Bulimia Nervosa

The term ‘bulimia’ refers only to the episodes of uncontrollable excessive eating, and may also be present in other forms of eating disorder.

Moreover, Unlike anorexia nervosa, for which there are historical accounts dating back to medieval times, bulimia nervosa was first described as a distinct clinical entity in 1979.

Gerald Russell, a British psychiatrist, published a case series of 30 patients with bulimia nervosa also used them to describe the defining features of the condition.

Since Russell’s initial work, it has been realized that bulimia nervosa is a common condition, additionally, effective treatments have since been developed to treat it. [1]

It is characterized by recurrent also frequent episodes of eating unusually large amounts of food also feeling a lack of control over these episodes.

This binge-eating is followed by behavior that compensates for the overeating for instance; forced vomiting, excessive use of laxatives or diuretics, fasting, excessive exercise, or a combination of these behaviors. [3]

There is an intense fear of becoming higher-weight person . There may be an earlier history of anorexia nervosa.
It is usually body-image disturbance and the person is unable to perceive own body size accurately. [2]

There is a persistent preoccupation with eating, also an irresistible craving for food. Besides this, There are episodes of overeating in which large amounts of food are consumed within short periods of time (eating binges). [2]

Fascinated by food they sometimes buy magazines also cookbooks to read recipes, and enjoy discussing dieting issues. [3]

Weight control e.g.:

• Strict dieting interspersed with episodes of indulging eating
• Compensatory behaviours to prevent weight gain
• Self-induced vomiting
• either Laxatives or diuretics
• Excessive exercise
• Diet pills

Psychopathology e.g.:

• Excessive concern about shape and weight
• Distorted body image
• Low self-esteem also perfectionism

Physical consequences of weight control behaviours i.e.:

• Normal body weight
• Hypokalaemia, hyponatraemia, hypochloremia
• Menstrual abnormalities
• Swollen parotid glands
• Erosion of dental enamel
• Calluses of the dorsal aspect of the fingers (in other words, Russell’s sign)
• Peripheral oedema
• Increased plasma amylase

Other comorbid psychiatric conditions e.g.:

• Depression
• Anxiety
• Deliberate self-harm
• Misuse of either alcohol or drugs
• Borderline personality disorder [1]

Biological i.e.:

• Female sex Age (15–40 years)
• Family history of:

1. 1. Mood disorders
   2. Substance abuse
   3. Eating disorder
   4. Obesity

• Type 1 diabetes
• Early menarche

Psychological i.e.:

• Critical comments in early life about eating, either shape, or weight
• Family environment with a focus on shape also dieting
• either Sexual or physical abuse in childhood
• Low self-esteem
• Perfectionism

Social i.e.:

• Living in a developed country
• Cultures that encourage dieting and value thinness
• Occupation (e.g. ballet dancer) [1]

The formal diagnostic criteria for bulimia nervosa are i.e.:

1. Recurrent episodes of indulging eating, characterized by eating a large amount of food and by a sense of lack of control over eating
2. Recurrent inappropriate behavior to prevent weight gain
3. Evaluation of self-worth primarily based on weight also shape
4. Symptoms do not occur exclusively during episodes of anorexia nervosa.

The last point means that a diagnosis of anorexia nervosa effectively ‘trumps’ bulimia nervosa; additionally, if the patient has a BMI of less than 17.5, the diagnosis is always anorexia nervosa. [1]

1. Anorexia nervosa:

It can be differentiated from bulimia nervosa principally by a low body weight (BMI <17.5). Binges may occur in anorexia nervosa, but must be present for a diagnosis of bulimia nervosa.

2. EDNOS:

It describes those patients with disordered eating which is clinically significant, but which does not fit criteria for a specific eating disorder; for example, a patient with all the features of bulimia nervosa, except for the use of compensatory behaviors to prevent weight gain.

3. Klein–Levin syndrome:

In brief, This is a sleep disorder seen in adolescent males, characterized by recurrent episodes of indulging eating also hypersomnia.

4. Mood disorder such as:

Core features include low mood, fatigue, also anhedonia. Weight gain and indulging eating may occur, but the patient will not show the specific psychopathology and other weight control behaviours seen in bulimia nervosa.

5. Iatrogenic drugs such as:

Many drugs may cause weight gain, either through increased appetite or a direct effect on metabolism; for example, antipsychotics, lithium, steroids.

6. Organic disorders:

These can usually be identified by a clear history and lack of associated core psychopathology, but specific investigations may need to be done; for example, upper GI disorders with associated vomiting, brain tumours. [1]

Homeopathic Treatment of Bulimia Nervosa

Argentum nit:

Binging especially with chocolate, fixed ideas, impulsive behaviour, anticipation, overriding impulses for certain foods, chocolate, salty foods, they will eat a whole box of chocolates until they get sick.

Carcinosin:

Obsessive compulsive disorder. Moreover, Perfectionism, fear of becoming fat, fear of rejection. Etiology-abuse, grief or fears, often related to weight.

Ignatia:

Perfectionism, fear of becoming fat, fear of rejection. Hysteria-loss of control of emotions, fainting. Besides this, Etiology-grief or big disappointment, often related to weight.

Medorrhinum:

Ups and down in the person’s energy, very outgoing for 2 or 3 days than wiped out for several days and with that their diets fluctuate from good to binging. Bulimia also with alcohol and drugs.

Natrum mur:

Often indicated remedy in anorexia, a lot of guilt. Furthermore, Fear of being rejected, hurt easily. Very self-conscious of their weight.

Pulsatilla:

Fear of being abandoned also unloved. Fixed ideas about food, their weight, they gain and lose weight easily, eat also indulging to console themselves, binges out of loneliness, or depression, then they get guilt and fear about it and then suppress it.

Staphysagria:

indulging out of guilt, depression. Additionally, Poor self-confidence and worthlessness. It is out of self-denial, they do not deserve that -lemon meringue pie so they suppress their desire for it, and then indulging on it. [3]

Frequently Asked Questions

What is Bulimia Nervosa?

Bulimia nervosa is an eating disorder characterized by recurrent episodes of uncontrolled excessive eating (‘binges’), compensatory methods of weight control, and a fear of becoming fat.

Homeopathic Medicines used by Homeopathic Doctors in treatment of Bulimia Nervosa?

• Argentum nit
• Carcinosin
• Ignatia
• Medorrhinum
• Natrum mur
• Pulsatilla
• Staphysagria

What are the causes of Bulimia Nervosa?

• Female sex Age (15–40 years)
• Family history
• Type 1 diabetes
• Early menarche
• Family environment with a focus on shape and dieting
• Sexual or physical abuse in childhood
• Low self-esteem
• Perfectionism

What are the symptoms of Bulimia Nervosa?

• Strict dieting interspersed with episodes of indulging eating
• Compensatory behaviours to prevent weight gain
• Self-induced vomiting
• Laxatives or diuretics
• Excessive exercise, Diet pills
• Excessive concern about shape and weight
• Distorted body image
• Menstrual abnormalities
• Depression, Anxiety
• Deliberate self-harm