Bulimia: what is this disease, how does it manifest itself and how to get rid of it? Bulimia (bulimia nervosa): causes, symptoms, complications, diagnosis, treatment and prevention. Specialist consultations

Diseases that are based on a mental disorder are quite difficult to treat, since all symptoms are only an external reflection of ongoing processes. In such cases, treatment of somatic conditions is ineffective without restoring the psyche, since the fight against the effect is useless unless the causes are eliminated. The problem is that it is extremely difficult to find out the cause of the disease - often the patient himself is not able to clearly explain when and how it all began, what served as the impetus for the emergence of a stable reflex. Moreover, it is generally difficult for a person to notice any deviations in himself, and when he does pay attention to them, he explains it as a common habit. To contact a doctor, the problem must begin to seriously bother the patient, so treatment begins when the disease is at an advanced stage. Often, a visit to the clinic is initiated by relatives or friends who convince the patient to seek help.

Bulimia is one of the types of eating disorders, a behavioral syndrome expressed in a reaction to stress, neuroses or other emotional states in the form of feelings of extreme hunger and absorption large volumes food. The patient does not feel full; he eats until painful sensations appear.

The consequence of this is a feeling of shame for such manifestations, attempts to get rid of what was eaten by inducing vomiting, the use of laxatives, attempts to starve or exhaust oneself with physical activity.

Important! Bulimia should not be confused with a similar disease - psychogenic (compulsive) overeating.

The similarities are very great, but the difference between them is that when overeating a person tries to close himself off from problems in this way, and with bulimia he simply experiences severe hunger, alternating with attempts to correct the situation radical methods. This behavior has a detrimental effect on:

1. Esophagus. Frequent passage of vomit causes a burn of digestive acid to the mucous membrane.
2. Oral cavity. The condition of tooth enamel deteriorates, the mucous membrane of the gums is damaged from exposure to gastric juice during vomiting, and constant irritation of the larynx is observed.
3. Impaired liver and kidney function.
4. Frequent use of laxatives causes intestinal disorders.
5. Metabolic disorders that provoke heart disease, menstrual irregularities in women, and there may be internal bleeding.
6. Lack of salts and minerals, causing cramps or involuntary muscle contractions.
7. Depressive states.

The greatest danger of the disease is that it is very difficult to recognize in the early stages, and the patient is not able to control his behavior and is not aware that he is sick. Most often they try to explain this by “features of the body,” “habit,” etc. At the same time, attempts to neutralize their actions are very active, they are used very intensively and in large doses. All this against the backdrop of constant stress due to a feeling of shame for one’s behavior. A “vicious circle” arises - nervous tension provokes attacks of hunger, which cause attempts to get rid of what was eaten and somehow neutralize what happened, causing new stress. Thus, the disease progresses, simultaneously destroying internal organs and causing additional destructive processes.

It is they who often become the reasons for visiting a doctor, and the main problem remains unrecognized, continuing its effect until the moment when it becomes completely obvious. The patient monitors his weight, external signs are almost completely absent. The disease is purely female; men suffer from this disease very rarely, although no one has yet been able to link this circumstance to gender. Many experts attribute this situation to the characteristics female psychology, increased emotionality and susceptibility to stress.

Treatment methods for bulimia

Medication methods will not solve the problem, since its essence lies in the psychological plane. In most cases, treatment of the disease takes place on an outpatient basis; hospitalization is used only in the most advanced cases, when the consequences of the disease require urgent measures.

For treatment, a complex method is used, combining psychoanalysis, behavioral therapy, and only last but not least, medication. The main task that arises during treatment is to help a person realize the presence of a problem, its signs and symptoms. The patient must learn to analyze his well-being detachedly, without emotional stress, and control his behavior and way of thinking.

The main issue becomes a person’s ability to understand and accept his condition, take control of his experiences and change his overall outlook on things. We must learn to break down a problem into its component parts and deal with each of them separately:

1. Monitor your diet, monitor the frequency and amount of food you eat.
2. Stop paying too much attention to your appearance, in particular, don’t be afraid of getting too fat.
3. Stop using laxatives and do not consider playing sports as a means to hide your illness.

The most important step in solving the problem is understanding that this is a disease that can be overcome to a greater extent by personal efforts than by medications and procedures. Help from specialists is required in purchasing the right psychological attitude, eliminating the occurrence of stressful situations and emotional breakdowns because of what is happening. The patient must understand that his problem is not an isolated incident, this has happened before and will continue to happen, therefore it must be treated as a nuisance, but not as a tragedy.

Correcting the patient’s interpersonal relationships is of great importance, in particular, changing the degree of his responsibility to others. A person must realize that the opinion of others is only someone's opinion, and in no way an order or obligation. Group therapy has a very great effect in this regard, where people with the same problems begin to gradually change their attitudes and increase their self-esteem.

Family therapy is no less important, helping to identify and eliminate the sources of pathological attitudes in thinking, and organize close and positive control over the patient’s condition.

Drug treatment is limited to the prescription of antidepressants that support psychological condition patient, as well as to eliminate side problems - blood pressure, dysfunction of the kidneys, liver, intestines, etc.

