Bulimia

Bulimia | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Mental health Bulimia Bulimia Bulimia nervosa is an eating disorder and mental health condition. People with bulimia are very anxious about their weight and focused on having the right body shape. They also spend a lot of time thinking about food. Symptoms of bulimia The main symptoms of bulimia are: bingeing  overeating in a particular pattern purging  trying to reduce the effect of binging by attempting to get calories out of your body focus on food  thinking about food all the time, even when you dont want to problems with self-esteem focussing on body image when it comes to food and weight Diagnosing bulimia When making a diagnosis, your GP will probably ask questions about your eating habits. For example, they could ask: how you feel about your weight if youre concerned about it if you make yourself vomit regularly if you binge-eat Its important to answer these questions honestly. Your GP isnt trying to judge you or catch you out. They just need to accurately assess how serious your symptoms are. Weight and BMI Your GP may check your weight and calculate your body mass index (BMI). Blood tests and other tests Your GP might check your pulse and blood pressure. Sometimes an (electrocardiogram (ECG) may be needed to check how well your heart is working. Your GP may do blood tests to check the level of: fluids in your body chemicals or minerals, like potassium in your blood Blood tests look for the complications of bulimia. Even if they come back as normal, your GP may still refer you to a specialist if youre experiencing bulimia symptoms. Treating bulimia Before your treatment begins, youll probably have an overall assessment of your health. Your GP or another healthcare professional will do this. The assessment will help your healthcare professional plan for your treatment and care. For example, they may assess: your overall health and any medical needs your social situation, like how much support you have from family and friends your mood any risks that affect you, like whether youre at risk of harming yourself whether there are any physical risks as a result of bulimia that need urgent treatment Guided self-help For many people, guided self-help can be an effective treatment for bulimia. Guided self-help is where you work through information and activities on your own. Youll have regular support sessions with a professional (usually a psychologist). Activities can include: worksheets a food diary meal plan writing about difficult thoughts and feelings Eating disorder service If guided self help is unsuccessful, your GP can refer you for treatment to an eating disorder service. An eating disorder service will usually offer a structured programme of psychological treatment. Psychological treatment The main type of psychological treatment for bulimia is cognitive behavioural therapy (CBT). CBT starts with the idea that thoughts, feelings, and behaviour are linked and affect one another. CBT helps to change the harmful behaviour while working on changing how you think about food, eating, and weight. One alternative to CBT is interpersonal therapy (IPT). IPT explores the way you interact with other people. It also looks at the relationships you have, with the goal of improving them. Learn more about talking therapies Medication Antidepressants like selective serotonin reuptake inhibitors (SSRIs) may be used to treat bulimia. They can reduce the urges to binge and vomit. The medication will usually take several weeks before it starts to work. Youll usually start on a low dose. The dose will gradually increase as your body adjusts to the medicine. Very few drugs are recommended for children and young people below the age of 18. Its best not to take SSRIs if you have epilepsy or a family history of heart, liver or kidney disease. Relapse Recovery from bulimia can take a long time. Its common for bulimia symptoms to return after treatment. This is often called a relapse, and is more likely during times of stress. If relapse happens, the approach to getting treatment is the same. The first step is going to your GP. Complications of bulimia There are physical complications associated with bulimia. These can include: dental problems  regular vomiting can cause your stomach acid to damage the enamel on your teeth, which can lead to tooth decay repeated vomiting can cause bad breath and a sore throat due to a lack of nutrients, your skin and hair can become dry and your fingernails can become brittle your saliva glands can become swollen from frequent vomiting, which makes your face appear rounder frequent use of laxatives can damage your bowel muscles, causing permanent constipation (finding it difficult to poo) an increased risk of heart problems Frequent vomiting or laxative use can cause: tiredness weakness abnormal heart rhythms kidney damage convulsions (fits) muscle spasms If you have periods, bulimia can cause them to become unpredictable, or stop altogether. This does not mean bulimia makes you infertile. While it may be harder to get pregnant, you should continue to use birth control if you arent planning a pregnancy. If you have diabetes , youll need regular health checks to help avoid problems with your eyes or other serious complications. This is particularly important if you have type 1 diabetes . Getting help for bulimia People with bulimia can be anxious about seeking treatment that might mean making changes to their eating habits. Helping yourself If you have eating problems or think you may have bulimia, its important to seek help as soon as possible. You could start by: talking to someone you trust, like a friend or member of your family going to see your GP  you may find it helpful to bring someone with you for support Helping someone else If someone close to you is showing signs of bulimia, you can offer help and support. You could try talking to them about how they feel, and encourage them to think about getting help. Try not to put pressure on them or be critical of them, as this could make things worse. You could also offer to help by going with the person to see their GP. You could speak to your own GP or a healthcare professional if youd like some advice on how to help someone. You could also get help from a support group for people who have loved ones with eating disorders. Your GP or Scotlands Service Directory can help you find services near you. Beat has a range of information on the help and support available for people with eating disorders, and their friends and families.