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Bulimia is more common among those who have a close relative with the condition. Cognitive behavioral therapy is the primary treatment for bulimia.
Globally, bulimia was estimated to affect 3. Bulimia typically involves rapid and out-of-control eating, which may stop when the bulimic is interrupted by another person or the stomach hurts from over-extension, followed by self-induced vomiting or other forms of purging.
This cycle may be repeated several times a week or, in more serious cases, several times a day  and may directly cause:. These are some of the many signs that may indicate whether someone has bulimia nervosa: As with many psychiatric illnesses, delusions can occur, in conjunction with other signs and symptoms, leaving the person with a false belief that is not ordinarily accepted by others.
People with bulimia nervosa may also exercise to a point that excludes other activities. With regards to interoception , people with bulimia report reduced sensitivity to many kinds of internal and external sensations.
For example, some show increased thresholds to heat pain compared and report the same level of satiety after consuming more calories than do healthy subjects.
Bulimics are much more likely than non-bulimics to have an affective disorder , such as depression or general anxiety disorder: As with anorexia nervosa , there is evidence of genetic predispositions contributing to the onset of this eating disorder.
Brain-derived neurotrophic factor BDNF is under investigation as a possible mechanism. There is evidence that sex hormones may influence appetite and eating in women, and the onset of bulimia nervosa.
Studies have shown that women with hyperandrogenism and polycystic ovary syndrome have a dysregulation of appetite, along with carbohydrates and fats.
This dysregulation of appetite is also seen in women with bulimia nervosa. In addition, gene knockout studies in mice have shown that mice that have the gene encoding estrogen receptors have decreased fertility due to ovarian dysfunction and dysregulation of androgen receptors.
Bulimia has been compared to drug addiction, though the empirical support for this characterization is limited. Dieting, a common behaviour in bulimics, is associated with lower plasma tryptophan levels.
Abnormal blood levels of peptides important for the regulation of appetite and energy balance are observed in individuals with bulimia nervosa, but it remains unknown if this is a state or trait.
Media portrayals of an 'ideal' body shape are widely considered to be a contributing factor to bulimia. When attempting to decipher the origin of bulimia nervosa in a cognitive context, Christopher Fairburn et al.
Accordingly, this would lead to unrealistically restricted eating, which may consequently induce an eventual "slip" where the individual commits a minor infraction of the strict and inflexible dietary rules.
Moreover, the cognitive distortion due to dichotomous thinking leads the individual to binge. The binge subsequently should trigger a perceived loss of control, promoting the individual to purge in hope of counteracting the binge.
However, Fairburn et al. In contrast, Byrne and Mclean's findings differed slightly from Fairburn et al. In turn, Byrne and Mclean argued that this makes the individual vulnerable to binging, indicating that it is not a binge-purge cycle but rather a purge-binge cycle in that purging comes before bingeing.
Similarly, Fairburn et al. Everyone differs from another, and taking such a complex behavior like bulimia and applying the same one theory to everyone would certainly be invalid.
In addition, the cognitive behavioral model of bulimia nervosa is very cultural bound in that it may not be necessarily applicable to cultures outside of the Western society.
To evaluate, Fairburn et al. Furthermore, it is difficult to ascertain cause and effect, because it may be that distorted eating leads to distorted cognition rather than vice versa.
A considerable amount of literature has identified a correlation between sexual abuse and the development of bulimia nervosa.
The reported incident rate of unwanted sexual contact is higher among those with bulimia nervosa than anorexia nervosa.
When exploring the etiology of bulimia through a socio-cultural perspective, the "thin ideal internalization" is significantly responsible. The thin ideal internalization is the extent to which individuals adapt to the societal ideals of attractiveness.
Studies have shown that young females that read fashion magazines tend to have more bulimic symptoms than those females who do not.
This further demonstrates the impact of media on the likelihood of developing the disorder. Kevin Thompson and Eric Stice claim that family, peers, and most evidently media reinforce the thin ideal, which may lead to an individual accepting and "buying into" the thin ideal.
In turn, Thompson and Stice assert that if the thin ideal is accepted, one could begin to feel uncomfortable with their body shape or size since it may not necessarily reflect the thin ideal set out by society.
Thus, people feeling uncomfortable with their bodies may result in suffering from body dissatisfaction and may develop a certain drive for thinness.
Consequently, body dissatisfaction coupled with a drive for thinness is thought to promote dieting and negative effects, which could eventually lead to bulimic symptoms such as purging or bingeing.
Binges lead to self-disgust which causes purging to prevent weight gain. A study dedicated to investigating the thin ideal internalization as a factor of bulimia nervosa is Thompson's and Stice's research.
The aim of their study was to investigate how and to what degree media affects the thin ideal internalization. Thompson and Stice used randomized experiments more specifically programs dedicated to teaching young women how to be more critical when it comes to media, in order to reduce thin ideal internalization.
The results showed that by creating more awareness of the media's control of the societal ideal of attractiveness, the thin ideal internalization significantly dropped.
In other words, less thin ideal images portrayed by the media resulted in less thin ideal internalization. Therefore, Thompson and Stice concluded that media greatly affected the thin ideal internalization.
People that associate themselves with thin models get in a positive attitude when they see thin models and people that associate with overweight get in a negative attitude when they see thin models.
Moreover, it can be taught to associate with thinner people. The onset of bulimia nervosa is often during adolescence, between 13 and 20 years of age, and many cases have previously suffered from obesity, with many sufferers relapsing in adulthood into episodic bingeing and purging even after initially successful treatment and remission.
Adolescents with bulimia nervosa are more likely to have self-imposed perfectionism and compulsivity issues in eating compared to their peers.
This means that the high expectations and unrealistic goals that these individuals set for themselves are internally motivated rather than by social views or expectations.
Bulimia nervosa can be difficult to detect, compared to anorexia nervosa , because bulimics tend to be of average or slightly above or below average weight.
Many bulimics may also engage in significantly disordered eating and exercise patterns without meeting the full diagnostic criteria for bulimia nervosa.
Purging often is a common characteristic of a more severe case of bulimia nervosa. There are two main types of treatment given to those suffering with bulimia nervosa; psychopharmacological and psychosocial treatments.
There are several supported psychosocial treatments for bulimia. Cognitive behavioral therapy CBT , which involves teaching a person to challenge automatic thoughts and engage in behavioral experiments for example, in session eating of "forbidden foods" has a small amount of evidence supporting its use.
By using CBT people record how much food they eat and periods of vomiting with the purpose of identifying and avoiding emotional fluctuations that bring on episodes of bulimia on a regular basis.
He states in order for the therapy to work, all parties must work together to discuss, record and develop coping strategies.
Barker claims by making people aware of their actions they will think of alternatives.