Self-treatment of bulimia

If it is not possible to turn to specialists, you can and should try to heal yourself. First of all, you should have a clear understanding of the magnitude of the problem and the fact that you have to fight with yourself. Therefore, help and support from household members is highly desirable. But the main burden, of course, falls on the shoulders of the patient himself, and one must be prepared for this. You need to fully define your feelings and accept that you have a disease. Not a habit, not a feature of the body, not a condition, but a disease that must be overcome, not with the help of drugs or diet, but by changing the way of thinking and attitude towards oneself and others.

The main postulates that you need to instill in yourself:

1. Understanding your condition, realizing that it is a disease.
2. Refusal to hush up the problem, calmly discuss it with friends and family members.
3. Getting rid of the fear of being misunderstood or judged by others. Understanding that this is not the most important thing in the current situation.
4. Recognition of the complexity of the problem that has arisen and the need for considerable effort to resolve it.
5. Willingness to make certain sacrifices in the healing process - remember that only bitter medicine heals.
6. Determination to overcome your illness, a strong desire to return to normal.

Important! All attitudes must constantly be strengthened and nourished, because any weakening of self-control threatens the loss of all achieved successes.

In parallel with psychological treatment, you need to re-teach your body to react correctly to the amount of food eaten and to give signals of satiety. Here you need constant self-control, recording the amount of food consumed. Everyone knows how much he should eat at one time, and we must build on this amount, not allowing the average values ​​to be exceeded. It is useful to know the number of calories in familiar products, nutritional value consumed food. You need to be prepared for the fact that at first you won’t feel full and feed yourself purely mathematically, according to the principle “as much is enough.” You shouldn't expect quick results; you shouldn't improve; it will be a very long and difficult process. Usually it lasts from 2-3 years, it is impossible to predict anything more precisely, everyone has their own, individual period.

Experts advise at first to create a meal schedule that is more frequent, but with small portions, about 100-200 grams. In this way, the stomach stops stretching, it gradually reduces its volume and begins to get used to normal amounts of digested contents. At the same time, it is recommended to eliminate all distractions - TV, music, etc., in order to fully concentrate on thoughtful eating. You need to chew it thoroughly, feel the taste, smell, reviving all the body’s reactions.

A proper diet is a very important factor in fighting the disease. Following the recommendations of nutritionists for bulimics will help speed up the process of restoring body functions and adjust the signaling system of the digestive complex. Let's look at the list of foods that can and shouldn't be consumed during treatment:

Recommended	Not recommended
Vegetable light soups	Fatty, floury or salty foods
Chicken bouillon	Semolina
Oatmeal, pearl barley	Fresh bread
Vegetable purees	Mayonnaise
Rye bread or bran bread	Vegetable oil
Fresh vegetables	Spices
Fresh herbs	Spicy dishes
Dairy products – kefir, cottage cheese, yogurt	Sour vegetables, fruits
Water, subsequently – compote	Coffee Tea

As can be seen from the table, the composition preferred products completely belongs to the category of light, dietary. This list is based on the need to remove the load from gastrointestinal tract, provide a simplified mode of operation of all digestive system and, what is most necessary, create conditions for contraction of the stomach.

Video - Bulimia Nervosa

Medication support

The psychological assistance measures used can be significantly enhanced by drugs that relieve stress and nervous tension. Excessive stress on the psyche will not bring any benefit; the use of antidepressants is a completely appropriate addition; the only condition that must be met is a consultation with a doctor. Only he will be able to correctly prescribe the dosage and determine whether this or that drug can be used in this case.

Most often used Fluoxetine And Phenibut. Both are classified as antidepressants, but act in the opposite way - Fluoxetine works as a stimulant, activating and mobilizing the nervous system. Phenibut, on the contrary, is calming and relaxing, which makes it most convenient to take before bed. With these differences, both medications promote resistance to hunger pangs.

Phenibut for the treatment of bulimia
Fluoxetine for bulimia

Folk ways to combat bulimia

Traditional medicine has in its arsenal some means to fight the disease. These include:

1. Garlic infusion. Several slices are grated on a fine grater and poured with boiled water at room temperature. Leave for about a day, after which you take one tablespoon before bed.
2. Linseed oil. Before eating, you should drink 20 ml of oil.
3. Wormwood infusion. A teaspoon of dry herb is poured with boiling water (1 cup). Drink 1 tbsp. Take a spoon half an hour before meals.
4. Infusion of mint with parsley. A mixture is made from equal parts of dried mint and parsley, ground into powder and poured with boiling water (1 tbsp mixture per 250 ml of boiling water). The infusion calms the feeling of hunger and lasts for about 2 hours.
5. Decoction of figs and plums. About 500 g is poured with three liters of water and cooked until about 500 g of water remains. Drink half a glass, four times a day.
6. Celery decoction. About 20 g of celery are poured into 250 ml of water and boiled for 15 minutes. The serving is for three doses before meals.

Video - How to treat bulimia

How long does treatment last?

Experts never determine the healing time in advance, which is explained by the complexity of the problem and large differences in psychology different people. Many factors influence the condition of the body, how advanced the disease is, age, personality traits, weight, etc. The combination of all these features largely determines the intensity and duration of treatment. It usually takes about 2-3 years, and this is not an exaggerated period - the problem is complex and insidious. Any weakening of the regime, deviation from the chosen treatment order may negate all previous efforts and you will have to start all over again. In addition, it is not always possible to say unequivocally that the disease has receded, everything is behind us. The final decision is the prerogative of the patient himself, but he can also make mistakes, wishful thinking.

