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Research Paper on a Mental Condition: Bulimia Nervosa
Mental health has become a main concern for many individuals since it can affect every aspect of life. This has made learning about different mental illnesses and disorders essential in promoting proper mental health care and increasing awareness of subtle mental disorders. One significant mental disorder that is worth discussing is bulimia nervosa. This eating disorder causes a patient to eat a large amount of food and then indulge in a “purging” activity to remove the excess food in their system. Bulimia nervosa is a serious mental disorder that not only affects a patient’s psychiatric condition but also causes physical harm to the human body.
Definition of Bulimia Nervosa
Bulimia nervosa is a type of eating disorder similar to anorexia nervosa and binge eating disorder. Patients with this disorder consume large amounts of food in one sitting, mostly due to an uncontrollable urge. After eating, the patient will use compensatory methods in an attempt to prevent weight gain (Bulimia nervosa, 2021; Hail & Le Grange, 2018; Nitsch et al., 2021). The compensatory methods involve forced vomiting, the use of laxatives, exercise, an unhealthy diet, and other methods to “purge” the large amount of food from the body. These purging methods, especially when patients utilize them excessively, can cause serious health effects on both mental and physical health.
A bulimia nervosa diagnosis includes both the presence of binge eating and purging behaviors. This separates bulimia nervosa from binge eating disorder–a disorder where a patient consumes large amounts of food but without the purging behavior. Most eating disorder patients tend to be young adults, meaning that these individuals are more prone to developing bulimia nervosa (Swanson et al., 2011, cited in Hail & Le Grange, 2018). Additionally, bulimia nervosa is significantly more common than anorexia nervosa (Nitsch et al., 2021). This makes the disorder an essential topic of discussion since it can affect a significant portion of the population and cause harm to both mental and physical health.
Causes of Bulimia Nervosa
Similar to other mental disorders, there are various potential causes for the development of bulimia nervosa. Genetics, physical environment, social environment, childhood trauma, personality, and underlying mental illnesses are some of the factors that can lead to bulimia nervosa (Bulimia nervosa, 2021; Nitsch et al., 2021). The variations between these factors can make it difficult for a psychiatrist to assess the cause of a patient’s condition. However, since bulimia nervosa is related to body image and self-perception , patients may “binge eat” to cope with stress which then leads them to “purge” after realizing the potential effect of the food on their body image. It is also possible that the binge eating reaction is a symptom of another mental illness or developmental impairment.
Societal pressure is another possible cause of bulimia nervosa. Society, especially on social media, creates pressure on individuals to achieve a certain body image. Individuals may undergo diet regimens that require them to fast which could then lead to extreme hunger. Extreme hunger can then lead to binge eating since the individuals may not be able to control themselves. After the binge eating session, they may then feel guilt and realize that the food they consumed could increase their weight. This results in the “purging” behavior (Bulimia nervosa, 2021). As an individual undergoes this process multiple times, they increase the chance of developing bulimia nervosa.
Diagnosing Bulimia Nervosa
As mentioned earlier, a bulimia nervosa diagnosis includes a patient having binge eating and purging behaviors. However, the American Psychiatric Association (APA) provided certain requirements before a psychiatrist can diagnose a patient with bulimia nervosa. This prevents misdiagnosing a patient who may have a different disorder or just experienced a rare mental episode. The fifth edition of APA’s Diagnostic and Statistical Manual of Mental Disorders stated that a patient has bulimia nervosa if they indulge in binge eating and purging at least once a week within a three-month period (cited in Hail & Le Grange, 2018). Patients with fewer episodes may be experiencing other illnesses, such as binge eating disorder.
A bulimia nervosa diagnosis also highlights the purging behavior more than binge eating. Studies suggest that some bulimia nervosa patients do not consume large amounts of food compared to full-threshold patients but their purging behaviors are the same (cited in Hail & Le Grange, 2018). This indicates that purging behaviors are the defining characteristics of a bulimia patient. A patient may feel shame or guilt after eating even a small amount of food which can then cause them to “purge”. Aside from this, bulimia nervosa patients may also have secretive eating behaviors, obsession with body image, weight fluctuation, and feel tired all the time (Bulimia nervosa, 2021). These symptoms are more subtle and individuals living with bulimia nervosa patients are the most likely to notice them.
