12.16 : Bulimia Nervosa

Bulimia nervosa is a complex and severe eating disorder characterized by a cyclical pattern of binge-and-purge eating pattern. It generally involves an episode of binge eating, followed by compensatory behaviors such as vomiting, excessive exercise, laxative use, or fasting, to prevent weight gain. Despite often maintaining a normal weight, individuals with bulimia are intensely preoccupied with their body image and harbor an overwhelming fear of gaining weight. This can contribute to the disorder being hidden and harder to detect.

Psychological and Sociocultural Influences

Bulimia nervosa is closely associated with psychological challenges, including anxiety, depression, low self-esteem, and perfectionism. These traits contribute to emotional distress, which individuals may attempt to alleviate through disordered eating behaviors. Impulsivity and obsessive-compulsive tendencies are also prevalent, reflecting a struggle to manage intense emotional experiences. Childhood experiences of trauma, including abuse, further increase vulnerability to the disorder.

Sociocultural factors play a significant role in the development and maintenance of bulimia. Societal norms that equate thinness with beauty and success, amplified by media portrayals of unrealistic body ideals, pressure individuals to conform, often triggering or worsening disordered eating behaviors. These influences are particularly potent during adolescence and early adulthood, the life stages during which bulimia typically emerges.

Physical Health Consequences

Bulimia nervosa poses significant risks to physical health. Self-induced vomiting exposes teeth to stomach acid, causing dental erosion, cavities, and heightened sensitivity. Frequent vomiting and laxative use can lead to chronic sore throats, esophageal damage, and gastrointestinal complications. Electrolyte imbalances, resulting from dehydration and purging, increase the risk of cardiac arrhythmias and other cardiovascular issues. Prolonged bulimia can damage the kidneys and result in lasting health complications if untreated.

Genetic and Biological Factors

Emerging research highlights the role of genetic and neurobiological factors in bulimia nervosa. Disruptions in serotonin regulation, a neurotransmitter involved in mood and appetite control, have been linked to the disorder. Genetic predispositions influence susceptibility, interacting with environmental triggers to exacerbate risk.

Given the profound physical and emotional toll of bulimia nervosa, early recognition and intervention are crucial. Addressing the disorder requires a multidisciplinary approach, integrating psychological, medical, and societal perspectives to support recovery and mitigate long-term consequences.