Psychological problems are insidious, they can return even if it seems that they are gone forever. Nevertheless, positive changes are noticeable quite clearly, and the resulting habit of self-control is a guarantee against relapse.

What to eat after finishing treatment

So, all the problems are behind us, life is wonderful. And now everything is possible. Or is it not? The opinions of doctors here agree that you should not immediately start eating all previously forbidden foods, since a sharp change in diet in itself is quite harmful; it can provoke, if not a return of past problems, then create the preconditions for it. At the same time, there is such a point of view: everything that is prohibited is most desirable. The stronger the ban, the more you want. For these cases, it is recommended to use a regime of reasonable consumption - you don’t need to drive yourself to obsessive visions, you just need to take and eat what you want, but in moderation. In this way, you can relieve the psychological stress that arises from the ban and save yourself from fighting desires. In addition, after a long diet, the body itself will not accept anything unnecessary; it will certainly give a signal that this product is undesirable. A little bit of everything - this should be the motto for everyone involved in a regular diet, and this can easily be attributed not only to bulimia, but also to most other ailments.

is an eating disorder that occurs as a result of mental and somatic reasons. Characterized by heightened feeling hunger with reduced satiety. Bulimia is based on an obsessive fear of gaining weight.

It has been established that mainly young girls suffer from bulimia. The disease begins at a young age and can last for years.

Picture of the disease

Bulimia causes physiological disorders body. Bouts of overeating, combined with constant procedures for cleansing the gastrointestinal tract, contribute to the occurrence of diseases of the esophagus. As the patient tries to overcome his cravings for food, he begins to develop vegetative symptoms: heart pain, tachycardia ( cardiopalmus), chills, sweating, fainting states. The desire to snack, on the one hand, and the fear of obesity, on the other hand, cause mental changes personality. Emotional instability, anxiety, and lack of self-confidence develop. The combination of all these factors leads to the fact that a person can be completely cured only with long-term inpatient treatment.

Patients often experience painful attacks of hunger that they cannot cope with. At such moments, experiencing a strong craving for food, and unable to restrain themselves, they begin to absorb food in large quantities, but cannot feel full.

Lack of feeling of satiety ( akoria), occurs when receptors in the hypothalamic region are damaged, which signal the accumulation of carbohydrates in the blood. Violation of this function of hypothalamic receptors leads to a constant feeling of hunger.

The process of eating in patients with bulimia can be divided into 3 stages:
1. Strong and irresistible desire to eat.
2. Uncontrolled eating of food. Bulimics are sometimes called “binge eaters,” and this expression is true.
3. The subsequent desire to “cleanse” the stomach of excess food. Patients with bulimia resort to laxatives or artificially induce vomiting.

Often this behavior, characteristic of patients with bulimia, can be seen in anorexics. However, unlike anorexia, bulimia does not experience significant weight loss. If anorexics can be identified by severe physical exhaustion, then patients with bulimia, whose weight is within normal limits, can hide their disease from others for years.

First and main feature development of bulimia - constant craving for food. Food becomes a cult, and patients see the meaning of life in it. Bulimics only feel good when they eat. Having stopped chewing, they become irritable and cannot concentrate on anything. Oddly enough, most people suffering from bulimia do not have overweight. Constant fear obesity causes bulimics to immediately get rid of the food they eat, so that it is not absorbed by the gastrointestinal tract.
Patients set an optimal weight for themselves and try to achieve it by using various diet pills; intensively engage in sports exercises.

Main signs of bulimia

1. Depressive state, feelings of hatred, guilt and self-hatred.
2. Feeling unable to control yourself.
3. The strictest self-criticism.
4. An irresistible need for the actions taken to be approved by other people.
5. Distorted perception of one’s own weight, feeling “fat, disgusting, disgusting.”

Physiological signs of bulimia that require hospital treatment

1. Sharp fluctuations in body weight, both up and down ( plus - minus 5 - 10 kg).
2. Chronic irritation And painful sensations in the throat area associated with constantly induced vomiting.
3. Painful sensations in the muscles.
4. Inflammation parotid gland.
5. Tooth loss.

There is a misconception that bulimia is simply overeating. In fact, binge eating and bulimia are very different from each other. When overeating, a person still feels full and enjoys the taste of food. Patients with bulimia practically do not feel the taste of food; the process of absorbing food is important for them, and they do not experience a feeling of satiety.

In addition, the process of overeating in no way changes a person’s mood, nor does it put him into a depressed state, as in bulimics. An overeating person, unlike those suffering from bulimia, is not fixated on losing weight, even if he is objectively overweight.

All this indicates the fact that in bulimic syndrome the leading role is played by the pathopsychological component. That is why this disease is classified as a mental disorder.

It is almost impossible to cope with this disease on your own, since sooner or later a bulimic attack occurs and the person begins to consume food in huge quantities. It is these “eating binges” and attempts to resist them that make up bulimia. On early stage disease episodes of uncontrollable eating occur 1 - 2 times a month. Over time, episodes of overeating become more frequent up to several times a week, and in severe cases - up to several times a day.

If bulimia attacks occur more than twice a week, then this is an indication to seek medical help.

In severe cases of bulimic disorder, patients are hospitalized in a psychiatric hospital, drug treatment in conjunction with psychotherapy. Upon discharge, a schedule of doctor visits is assigned for subsequent therapeutic correction and strengthening of correct eating behavior skills.

