Bulimia Nervosa Information for service users www.lpft.nhs.uk
Bulimia Nervosa - what is it? Bulimia Nervosa, or bulimia as it is often called, is an eating disorder. People with bulimia have episodes of binge eating followed by self-induced vomiting, or other activities to counteract or purge their excessive food intake. What are the symptoms of Bulimia Nervosa? Bingeing and purging are the main symptoms and are usually done in secret. Bingeing means that an individual has repeated episodes of eating large amounts of foods and/or drinks. They feel out of control and unable to stop eating. After binge eating, the individual often experiences feelings of shame, embarrassment and self disgust about their actions. Purging means that the individual will try and counteract the fattening effects of food following their bingeing. Self-induced vomiting (making yourself sick) after a bout of bingeing is the most well known, but not all people with bulimia do this. Other purging methods include taking lots of laxatives, extreme exercise, extreme dieting, missing meals or even periods of complete starvation, taking diuretics (water tablets), or taking other medicines such as amphetamines. Sometimes people may use a combination of these strategies.
Who gets Bulimia Nervosa? Bulimia mainly affects women aged between 16 and 40 years. Although bulimia is most common in teenage girls and young women, anyone can develop the illness at any age. It affects around eight in 100 women in the UK. Women are ten times more likely to develop bulimia than men. However, bulimia is becoming more common in boys and men. Bulimia is more common than Anorexia Nervosa (which is the other main eating disorder) which is characterised by excessive weight loss. Sometimes people with bulimia have had, or go on to develop, anorexia. Bulimia is sometimes part of a broader mental health problem. For example, there is a higher than average rate of bulimia in people with anxiety disorders, obsessive compulsive disorder, depression, post-traumatic stress disorder and some personality disorders.
What are the physical problems caused by bulimia? There are a number of physical health problems which can be caused by the unusual eating habits and methods used to purge the body of food (such as vomiting or the excessive use of laxatives). Although physical problems do not always develop, they are more likely to if the individual binges and purges often. These include: Irregular periods (for women of menstrual age). Chemical imbalances in the body (such as a low potassium levels, which may cause tiredness weakness, abnormal heart rhythms, kidney damage and convulsions. Low calcium levels can lead to muscle spasms). Bowel problems and abdominal pains. Swelling of hands, feet and face (usually due to fluid disturbances in the body). Teeth problems (caused by the acid from the stomach rotting away enamel as a result of repeated vomiting). Depression. Psychological problems (such as feelings of guilt and self disgust after bingeing and purging. Poor self-esteem, mood swings; difficulties concentrating; distorted body image and social withdrawal etc). What causes Bulimia Nervosa? The reasons why people binge eat and then purge may not be easy to explain. It is thought that bulimia is caused by a number of interrelated factors. These include an individual s biological make up, thoughts, feelings, personal traits, combined with social and cultural pressures.
Although part of the problem may be a fear of getting fat, it is often not as simple as that. All sorts of emotions, feelings and attitudes may contribute. The physical act of bingeing and purging may be a way of dealing with the individual s emotions to feel more in control. Do people with bulimia require medical investigation? Although bulimia is predominantly a behavioural and psychological problem, there can be some medical complications as a result of this eating disorder. GPs may wish to undertake some blood tests and these are usually done to check kidney function and potassium levels. Getting help Getting help is very important. Admitting that there is a problem is the first, yet hardest step. If you feel you may have a problem and are able to take that step, you can find the support and treatment you need to stop bulimia taking over your life. Your GP is the first point of contact for help. They will ask you about your lifestyle and eating habits and will conduct an examination to check for any physical problems resulting from bulimia. The GP may refer you to your local primary care mental health team who will assess your difficulties and direct you to see the appropriate health care professionals in response to your current needs. This could be a psychologist or other health professional in the team (such as a cognitive behavioural therapist or a psychological wellbeing practitioner) who has been trained in the treatment of bulimia.
Treatment Bulimia can be helped more easily if the problem is identified and treated early. We offer treatments to adults with Bulimia Nervosa as recommended by the National Institute for Health and Clinical Excellence (NICE). This is the government body responsible for providing guidance and setting standards for quality and best practice to improve people s health and treatment. These treatments are available across Lincolnshire and are provided within each primary care mental health team. Treatments are provided based on an assessment of your individual needs. As a first possible step towards recovery, we may use a selfhelp programme which has been proven to help. This is supported by a clinician and allows you to continue your treatment at a pace that you feel comfortable with. Alternatively, you may be offered Cognitive Behavioural Therapy (CBT) specifically adapted for the treatment of eating disorders. CBT is provided on a one to one basis and treatment takes place over the course of 16 to 20 sessions, over four to five months. This therapy allows you to talk through the issues that upset you and that may lie at the heart of your eating disorder. It is designed to help you learn healthier ways of thinking about food and managing your bulimia.
Contact For further information about seeking treatment for bulimia or general information on bulimia, contact the eating disorder service on: T: 01476 584005. Other useful contacts Beating eating disorders (b-eat) 0845 634 1414 (adult helpline) help@b-eat.co.uk www.b-eat.co.uk Mental Health Foundation 020 7803 1101 www.mentalhealth.org.uk
Contact us Communications Team Lincolnshire Partnership NHS Foundation Trust Unit 9 - The Point, Lions Way Sleaford, Lincs NG34 8GG E: communicationslpft@lpft.nhs.uk Every effort has been made to ensure that the information in this leaflet was correct at the time of print. However, changes in law may mean that in time some details in this leaflet may be out of date. Anyone using our services will be treated with dignity at all times and their faith and cultural needs will be accommodated where practically possible. The Trust is fully compliant with the Data Protection Act and the NHS Code of Conduct Published by Lincolnshire Partnership NHS Foundation Trust - May 2011. www.lpft.nhs.uk