Service Based Activity Bulimia
Content
SERVICE BASED ACTIVITY
DIAGNOSIS – EATING DISORDER – BULIMIA NERVOSA
Criteria
Episodes of eating large amounts of food which is larger than the norm within
a short space of time (usually less than 2 hours).
The person will experience a sense lack of control during these binge eating
episodes.
Following a binge eating episode the person will attempt to compensate for
this behavior to prevent weight gain by deliberately vomiting, misusing
laxatives, fasting and excessive exercise.
The episodes of binge eating and purging occur on average at least once a
week for 3 months.
Self-image is determined by body shape and weight.
Differential diagnosis information
Individuals with bulimia nervosa typically are within the normal weight or
overweight range (body mass index [BMI] > 18.5 and < 30 in adults).
Between eating binges, individuals with bulimia nervosa typically restrict
their total caloric consumption and preferentially select low-calorie ("diet")
foods while avoiding foods that they perceive to be fattening or likely to
trigger a binge.
Menstrual irregularity or amenorrhea often occurs among females.
Rare but potentially fatal complications include esophageal tears, gastric
rupture, and cardiac arrhythmias
Serious cardiac and skeletal myopathies have been reported.
Individuals who chronically abuse laxatives may become dependent on their
use to stimulate bowel movements.
There are different levels of severity in Bulimia Nervosa. These are:
Mild: An average of 1-3 episodes of inappropriate compensatory behaviors
per week.
Moderate: An average of 4-7 episodes of inappropriate compensatory
behaviors per week.
Severe: An average of 8-13 episodes of inappropriate compensatory
behaviors per week.
Extreme: An average of 14 or more episodes of inappropriate compensatory
behaviors per week.
Risk and Prognostic Factors
Temperamental - Weight concerns, low self-esteem, depressive symptoms,
social anxiety disorder, and overanxious disorder of childhood are associated
with increased risk for the development of bulimia nervosa.
Environmental - Internalization of a thin body ideal has been found to
increase risk for developing weight concerns, which in turn increase risk for
the development of bulimia nervosa. Individuals who experienced childhood
sexual or physical abuse are at increased risk for developing bulimia nervosa.
Genetic and physiological - Childhood obesity and early pubertal maturation
increase risk for bulimia nervosa. Familial transmission of bulimia nervosa
may be present, as well as genetic vulnerabilities for the disorder.
Course modifiers - Severity of psychiatric comorbidity predicts worse longterm outcome of bulimia nervosa.
Other info
Increased risk of suicide.
Increased risk of self-harm.
Social life can be adversely affected.
Far less common in males than it is in females.
Treatment
GP
Cognitive Behavioral Therapy (CBT)
Interpersonal Therapy (IPT)
Support Groups
In-patient hospital treatment
Medication
selective serotonin reuptake inhibitors (SSRI) antidepressants
-side effects can include: Nausea, nervousness, agitation or restlessness,
dizziness, reduced sexual desire or difficulty reaching orgasm or inability to
maintain an erection (erectile dysfunction), drowsiness, insomnia, weight gain
or loss, headache, dry mouth, vomiting, diarrhea.
DIAGNOSIS – EATING DISORDER – BULIMIA NERVOSA
Criteria
Episodes of eating large amounts of food which is larger than the norm within
a short space of time (usually less than 2 hours).
The person will experience a sense lack of control during these binge eating
episodes.
Following a binge eating episode the person will attempt to compensate for
this behavior to prevent weight gain by deliberately vomiting, misusing
laxatives, fasting and excessive exercise.
The episodes of binge eating and purging occur on average at least once a
week for 3 months.
Self-image is determined by body shape and weight.
Differential diagnosis information
Individuals with bulimia nervosa typically are within the normal weight or
overweight range (body mass index [BMI] > 18.5 and < 30 in adults).
Between eating binges, individuals with bulimia nervosa typically restrict
their total caloric consumption and preferentially select low-calorie ("diet")
foods while avoiding foods that they perceive to be fattening or likely to
trigger a binge.
Menstrual irregularity or amenorrhea often occurs among females.
Rare but potentially fatal complications include esophageal tears, gastric
rupture, and cardiac arrhythmias
Serious cardiac and skeletal myopathies have been reported.
Individuals who chronically abuse laxatives may become dependent on their
use to stimulate bowel movements.
There are different levels of severity in Bulimia Nervosa. These are:
Mild: An average of 1-3 episodes of inappropriate compensatory behaviors
per week.
Moderate: An average of 4-7 episodes of inappropriate compensatory
behaviors per week.
Severe: An average of 8-13 episodes of inappropriate compensatory
behaviors per week.
Extreme: An average of 14 or more episodes of inappropriate compensatory
behaviors per week.
Risk and Prognostic Factors
Temperamental - Weight concerns, low self-esteem, depressive symptoms,
social anxiety disorder, and overanxious disorder of childhood are associated
with increased risk for the development of bulimia nervosa.
Environmental - Internalization of a thin body ideal has been found to
increase risk for developing weight concerns, which in turn increase risk for
the development of bulimia nervosa. Individuals who experienced childhood
sexual or physical abuse are at increased risk for developing bulimia nervosa.
Genetic and physiological - Childhood obesity and early pubertal maturation
increase risk for bulimia nervosa. Familial transmission of bulimia nervosa
may be present, as well as genetic vulnerabilities for the disorder.
Course modifiers - Severity of psychiatric comorbidity predicts worse longterm outcome of bulimia nervosa.
Other info
Increased risk of suicide.
Increased risk of self-harm.
Social life can be adversely affected.
Far less common in males than it is in females.
Treatment
GP
Cognitive Behavioral Therapy (CBT)
Interpersonal Therapy (IPT)
Support Groups
In-patient hospital treatment
Medication
selective serotonin reuptake inhibitors (SSRI) antidepressants
-side effects can include: Nausea, nervousness, agitation or restlessness,
dizziness, reduced sexual desire or difficulty reaching orgasm or inability to
maintain an erection (erectile dysfunction), drowsiness, insomnia, weight gain
or loss, headache, dry mouth, vomiting, diarrhea.