Bulimia nervosa is an eating disorder characterized by periodic bouts of binge eating, which are preceded by feelings of sudden and acute hunger. Such episodes are usually caused by some negative (failures at work or school, quarrels with loved ones, feelings of loneliness, etc.) or positive (holiday, promotion, prospect of meeting a new guy, etc.) factors. Against the backdrop of such experiences, a person develops an uncontrollable appetite, and to relieve his anxiety, he begins to absorb food in unlimited quantities. After such an attack of gluttony, a feeling of guilt, shame and fear of gaining extra pounds arises, and in order to “cleanse” the body, attempts are made to get rid of what was eaten: artificially inducing vomiting, taking diuretics and laxatives, intermittent fasting or grueling physical activity.

In this article, we will introduce you to the suspected causes, signs and symptoms, prognosis, methods of diagnosis and treatment of bulimia nervosa. This information will help you suspect the emergence of such an eating disorder, and you will make the right decision about the need for treatment from a specialist.

People with bulimia nervosa are much more difficult to identify than people with anorexia. They can maintain a completely normal weight, go on gluttony sprees in secret from others, and their behavior may be no different from normal. Typically, such people do not tell anyone about their problem for many years and then only one or two family members or their closest friend may find out about it.

On the contrary, they lose weight so much that others cannot help but notice it, and even at the onset of a mental disorder, their behavior changes: they search for the ideal diet, are overly keen on studying the principles of proper nutrition, carry out regular measurements of body volumes or weighings, and often refuse food supposedly because of this. for lack of appetite, etc.

According to statistics, bulimia nervosa is detected more often than anorexia nervosa. Most of these patients are teenage girls and women under 35 years of age.

Causes

Anxiety, stress, low self-esteem, personal problems - all these factors can trigger the development of bulimia nervosa in a girl.

Bulimia nervosa can be caused by various physiological and psychological reasons.

This eating disorder can be provoked by the following physiological factors:

• hormonal disorders (hypothalamic-pituitary disorders);
• organic damage to the food center of the cerebral cortex and functional damage to the central nervous system(, epilepsy);
• insulin resistance, metabolic syndrome and other metabolic abnormalities.

According to many experts, bulimia nervosa is most often caused by various psychological factors:

• personal problems;
• low self-esteem;
• increased anxiety;
• stress;
• the habit of “seizing” problems and nervous experiences;
• tendency towards perfectionism;
• long-term adherence to diets, leading to eating disorders;
• active sports;
• imposing the canons of success and beauty, expressed in harmony;
• mental illnesses (psychopathy, schizophrenia, obsessive-compulsive disorder).

As a rule, bulimia nervosa, which is not associated with physiological causes, begins due to the misconception that with the help of vomiting, taking laxatives and other techniques, you can easily control weight gain and not deny yourself anything when eating. And attempts to eliminate life’s troubles with the help of food indicate a lack of willpower and an inability to solve one’s own problems. In such cases, eating becomes an attempt to escape from emerging difficulties; this is how a person corrects his dysfunctional situation. emotional condition according to the “eat and enjoy” principle.

According to statistics, bulimia nervosa occurs more often in wealthy families with ambitious family goals. Children in them often experience their own inferiority and fear of not meeting their parents' expectations.

Women aged 13-35 years are most susceptible to this eating disorder, and the peak manifestation of symptoms occurs at the age of 15-16, 22-25 or 27-28 years. Sometimes the fact of the disease is recorded in women of more mature age. Mild forms of bulimia nervosa can occur in people of any gender.

Symptoms

As a rule, patients with bulimia nervosa hide their illness from others for many years. Relatives of such patients may suspect an eating disorder based on the following signs:

• hasty absorption of food;
• swallowing large pieces of food;
• eating large amounts of food;
• the habit of going to the toilet after eating (where the patient secretly induces artificial vomiting);
• there may be scratches on the fingers from the teeth that occur when trying to provoke vomiting;
• the presence of laxatives or diuretics in the house.

Conventionally, bulimia nervosa can occur in two forms:

• classic - the patient copes with gluttony by inducing vomiting, performing cleansing enemas, taking diuretics or laxatives;
• stage of anorexia - the patient compensates for his behavior with periods of fasting or excessive physical activity.

In addition, such an eating disorder can be primary or secondary (that is, it occurs as a complication of anorexia).

With bulimia, the patient often experiences periods of constant, painful and prolonged hunger, after which he cannot restrain himself from eating food and does not limit its volume. For food, he can choose his favorite dishes or the most beautiful and largest pieces of food. Many patients are very fond of sweets or starchy foods, while others have an irresistible need for certain foods.

Often episodes of painful hunger and uncontrollable overeating occur at night. After an attack of gluttony, patients begin to experience remorse and try to get rid of the food they have eaten as soon as possible in one way or another.

Almost always, people with bulimia nervosa try to carefully hide their excessive eating from others and spend it alone. They prepare for it as a ritual and make extensive purchases and preparations. If they are unexpectedly caught during gluttony, then bulemics try to bashfully and quickly hide or interrupt eating. In the same “secret” they try to get rid of the food they have taken by vomiting or other methods.

Patients with bulimia nervosa are concerned about their weight and try to diet. They may weigh themselves frequently and measure their body measurements. As a result, their life turns into an endless “struggle with diets” and alternating periods of control and its loss. As a rule, bulemics rarely develop obesity, and their weight is within the normal range or slightly increased.

