Etiology: biological • The exact cause of bulimia nervosa is unknown. • Research suggests that inherited biological and genetic factors contribute. • Research has also focused on abnormalities in the structure or activity of the hypothalamus, structure responsible for regulating eating behaviors. • Studies suggest that the hypothalamus of bulimics may not trigger a normal satiation (feeling full or finished) response • The binge behavior of bulimics may also be a response to low serotonin levels in the brain.
Etiology: cognitive • The perception of one’s body size is overestimated. • The idea of an oversized, or fat, body. • Ideas of dichotomous thinking leads to extreme forms (All or nothing). • Faulty beliefs lead to a distorted schemas. • Negative emotions lead to a faulty interpretation of the self.
Etiology: sociocultural • Film stars represent an ideal that people compare themselves to, so they establish standards for how we should look. • People constantly compare themselves to other people and their self-esteem is affected by this. • Women are more likely than men or children to be the target for the media propaganda that promotes thinness. • Schemas and social standards that are set in todays current society leads to the impossible and unattainable idea of a pleasant and aesthetic figure.
Symptoms • Eating uncontrollably followed by purging • Vomiting or abusing laxatives or diuretics in an attempt to lose weight • Using the bathroom frequently after meals • Excessive exercising • Preoccupation with body weight • Dental problems • Sore throat • Feeling out of control • Swollen glands in neck and face • Heartburn, indigestion, bloating • Irregular periods • Weakness, exhaustion, bloodshot eyes
Prevalence • Almost 50% of people with eating disorders meet the criteria for depression. • Up to 24 million people of all ages and genders suffer from an eating disorder (anorexia, bulimia and binge eating disorder) in the U.S. • An estimated 10-15% of people with anorexia or bulimia are male. • Among gay men, nearly 14% appeared to suffer from bulimia and over 20% appeared to be anorexic. • An estimated 1.1 to 4.2 percent of women have bulimia nervosa in their lifetime.
Diagnosis • Among the criteria for a diagnosis of bulimia in the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) are: • Repeated episodes of binge eating, including eating an abnormally large amount of food and feeling a lack of control over your eating. • Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, enemas, or other medications; fasting; or excessive exercise. • These behaviors occur at least twice a week for at least three months. • Self esteem is overly influenced by body shape and weight. • The eating disorder behavior doesn't occur during periods of anorexia.
Cultural factors • Particularly in modern Westernized countries, models, the media and dieting fads currently influence women and girls to be as thin as possible. • Sociologists studying the development of eating disorders across time have noted that the ideals of beauty have changed and that thinness wasn't always considered attractive. In 1999, a study was published about the effects of exposing a culture to Western television for the first time. Prior to the television viewing, the people of Fiji believed that the ideal body was plump, round, and soft. Interviews after 38 months of exposure to Westernized shows suggested a sharp decrease in self-esteem and an increase in symptoms of eating disorders in teenage girls.
Gender differences • Far more common in women than men. • Still apparent in men. • Men are more likely to have a greater factor in binge eating, as women are more likely to have a greater factor in the immediate and excessive loss of weight.
Treatment approaches • Bulimia treatment requires the consideration of the physical as well as the psychological needs of the person. Treatment may include psychological counseling and medications such as antidepressants or other drugs. In many cases, treatment is undertaken by a team of medical, nutritional, and mental health professionals. The ideal outcome of treatment is to restore physical health and normal eating patterns.
Stress (sociocultural): The imposing view of the perfect body by the media and faulty schemas created. Bodily Factors (biological): Different levels of serotonin. Damaged or altered hypothalamus. Constitutional (biological) Vulnerability Psychiatric Outcome (Bulimia Nervosa) Cognitive Factors: Perception of one’s body size is overestimated. Negative emotions. Faulty beliefs leading to faulty schemas. Agras, W. Stewart, (2000) Inherited Factors (Biological): Genetics determine weight and diet of the individual. Striegel-Moore, Ruth H., Lisa R. Silberstein, and Judith Rodin. (1986)