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While the disorder of bulimia centers on food, its roots are not food related in any way. Instead, bulimia is now thought to be a result or manifestation personal, social, or emotional problems or issues. Many bulimic behavior patterns are not truly about food, but are a way of suppressing feelings or keeping control when losing control is feared. Bulimic patterns are associated with guilt feelings, low self-esteem, secrecy, and overt depression.
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The Origin of an Eating Disorder
Children are often taught to only express positive emotions such as happiness, love, and cheer. When feelings such as anger, sadness, jealousy, fear, or other negative feelings are expressed, children are taught to hide or suppress them. This early lesson may result in difficulty experiencing them later in life. Many grow up simply trying to hide them or completely block them out.
For a bulimic, binging, and purging can temporarily make feelings go away. A girl may be bullied at school and instead of expressing her anger, hurt, or fear, she will binge eat. However, this binge results in her feeling guilty and ashamed, leaving her searching for a way to undo her actions or punish herself for what she’s done. To rid herself of the “guilt," she will purge. Bulimia may become a way of blocking out thoughts and feelings, as the bullemic behavior patterns of binging to purging takes focus away from the underlying issues or problems.
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Lying to Fit In
Bulimics will often deceive, lie, or attempt to blend into their group of friends and family, in an attempt to hide their disorder. They will make excuses as to why they can’t or won’t eat when out with friends, (I ate earlier; I think I have a stomach bug; I promised Mom I’d eat at home tonight). When eating with family, a bulimic will use deception to avoid eating. Pushing food around on the plate, rearranging it to make it look as if food was eaten, or hiding food in a napkin, bottom of a glass, or even in pants pockets are a few tricks that have been reported to be used. If the topic of the bulimics' eating disorder is brought up, it’s not unusual for the bulimic to start an argument in order to storm out of the room to avoid the conversation – and the meal.
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The Binge – Purge Cycle
Binge eating is defined as eating a large amount of food in a fixed period of time. Many bulimics report extravagant or lavish food feasts, sometimes with odd food combinations. The binge eating is directly followed by some sort of compensating technique. This can be in the form of excessive exercise, the use of laxatives, or, most commonly, the practice of purging – self-induced vomiting.
The most basic and common technique practiced by bulimics is eating until the stomach is full (some eat until they are overly full, or have a sick feeling), retreating to the nearest bathroom, and inducing vomiting by forcing a finger or other object down the throat. Those who have been practicing bulimic behavior patterns for some time can induce vomiting with little effort, giving no thought to numerous vomiting sessions a day.
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Bulimics have a tendency to hoard food, especially those they feel are forbidden. These foods are bought in bulk, by the dozens, and kept in places where they will not be discovered, found, or bothered, such as a box in the closet, a suitcase, dirty clothes basket, or in the trunk of a car. In addition, bulimics also have a tendency to hoard food-related items such as recipes and cookbooks, and seem to be preoccupied with activities or subjects related to food (television shows, magazines, celebrity chefs, etc.). Most times the items that are hoarded by the bulimic are used in the binging phase of their bulimic behavior patterns.
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The practice of binging or purging is not one that is done in public. In fact, according to “An Analysis of Moods and Behavior," written by Craig Johnson and Reed Larson, the majority of bulimics practiced their behaviors alone, at home. In some incidences, for example, when eating at a restaurant with family, a bulimic will retreat to the public bathroom to purge. Bulimia appears to be a solitary disorder, consisting of private binging and purging events, primarily confined to the privacy and security of the home.
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Overcoming Bulimia can be challenging. The earlier treatment begins, the better the chances for a positive – and lasting – result. While addressing the binging and purging issues, it is important to discover and resolve underlying emotional issues in order to reduce the chances of relapse.
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To aid in the treatment of bulimia, it is recommended that some form of psychotherapy be introduced, as bulimia is, according to Penn State Milton S. Hershey Medical Center College of Medicine, a psychological disorder “wrapped in emotions and personal conflicts" that needs to be addressed if success over the disorder is possible. Therapy can be introduced in the form of individual cognitive behavioral therapy, family, or group therapy, as all have a history of being successful in treating Bulimia. Research all types and utilize those that would best suit the situation and persons involved.
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Cognitive Behavioral Therapy
Cognitive behavioral therapy (CBT) can help those suffering from bulimia address negative ideas surrounding food, body-image, and self-esteem. CBT also helps to introduce positive and constructive ways of implementing new food habits.
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Attending therapy as a family may help with underlying conflicts and issues, and provide coping techniques for the whole family. Addressing family issues while in the presence of a professional may help the bulimic to express feelings, thoughts, and attitudes that otherwise would have continue to be hidden or suppressed with the eating disorder.
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Groups can provide a source of both support and comfort for those who may feel they are alone in dealing with their issues and trials of bulimia. Identifying with another individual often helps alleviate that “alone" feeling that many bulimics report.
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As many bulimics may also suffer from depression, anxiety, and/or obsessive behaviors, medication may be prescribed to help improve symptoms related to these additional conditions. These drugs have been reported to help in the initial phase of recovery; up to 80 percent of patients suffer some degree of relapse after the medication was discontinued. Before agreeing to drug therapy, research medications thoroughly.
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Bulimia Treatment. What is Bulimia Nervosa. (2010). Retrieved from http://www.bulimia-treatment.net/ on December 11, 2010.
Johnson, Ph.D., Craig, and Larson, Ph.D., Reed. Bulimia: An Analysis of Moods and Behavior. Psychosomatic Medicine, Vol. 44, No. 4 (September 1982). Updated March, 2008. Retrieved from www.psychosomaticmedine.org/cgi/reprint/44/4/341.pdf on December 11, 2010.
Penn State Milton S. Hershey Medical Center College of Medicine. (2010). Retrieved from http://www.hmc.psu.edu/healthinfo/d/depression.htm on December 11, 2010.