Understanding bulimia - the basics, symptoms, diagnosis, treatment and prevention

What is bulimia?

Bulimia, like anorexia nervosa, is an eating disorder. Both begin as a psychological problem, but, over time, they can bring very serious physical effects on the body and can even be fatal.

While there are some similarities between these two eating disorders, they are separate problems. If you have anorexia, it's likely you will slowly starve yourself to lose weight, and you may use other methods to try to help you lose even more. But if you have bulimia, you do eat - and sometimes much more than usual in a short time, which is called a binge. Then you purge, or make yourself vomit or use diet pills, laxatives or diuretics to keep all that food from making you gain weight.

These binge-and-purge episodes, typically happening at least twice a week for three months, is what makes bulimia separate from other eating disorders. The purging may serve two purposes: preventing weight gain and also temporarily relieving depression and other negative feelings.

Like anorexia, bulimia mostly afflicts young women although men occasionally suffer from it too. Because binge eating and purging are practiced in secret, the incidence of the disorder is uncertain. According to the NHS, around eight in every 100 women will have bulimia at some point in their lives. The condition often starts around the age of 18 or 19, but can occur earlier than this and indeed at any age.

Experts generally agree that they still have a lot to learn about how many people have bulimia and other eating disorders.

Bulimia can occur on its own or intermittently with anorexia. In the intermittent pattern - which occurs in about one case out of five -sufferers will not eat for some time, setting themselves up for a binge; they may use appetite suppressants during the time they are not eating.

Remember that anorexia and bulimia may have some similar characteristics, but they are two different eating disorders. They may affect your personality in different ways. Anorexia usually causes you to suppress all urges, including sexual ones. But if you have bulimia, you tend to indulge your cravings and act on impulse. This could lead to drug use, engaging in sex with many partners, shoplifting or binge buying.

A bulimic's overall health depends on how often they binge and purge. They may vomit occasionally (once a month) or very frequently (many times a day). The health consequences generally relate to the purging and not the binge eating. Physical repercussions include swelling of the stomach or pancreas, inflammation of the oesophagus, enlarged salivary glands, and tooth decay and gum disease from vomiting stomach acids. Frequent self-induced vomiting also depletes the water and potassium in bodily tissues, causing abnormal heart rhythms, muscle spasms and even paralysis. In severe cases, some of these physical problems can lead to death. Another danger is suicidal depression.

Bulimia is a real illness. Once it develops, you probably cannot control it without help. Although family or friends may think they are trying to help by warning you about your habits, such criticism usually isn't helpful on its own and may even contribute to unhappiness or being more secretive. Support from your family and friends can help, but you need professional treatment to get better.