People suffering from bulimia not only try to hide episodes of overeating, but also in every possible way deny the fact of the problem. They are unable to think critically about their condition, and often only their loved ones can help them realize the need for treatment from a specialist.

Against the background of such changes in eating behavior and the experiences that arise from them, patients may become emotionally unstable, experience depression, and voluntarily give up communication with friends or favorite activities. In advanced stages of the disease, such changes in the psyche can lead to complete social isolation and thoughts of suicide. In the absence of timely qualified assistance, patients may commit suicide.

In bulimia nervosa, poor eating habits lead to the following symptoms:

• discoloration and destruction of tooth enamel, gum lesions, throat irritation and enlargement of the parotid salivary glands under the jaw caused by frequent vomiting;
• increased salivation;
• small ruptures blood vessels on the whites of the eyeball;
• dullness and brittleness of hair and nails;
• dehydration skin;
• unhealthy skin color;
• stomach pain;
• changes in stool (diarrhea, diarrhea);
• violations;
• muscle spasms and twitching;
• signs of impaired functioning of the kidneys and liver.

Such changes in physical condition lead to the fact that a patient with bulimia nervosa appears weak, has decreased ability to work, and feels unhealthy. Patients experience sharp fluctuations in weight - from 5 to 10 kg, plus or minus.

Later, such physiological abnormalities can lead to more severe consequences of bulimia:

• dental diseases: caries, periodontitis, periodontal disease;
• inflammation of the esophagus;
• and enteritis;
• gastric rupture (in rare cases);
• pathologies of the heart and blood vessels;
• gynecological diseases (up to amenorrhea);
• problems with the onset and pregnancy;
• endocrine pathologies: diabetes mellitus;
• tendency to alcoholism or drug addiction against a background of prolonged depression.

Diagnostics

The main method for diagnosing bulimia is a conversation between a doctor and the patient or her relatives and a series of special tests.

The main goal of diagnosing bulimia nervosa is aimed at identifying evidence of systematic bouts of overeating. To do this, the doctor talks with the patient and may offer him various tests. Sometimes, in the presence of circumstances that do not allow direct communication, the conversation is carried out only with the patient’s relatives.

During such conversations it becomes clear:

• all circumstances that contributed to the development of eating disorders;
• symptoms;
• features of the patient’s appearance, mental state and general well-being.

Additionally, the necessary lab tests And instrumental studies, allowing us to determine changes in the physiological state caused by bulimia.

The diagnosis is made in cases where the doctor identifies facts of overeating and signs of “cleansing” procedures (vomiting, enemas, taking laxatives and diuretics, fasting and grueling physical activity), occurring at least 2 times a week for 3 or more months.

Treatment

The treatment strategy for bulimia nervosa is determined by the causes of its occurrence. In organic forms of such eating disorders, to get rid of the disease, therapy is carried out for the underlying pathology (hormonal disorder, tumor, consequences of injury, mental illness etc.), and if the disorder is caused by changes of a psychological nature, then therapy is aimed at correcting such disorders.

Treatment for bulimia nervosa should begin as early as possible and be comprehensive. The most effective is a combination of individual and family psychotherapy, diet therapy and drug therapy.

Depending on the complexity of the clinical case, the course of treatment can be carried out on an outpatient basis or in a specialized hospital.

Psychotherapy

To treat bulimia nervosa, the patient may be recommended individual, family, or group therapy. The treatment plan is drawn up depending on the patient’s personality characteristics, and its main goal is aimed at getting rid of psychological barriers that lead to the desire to “eat up” an uncomfortable psychological state, and developing the right attitude towards food.

In addition to working on the patient’s behavior in the treatment of bulimia nervosa, cooperation with the patient’s close circle (relatives and friends) is of great importance. The doctor gives them recommendations that could eliminate the appearance of thinking pathologies in the patient, teaches them adequate tactics for communicating with a bulemic person and proper monitoring of his food intake.

Group psychotherapy is usually recommended for patients in recovery. In such groups, people suffering from bulimia nervosa can share their experiences, achievements and ways of overcoming the disease. Such communication allows them to feel the hopelessness of the current situation and learn about the existence of ways to solve the problem. In addition, helping other people increases the patient's self-esteem.

Usually, for patients with bulimia nervosa, one psychotherapeutic course is not enough to cure. Such therapy should be long-term and should be discontinued only after the onset of complete deliverance from an incorrect nutritional pattern. After reaching desired result Some patients may be advised to have regular follow-up with a psychotherapist to completely rule out relapses of bulimia nervosa.

Diet therapy

Important importance in the treatment of bulimia nervosa is given to the correct preparation of the daily menu. When selecting an individual nutrition plan, the dietitian takes into account the patient’s personality and health status. In addition, the specialist develops in the patient the following attitude towards food: “Food is not only pleasure, but also a necessary source of energy, the receipt of which must be carefully planned.”

Drug therapy

Reception medicines for bulimia nervosa, it is prescribed to eliminate both the causes (for example, prolonged depression) and the consequences of eating disorders (lack of vitamins, macro- and microelements, treatment of gastritis and other complications). For this purpose, potassium and magnesium supplements may be recommended, multivitamin complexes and dietary supplements, drugs for the treatment of certain diseases and antidepressants (Prozac or Fleoxtin), which complement the effectiveness of psychotherapy.