Effects of Bulimia Nervosa
Most of the effects of Bulimia nervosa are from patients’ “purging” behaviors. These effects often lead to high mortality rates since patients tend to repeat the “purging” behaviors multiple times a day (Nitsch et al., 2021). For instance, a patient may force themselves to vomit five or more times a day, potentially causing harm to their throat, stomach, and other body parts. The forced vomiting can also lead to the development of Russell Sign, dental erosion, trauma to the pharynx, and dental caries. Since vomiting is a common compensatory method for most patients, they are likely to develop these effects.
Since “purging” behaviors also include the use of laxatives and extreme exercise, bulimia nervosa can cause a variety of physical issues. Patients can suffer cardiovascular issues, pulmonary issues, gastrointestinal issues, esophageal complications, colonic inertia, melanosis coli, endocrine issues, metabolic and electrolyte disturbance, hypokalemia, and hypochloremia (Nitstch et al., 2021). These complications come from the abusive and uncontrollable use of compensatory methods to reduce weight. Even when a bulimia nervosa patient is already suffering from these issues, they may continue with their “purging” behavior. This then leads to a high mortality rate as they disregard their health and life to purge weight.
Treatment for Bulimia Nervosa
Similar to most mental disorders, psychiatric therapy is the main treatment for bulimia nervosa. Various studies suggest that cognitive behavioral therapy is the best treatment for the disorder (cited in Hail & Le Grange). This type of treatment allows patients to understand their condition and form rational behaviors through the acknowledgment of negative thoughts. Alternatively, Pietrabissa et al. (2019) suggested brief strategic therapy as another effective treatment for bulimia nervosa. This type of therapy helps patients identify solutions to their issues and follow the solutions to promote recovery. While different therapies provide varying solutions to bulimia nervosa, they mostly help individuals recognize their situation and develop a healthier self-perception.
Aside from psychiatric therapy, it is also worth considering the anecdotal evidence regarding the connection between marijuana and eating disorders. Pryor (n.d.) stated that an eating disorder patient experienced positive results from marijuana consumption. Furthermore, a study found that eating disorder patients have underactive endocannabinoid systems (Wenk, 2021). Marijuana use can activate these systems which may improve the conditions of bulimia nervosa patients. However, since there are few clinical studies on the topic, patients cannot guarantee positive results when using medical marijuana.
Bulimia nervosa is a mental disorder that detrimentally affects an individual’s mental and physical health. Its main characteristics include binge eating and “purging” behaviors. However, a bulimia nervosa diagnosis puts more focus on the “purging” behaviors since some cases may involve mild levels of binge eating. Additionally, the most harmful effects of the disorder come from repetitive “purging” behaviors which lead to serious complications that increase mortality. While psychiatric therapy is an effective treatment for bulimia nervosa, the continued pressure from society; especially on social media, can make it difficult for patients to adopt more positive behaviors regarding weight. Psychiatric therapy is effective but the collective effort of society to promote positive mental health can have lasting effects on bulimia nervosa patients and other eating disorder sufferers.
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Hail, L. & Le Grange, D. (2018). Bulimia Nervosa in Adolescents: Prevalence and Treatment Challenges. Adolescent Health, Medicine, and Therapeutics. Available at https://doi.org/10.2147/AHMT.S135326. Accessed August 2, 2022.
Healthdirect.gov.au. (2021). Bulimia Nervosa. Health Direct. Available at https://www.healthdirect.gov.au/bulimia-nervosa . Accessed August 2, 2022.
Nitsch, A., Dlugosz, H., Gibson, D. & Mehler, P. (2021). Medical Complications of Bulimia Nervosa. Cleveland Clinic Journal of Medicine, vol. 88(6). Available at DOI: https://doi.org/10.3949/ccjm.88a.20168. Accessed August 2, 2022.
Pietrabissa, G., Castelnuovo, G., Jackson, J., Rossi, A., Manzoni, G. & Gibson, P. (2019). Brief Strategic Therapy for Bulimia Nervosa and Binge Eating Disorder: A Clinical and Research Protocol. Frontiers in Psychology. Available at https://www.frontiersin.org/articles/10.3389/fpsyg.2019.00373/full. Accessed August 2, 2022.
Pryor, T. (n.d.). Budding New Considerations about the Use of Cannabis in Eating Disorder Treatment. Canadian Journal of Medical Cannabis. Available at https://eatingdisorder.care/cannabis-use-eating-disorder-treatment/#. Accessed August 4, 2022.
Wenk, G. (2012). The Connection Between Anorexia, Bulimia, and Marijuana. Psychology Today. Available at https://www.psychologytoday.com/intl/blog/your-brain-food/201204/the-connection-between-anorexia-bulimia-and-marijuana. Accessed August 4, 2022.