Bulimia Nervosa

Bulimia nervosa:

these individuals engage in repeated episodes of binge eating

The binge eating of bulimia occurs in:

any 2 hr period → eating btwn 1500-5000 calories

Binge eating is followed by:

compensatory behaviors → self-induced vomiting; misuse of laxatives, diuretics, or other meds; fasting; or excessive exercise

Bulimia is characterized by:

a significant disturbance in the individual’s perception of body shape and weight

Thoughts and behaviors associated w bulimia:

binge-eating behaviors, often self-induced vomiting (or laxative or diuretic use) after binging, hx of anorexia, depressive s/s, problems w interpersonal relationships, self-concept, impulsive behaviors, increased levels of anxiety and compulsivity, possible substance use disorders, possible impulsive stealing

S/S of bulimia:

normal to slightly low weight, dental carries, tooth erosion, parotid swelling, gastric dilution/rupture, calluses (scars on hand), peripheral edema, muscle weakening, abnormal lab values, cardio abnormalities, cardiac failure, seizure

Cause of normal to slightly low weight in bulimia:

excessive calorie intake w purging, excessive exercising

Cause of dental carries, tooth erosion in bulimia:

vomiting (HCI reflux over enamel)

Cause of parotid swelling in bulimia:

increased serum amylase levels

Cause of gastric dilation, rupture in bulimia:

binge eating

Calluses, scares on hand (Russel sign) w bulimia:

self-induced vomiting

Cause of peripheral edema in bulimia:

rebound fluid, esp. if diuretic is used

Cause of muscle weakening in bulimia:

electrolyte imbalance

Cause of abnormal lab values in bulimia:

purging: vomiting, laxative, and/or diuretic use

Cause of cardio abnormalities in bulimia:

electrolyte imbalance → can lead to death

Cause of cardiac failure w bulimia:

ipecac intoxication

Cause of seizure w bulimia:

purging via self-induced vomiting: lowers seizure threshhold

Bulimia commonly begins in:

later adolescence, the prevalence then peaks into young adulthood

Bulimia is rare in:

12 or younger and 40+