men, respectively.”

Researchers noted that this is only representative of those who actually seek professional mental health care. The true numbers are likely much larger for both populations.

Awareness Within the Medical Field

Bulimia nervosa is often misdiagnosed or undiagnosed when an individual presents symptoms to a general practitioner. This is because eating disorders are often not well understood within the medical field.

Nurse - 640x545Angela Guarda, M.D., of The Johns Hopkins Hospital, explains that medical professionals need to be aware of the possible physical symptoms of eating disorders, including bulimia nervosa. These symptoms include metabolic and electrolyte imbalances, as well as gastrointestinal, gynecologic, neurologic, cardiac, endocrine, and renal abnormalities directly related to bingeing and purging behaviors.

According to Dr. Guarda, medical professionals should ask direct questions about food behaviors, eating patterns, and anxiety regarding weight.

Even if a patient is in denial about the presence of bulimia nervosa or tries to conceal symptoms, the combination of physical signs and eating disorder logic determined through this line of questioning can allow the practitioner to make a diagnosis or refer the individual to an eating disorder specialist.

Prevention and Early Intervention are Key

Bingeing and purging behaviors are not the root of the issue, but rather the symptoms of underlying anxiety, depression, low self-worth, post-traumatic stress, or other uncomfortable feelings. Addressing these emotions and low self-esteem early in life can arm an individual with coping tools to reduce the likelihood of disordered food behaviors developing.

family - 640x426Changing the social acceptability of food shaming and negative food talk also has the potential to reduce the prevalence of eating disorders. Some level of disordered eating and compulsive exercise has become the norm, which is dangerous for anyone but particularly those who are at high risk of developing an eating disorder. Promoting intuitive eating and positive self-talk can counteract these new social norms.

Advocating and raising awareness can be a means of prevention, as it starts a discussion and educates the general public on eating disorder warning signs and treatment options. While it might be difficult to prevent bulimia nervosa altogether, it is possible to raise awareness and encourage those who are struggling to get help.

If you notice that a friend or family member is wrestling with thoughts and behaviors characteristic of bulimia nervosa, seeking professional help is pivotal to their recovery process. Early intervention increases an individual’s chances of full and lasting recovery. It also reduces the long-term damage that bingeing, purging, and related behaviors have on the body.

Community Discussion – Share your thoughts here!

Have your or your loved one struggled with Bulimia Nervosa? Were you approached by someone you care about that was concerned about your eating disorder struggle? Or have you as a loved one approached someone you care about? What was said that might be helpful to others?


Courtney Howard Image - 2-17-16About the Author: Courtney Howard is the Administrative Assistant for Eating Disorder Hope and Addiction Hope. She graduated summa cum laude with a B.A. from San Diego State University, holds a paralegal certificate in Family Law, and is a Certified Domestic Violence Advocate. After obtaining her certification as a life coach, Courtney launched Lionheart Eating Disorder Recovery Coaching in 2015 and continues to be a passionate advocate for awareness and recovery.


References:

[1]: Hoek, H. W., van Hoeken, D. (2003). Review of the prevalence and incidence of eating disorders. Int. J. Eat. Disord., 34: 383–396. doi: 10.1002/eat.10222


The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on February 23, 2016
Published on EatingDisorderHope.com