Eating problems do not plague people as often as colds and flu, but being able to recognize them at an early stage is no less important. What are the symptoms and treatment of bulimia, what causes uncontrolled overeating and how to cope with an attack - to modern man you need to know the answers to these questions so that, when faced with the first manifestations of the disease in yourself or your loved ones, you will be fully armed..

What is bulimia

IN official medicine There is an alternative name for this disease - kinorexia; among its main symptoms is uncontrolled appetite. It differs from a simple craving for overeating by its consistency, and bouts of gluttony may be replaced by an obsessive desire to cleanse the body. According to the medical classification, bulimia can be:

• Primary – frequent attacks of hunger, a constant desire to chew something.
• Secondary – against the background of anorexia, with an obligatory attempt to get rid of what has been eaten.

It is difficult to differentiate the stages of this disease, since the role here is played not by the duration, but by the intensity of the symptoms, the frequency of remissions and exacerbations, and the characteristics of human behavior. The most common classification:

• Initial stage: patients vomit up to 3 times per month, the disease is present for 3 years.
• Chronic disease: lasts about 5 years, the frequency of attacks is daily, or for 7 years several times a week.

Gluttony as a disease

In a weak form with rare overeating as the only symptom Bulimia is not considered a serious pathology, since it can be a one-time reaction of the body to external psychogenic factors (mainly severe stress). However, if the symptoms of the disease are repeated day after day, a person feels a constant craving for taking laxatives, or people with normal weight feel guilty for every bite of food, but cannot stop, this is a mental disorder fraught with complications.

What happens to the body during a bulimia attack?

For a person who has symptoms of bulimia, food becomes a drug, the dose of which must be constantly increased due to the disappearing feeling of satiety. Episodes of overeating and endless snacking are becoming more common. However, a person is aware of the abnormality of his diet, so a feeling of guilt for what he has eaten constantly lives inside, which at the same time gives rise to a new attack of hunger and the need to cleanse the body - the circle closes.

As a result, from constantly induced vomiting, the body experiences dehydration, the mucous membranes are injured, and uncontrolled reception laxatives cause intestinal problems.

Causes of gluttony

According to medical statistics, doctors predominantly diagnose the psychological cause of the development of an eating disorder in people with bulimia, especially when it comes to women aged 15-16 and 22-25 years. People with emotional instability are especially susceptible to bulimia. There are also physiological factors that provoke the disease:

• insulin resistance;
• the presence of hormonal disorders (mainly hypothalamic-pituitary insufficiency);
• damage to the food center in the cerebral cortex (trauma);
• metabolic syndrome.

If we consider exclusively bulimia nervosa, which is considered the most common, there are several groups of reasons that can provoke it. Social pressure can lead to a mental eating disorder, last years obsessed with thinness. A family factor cannot be ruled out - poor relationships with parents, a painful desire for perfectionism, attempts to follow other people's expectations often accompany the disease.

Signs

The group of eating disorders is very broad, but the characteristic symptoms of bulimia are not difficult to recognize. Thus, bulimia is characterized by a lack of behavioral control (unlike anorexia), which can lead to excessive consumption not only food, but also medicine. The main symptom of this disease is constant overeating, but besides this, the undoubted signs are:

• manic weight control;
• constant thoughts about food;
• dependence of self-esteem on appearance (figure, body weight);
• regular attempts to cleanse the gastrointestinal tract;
• exhausting physical activity for weight loss.

Obsessive thoughts about food

The mind of a person suffering from bulimia is almost always occupied exclusively with food: from endless planning of breakfast, lunch and dinner, to the desire to constantly throw something into his mouth. An extra half hour or hour spent without food already causes the need to urgently eat a solid meal, even when there is no physiological hunger. If attempts to distract consciousness do not bring success, it is time to urgently treat bulimia: This is no longer the initial stage.

Conversations about proper nutrition and excess weight

The current trend for natural food and a pumped-up body in itself is not dangerous. However, a psychologically healthy person, striving for a beautiful figure and the rejection of “harmful” things, knows the limits and limits of his capabilities, and a person suffering from bulimia goes to the extreme: he trains to the point of exhaustion, tries to eat only healthy things, but constantly breaks into high-calorie foods and then diligently provokes vomiting or is on laxatives.

Sudden weight fluctuations

Severe exhaustion is predominantly characteristic of anorexics, and bulimia is considered a disease that does not provoke large weight loss, but is characterized by its instability. The patient either actively absorbs food or tries to drive it out, which leads to disturbances in the functioning of the endocrine system and may be the cause sharp decline and increase in body weight without major changes in volume.

Deterioration in general health

Constant nervous tension and stress undermine the body's defenses, so a person becomes open to infections. Often the patient experiences sore throat and pharyngitis. Daily bouts of vomiting, especially with long-term bulimia, lead to serious consequences:

• Oral diseases develop;
• teeth crumble;
• heartburn and peptic ulcer;
• Scratches and wounds form on the fingers.

Psychological and psychosomatic disorders

An eating disorder and especially an obsession with food lead to constant tension in the nervous system, and if this is accompanied frequent attacks vomiting, the body receives severe stress. The result is increased fatigue, decreased concentration, memory impairment, daytime sleepiness, and, conversely, the inability to fall asleep at night. Due to disruptions against the backdrop of cravings for healthy eating the person develops depression.

