Bulimia Nervosa: Difference between revisions
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== Causes == | == Causes == | ||
There have been no specific things proven to cause bulimia. Triggers to bulimia nervosa have been suggested, including dieting, stress, emotions, and the need for control (to ease stress or anxiety in a person's life). Factors that are suggested to contribute to bulimia include culture, family history, stressful life event, personality, and biology. <ref name="Office on Women's Health" /><br> | |||
== Systemic Involvement == | == Systemic Involvement == | ||
Revision as of 02:29, 2 March 2010
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Definition/Description[edit | edit source]
A condition during which a person eats a large amount of food in a short amount of time (binges), then uses some method of purging to avoid weight gain. Methods of purging include self-induced vomiting, use of laxatives or diuretics, and excessive exercise. [1]
Two types of bulimia nervosa have been defined. The purging type which involves self-induced vomiting or use of other forms of compensation to avoid weight gain after binge eating; this cycle must be performed on a regular basis to be diagnosed as such. The non-purging type of bulimia involves the use of excessive exercise or dieting/fasting to prevent/avoid weight gain. [2]
Prevalence[edit | edit source]
The incidence of people suffering from bulimia has increased over the last 30-40 years. Around 1 to 2% of females in late adolescence and adult women meet the diagnostic criteria for bulimia nervosa. [2]
About 80% of people with bulimia nervosa are female. [3]
Characteristics/Clinical Presentation[edit | edit source]
Bulimia can affect anyone: male, female, young, old, and all races. These patients can present with normal weight or they may be underweight or overweight. The patient may use pills (diet pills, diuretics, or laxitives). They may often take trips to the bathroom after eating (suggested that they use this time to purge after a meal) and may exercise despite weather, injury, or energy levels to control their weight. [1]
Signs of binging include: the disappearance of large amounts of food in a short time period and finding wrappers/containers of consumed food around the person's living environment. [3]
Signs of purging include: frequent trips to the bathroom after meals, signs or smells of vomiting, evidence of use of laxatives/diuretics (wrappers, containers, etc.), excessive and rigid exercise routines (continued despite weather, illness, injury, energy levels), rigid schedules that allow time for binge/purge cycles, withdrawal from normal activities, main focus and concern on weight loss, dieting, and controlling their food (intake/outtake). [3]
Signs of self-induced vomiting include: swelling of the patient's cheeks/jaws, calluses or scrapes on the knuckles, clear-looking teeth, broken blood vessels in the eyes. Patients with bulimia nervosa may also present with other mental health problems such as depression, anxiety, substance abuse, distorted body image (thoughts and verbal expressions of hating body, image of being fat despite thin appearance, and fear of gaining weight), and reports from family and friends on activity not "normal" for the person (i.e. moody, sad, unsocialable). [1]
Physical signs and symptoms can include: weight loss/gain; muscle weakness and/or myopathy; chronic fatigue; dehydration or rebound water retention, pitting edema; discoloration of teeth, broken blood vessels in eyes, enlarged salivary glands, scrapes/calluses on dorsums of hands/fingers; inability to tolerate cold; irregular or absent menstrual cycles, delay in menses in young girls; dry skin and hair, hair loss, lanugo growth over entire body, brittle nails; reports of heartburn, gas, constipation, or diarrhea; slow heart rate and low blood pressure.[4]
Behavioral signs and symptoms can include: preoccupation with weight, food, calories, fat grams, dieting, clothing size, and body shape; personality changes (i.e. mood swings and irritability that may not have been present before); binging and purging behavoirs or food restriction behaviors; frequent trips to the bathroom after meals; distored body images (both thoughts and verbal expressions of dissatisfaction, despite thin body); excessive and rigid exercise routine; use of pills or other drugs to control weight (i.e. diuretics, laxatives, enemas, etc.). [4]
Associated Co-morbidities[edit | edit source]
Often times bulimia nervosa is also associated with mental health disorders such as depression, anxiety, and substance abuse. [1]
Medications[edit | edit source]
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Diagnostic Tests/Lab Tests/Lab Values[edit | edit source]
In diagnosing bulimia nervosa, patients must meet specific criteria. Patients can NOT simultaneously meet the diagnostic criteria for anorexia nervosa. To meet the bulimia nervosa criteria, a patient binges and then engages in "inappropriate compensatory behavior at least twice weekly for at least three months." [2]
Causes[edit | edit source]
There have been no specific things proven to cause bulimia. Triggers to bulimia nervosa have been suggested, including dieting, stress, emotions, and the need for control (to ease stress or anxiety in a person's life). Factors that are suggested to contribute to bulimia include culture, family history, stressful life event, personality, and biology. [1]
Systemic Involvement[edit | edit source]
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Medical Management (current best evidence)[edit | edit source]
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Physical Therapy Management (current best evidence)[edit | edit source]
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Alternative/Holistic Management (current best evidence)[edit | edit source]
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Differential Diagnosis[edit | edit source]
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Case Reports[edit | edit source]
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Resources
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Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
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- ↑ 1.0 1.1 1.2 1.3 1.4 Office on Women's Health in the U.S. Department of Health and Human Services. 2009. Available from: U.S. Department of Health and Human Services, Web site: http://www.womenshealth.gov/faq/bulimia-nervosa.cfm. Accessed February 2010.
- ↑ 2.0 2.1 2.2 Academy for Eating Disorders. Web site: http:// www.aedweb.org/eating_disorders/index.cfm. Accessed February 2010.
- ↑ 3.0 3.1 3.2 National Eating Disorders Association. Web site: http://www.nationaleatingdisorders.org/nedaDir/files/documents/handouts/Bulimia.pdf. Accessed February 2010.
- ↑ 4.0 4.1 Goodman CC & Snyder TE Differential Diagnosis for Physical Therapists: Screening for Referral. 4th ed. St. Louis, Missouri: Saunders Elsevier; 2007.