Impaired functioning of the kidneys, liver and cardiovascular system

Metabolic changes provoked by eating disorders are fraught with dangerous heart diseases (convulsions are a common symptom of their onset). No less vulnerable in this situation are the liver and kidneys, which cease to function properly. Less commonly, the pancreas and rectum suffer - the production of bile is disrupted, and problems with stool arise.

Hormonal imbalances

The above-mentioned weight fluctuations and psychosomatic disorders always affect the functioning of the endocrine and reproductive systems, especially in women, which leads to serious consequences. The “mildest” complication is decreased libido and disruption of the menstrual cycle. As kinorexia progresses, amenorrhea and infertility are possible. Here you will already need hormonal treatment see an endocrinologist.

How to Diagnose Bulimia

If an anorexic person, even in a photo, can be easily recognized by their emaciated appearance, then persons with kinorexia differ little in appearance from healthy people, although the lack of self-control in eating behavior can give them away. Only a doctor can make a diagnosis, and the person himself often discovers this disease only at a late stage, when all the symptoms are present. However, since it is difficult to cure bulimia on your own in an advanced state and it leads to serious consequences for the entire body, you need to monitor:

• attitude towards food;
• weight dynamics;
• perception of your body.

Uncontrollable food cravings

Doctors call overeating among the key signs of the disease, but this word means not only large portions of food during main meals. Experts identify 3 forms of this disease (the general symptoms and treatment of bulimia will be similar for them):

• Sudden appetite, which can appear regardless of where you are and the time of day.
• Night hunger.
• Constant overeating (a person endlessly chews something).

Using inappropriate methods of losing weight

Among the symptoms of kinorexia, a person’s attempts to get rid of the food he has just eaten are particularly striking, since he understands that he has abused its quantity and daily calorie content. This mainly happens through constant vomiting, which the patient causes independently and purposefully, but it is also possible to use laxatives or enemas.

Low body weight

People suffering from bulimia in the early stages often have a normal weight - there is no exhaustion typical of anorexics. However, if the disease progresses to chronic form and has been observed for more than 5 years, due to the constant cleansing of the body against the background of overeating, the patient has constant weight fluctuations up and down, and there are minor deviations from the normal body mass index.

Low self-esteem

When eating habits are disrupted due to social and family factors, doctors often diagnose the patient with problems with self-perception. Even with a normal weight, a person experiences dissatisfaction appearance, manically strives to lose weight, combining cleansing the body after overeating with exhausting physical activity, and against the background of this dissatisfaction, seeks solace in food.

How to deal with gluttony

A visit to a psychotherapist (not a psychologist!), if the illness does not have physiological prerequisites, is the main point in the fight against kinorexia as a initial stages diseases and later. It is almost impossible to get rid of this problem on your own, so you need to discuss the symptoms and treatment regimen for bulimia with a specialist. The patient can stay at home, but at a later stage it is possible to move to a hospital.

Indications for inpatient treatment

Hospitalization of a person who has symptoms of eating problems is required if complications occur with the heart or gastrointestinal tract, or if this mental disorder became the cause of anorexia, a decrease in body weight by 70% of normal. A doctor may require treatment of a patient in a hospital if:

• the appearance of suicidal thoughts;
• confusion, complete insomnia;
• heart failure;
• calcium deficiency;
• the occurrence of internal bleeding.

Folk remedies

When studying the symptoms and treatment methods for bulimia, you can turn to herbal medicine, but it has little effect. It is impossible to overcome the disease solely with herbal decoctions, but they help strengthen the nervous system, partially suppress appetite, support the heart, kidneys, and liver. Herbal medicine makes sense at any stage of treatment, but they resort to it after consulting a doctor.

Treatment methods for bulimia

Binges of overeating occur mainly against the background of psychological problems, so psychotherapeutic techniques used by a specialist should take a central place in the treatment regimen created to combat bulimia. The use of medications is more common for people with an organic eating disorder, or as an additional component to the main course of psychotherapeutic sessions for late stages diseases.

Psychotherapeutic techniques

Doctors call behavioral therapy one of the most effective methods of treating bulimia, in which the patient learns to rethink his actions and beliefs, and cope with situations that in his opinion are insoluble. If we compare this method in terms of effectiveness with taking antidepressants, it will be much more effective, but in the later stages of the disease even drug therapy is added to it. Additionally, doctors may advise:

• Hypnosis (less commonly, self-hypnosis) - to control the need for food. But it will not eliminate the causes of the disease.
• Group psychotherapy sessions - they help the patient to realize psychological dependence, relax in a circle of people with the same problem.
• Family therapy is needed to help the patient develop healthy self-esteem thanks to the support of relatives, but this makes sense only for those who are close to the family.

Drug treatment

In the case of diagnosing diseases of the nervous system and brain, doctors primarily prescribe drugs to solve this problem, and if other prerequisites nervous disorder eating behavior, patients take antidepressants and antiemetics. Their independent administration is prohibited, especially for long-term treatment. IN complex treatment present:

• Selective serotonin reuptake inhibitors - Fluoxetine, Citalopram: stimulate serotonin receptors, used for severe depression and obsessive-compulsive disorder.
• Tricyclic antidepressants - Amitriptyline, Melipramine: for the treatment of moderate depression, appetite disorders, insomnia.
• Antiemetics - Cerucal, Domperidone: quickly suppress dopamine receptors, but do not contribute to the treatment of eating disorders.

Unconventional methods of combating the disease

Highly effective treatment methods oriental medicine and several other unconventional methods, according to doctors, is no different, but can be used as an additional factor to speed up the healing process. Mostly correct treatment Bulimia includes:

• reflexology (acupuncture);
• art therapy (creative activity to solve psychological problems);
• yoga.

What does gluttony lead to - dangerous consequences

Primary kinorexia can cause obesity, diabetes, malfunction of the gallbladder and liver due to uncontrolled food consumption. However, if it occurs against the background of anorexia, with constant attempts to cleanse the stomach, we have to talk about more severe consequences bulimia:

• destruction of tooth enamel;
• menstrual irregularities;
• peptic ulcer, enteritis;
• endocrine diseases;
• water-electrolyte imbalance;
• damage to the mucous membrane of the respiratory tract.

Video

The term "bulimia" has become increasingly popular in recent years. It can be found both in scientific and medical literature, as well as on the pages of newspapers and popular magazines. The popularization of this concept is associated with an increase in the number of morbidity cases. So what is bulimia? What causes the disease and what consequences can it lead to?

What is bulimia and how does it manifest?

Bulimia is the uncontrolled consumption of food in volumes greater than necessary to maintain energy metabolism. Simply put, the disease is a type of gluttony in which a person experiences a constant feeling of hunger. There are several reasons for this condition. However, in most cases, the disease is the result of neuropsychiatric disorders or organic pathology of the central nervous system.

Until the beginning of the twentieth century, medical specialists did not classify the condition in question as a disease. It was believed that an excessively increased appetite is nothing more than one of many bad habits, characteristic of man. The term entered medical textbooks only when the phenomenon began to become widespread. The reason was the acceleration of the rhythm of life and the increase in the number mental disorders associated with this phenomenon.

Bulimia is characterized by fluctuations in the patient's weight from less to more and vice versa. At the same time, a person usually understands that consuming such an amount of food is not normal. Patients often use emetics, try to limit themselves using willpower or medicines filling the stomach. However, such attempts, not combined with psychological help, are usually useless. It is difficult to draw the line between simple overeating and the onset of a disease.

Types of disease

Modern medical science distinguishes two types of disease:

• primary bulimia;
• bulimia as a compensatory reaction for anorexia.

Primary bulimia in most cases is a symptom of a neuropsychiatric disorder and is characterized by constant hunger. The feeling of satiety, which limits the food intake of a healthy person, is absent in a patient with bulimia. Patients prefer to eat high-calorie foods: baked goods, fatty meats and fish, pasta. Some experts consider the disease to be a type of drug addiction, since the patient needs more and more food as his body weight and stomach volume increase. In its absence, a condition similar to alcohol withdrawal occurs.

Symptoms of bulimia can also occur in people with anorexia. More often these are girls aged 18-28 years old, fixated on their own weight. Exhaustive diets lead to exhaustion of the body, which triggers a compensatory reaction. The body is trying to short time restore body weight necessary to maintain vital processes. Therefore, anorexics sometimes experience breakdowns in which they begin to indiscriminately absorb any food that is available. Bulimia of this type is characterized by alternating periods of gluttony and hunger, fluctuations in the patient’s body weight and poor absorption nutrients and dishes eaten.

Interesting to know: sudden arrival large quantity food after a long period of fasting often leads to serious problems in bowel function. In some cases, such breakdowns in anorexics become the cause of acute intestinal obstruction.

Causes of bulimia

The causes of bulimia are divided into:

• psychological;
• physiological.

To the number psychological reasons Overeating includes inferiority complexes, often cultivated since childhood, depressive states, and low self-esteem. With all this, the process of eating is the only way for the patient to achieve psychological comfort. While eating, a person enjoys it and forgets about existing psychological problems. A similar mechanism for the development of bulimia is by far the most common and occurs in 70-80% of cases of the disease.

As mentioned above, another mechanism for the development of pathology is a compensatory reaction during anorexia. Psychological disorders also occur here. Bulimia of a compensatory nature is the lot of girls who are overly addicted to diets and obsessed with their own weight.

Physiological causes include hormonal disorders, insulin resistance and diabetes mellitus, hormonal imbalances. Also, the cause of the disease may be a history of trauma associated with damage to the food center in the cerebral cortex. There are known cases of the development of bulimia in patients admitted not only with open, but also with closed craniocerebral injuries.

Consequences for the body

The main consequences of bulimia are associated with a slowdown in metabolism and the development of obesity.

It should be remembered that the means traditional medicine Use only after consultation with your doctor.

Prevention

Preventative measures mainly consist of creating a healthy environment around you. psychological climate. You should not take the comments of people around you to heart, enter into conflicts, or get hung up on external data. Emerging psychological problems should be addressed immediately, without waiting until they become the cause of serious somatic pathology.

The second important preventive measure is strict control of diet. You should eat meals in small portions, 3-6 times a day. There should be no snacks between planned meals. Special attention You should avoid going to the kitchen at night.

All of the above gives an idea of ​​what bulimia is and how it manifests itself. This will allow you to reasonably assess your well-being and diet, notice signs of illness in time and correct your health status. It must be remembered that a negligible number of patients manage to cure bulimia on their own. Therefore, at the first signs of illness, it is recommended to seek help from a doctor.