Eating disorders such as bulimia nervosa negatively impact millions of men and women every year. Bulimia nervosa is a psychological disorder that involves binge eating, which is then followed by unhealthy methods to avoid weight gain. These methods include forced vomiting and the use of laxatives to attempt to lose weight. Associated features of bulimia nervosa include obsessive compulsive disorder, depression, anxiety, perfectionism, and a lack of impulse control. Although there are treatments for bulimia such as medication and therapy, the recovery period is complicated, and relapses occur often. This disorder can be difficult to diagnose, which leads to a higher risk of patients experiencing negative health outcomes.  Bulimia needs immediate treatment in order to prevent health risks, illustrating the need for a hasty diagnosis. There is a long list of negative impacts of bulimia, such as low self-esteem, anxiety, gastrointestinal issues, tooth decay, and potential death. Bulimia should be prevented by reducing the social stigma, creating awareness, and providing knowledge of the disorder.

Bulimia nervosa, also known as the secretive syndrome, clearly impacts the lives of the those inflicted and the lives of those around them. People with bulimia often hide their disorder because of shame and fear of judgement.  By hiding their disorder, they often receive delayed treatment and increased stress. Many patients with bulimia idealize thin people they see in the media. This disorder has become a social concern because todays culture has strong opinions on weight control. The creation of social media has impacted the number of cases seen in recent years. By having easy access to the media, some teenagers and adults become obsessed with their body image and try to control their weight. For example, people have created “pro mia” blogs and websites, which provides tips and encouragement for those with bulimia. They encourage fasting, binging, and purging as well as images of skinny women to encourage their viewers to lose weight. The bloggers who create these websites “perceive their illness as a lifestyle and encourage others to do the same” (Rainey). Marcela Rojas, a journalist for USA Today, argues that when people see posts on Instagram and Facebook encouraging bulimia and anorexia, it puts eating disorders in a positive light. This can influence adolescents and adults to lose weight or not eat as much, potentially leading to an eating disorder. Rojas also refers to a study done by the University of Haifa in 2011. The study determined that “the more time teenage girls spend on Facebook”, the more likely they are “of developing negative body image and eating disorders” (Rojas). Those with bulimia nervosa often think they are overweight or are striving for a perfect body. The patients typically have associated features such as “perfectionism, obsessive compulsive disorder, impulsivity, and narcissism” (Beresin). The encouragement to lose weight and the unrealistic body expectations that appear on social media help intensify bulimia and its associated features, which demonstrates why it needs to be prevented

In recent years, bulimia nervosa has become a well-known disorder in men and women. According to a study from the National Comorbidity Replication, the lifetime prevalence estimates of bulimia nervosa are 1.5% among women and 0.5% in men (Hudson et al. 348). These percentages represent how many men and women in the world have had bulimia nervosa at some point in their life. In the study, it was determined that less than half of these men and women “had ever sought treatment for their disorder” (Hudson et al. 348). Many health risks accompany those with bulimia nervosa. Some of the physical health outcomes are erosion of dental enamel, bowel problems, and dehydration (“Bulimia Nervosa”). These can cause the patient to lose their teeth, rupture their bowel, and experience kidney failure. There are also mental health outcomes, such as depression, anxiety, self-harm, and substance abuse (“Eating Disorders and Common Co-Occuring Disorders”). The more serious physical health outcomes include infertility, heart failure, swollen jaw, stomach rupture, and low blood pressure (“Bulimia Nervosa”). Having bulimia can also increase the risk of miscarriage, premature birth, and having a baby with a birth defect (“Bulimia Nervosa”). These are all consequences of having bulimia, which can possibly lead to death. It is no secret that having this disorder is dangerous. In a study done using the “National Death Index”, it was determined that the mortality rate for bulimia is 3.9% (Crow et al. 1342). However, 30-80% of those who receive treatment go through remission (Beresin). This demonstrates how crucial treatment is and why bulimia should be prevented. 

There is not one specific cause for bulimia, but researchers have determined that certain factors can lead to it. It was determined that excessive television or computer usage can influence adults and adolescents negatively. Between the thin celebrities in the media and the dieting commercials on television, there is an immense amount of influence to lose weight. In addition, those who have a direct family member with an eating disorder are more likely to develop one. Those who have “weight concerns, low self-esteem, and poor self-concept” (Bernacchi 175), or experienced environmental risks such as childhood abuse and trauma, also have a higher chance of developing bulimia. For example, a patient named Jade was “sexually abused by a family member”, which made her “hate her body” (Rainey), therefore leading to an eating disorder. Many patients who experience trauma turn to food for comfort or self- punishment.There are also demographics surrounding the typical patient with bulimia. These patients are typically women, have a mean age of 23.5, an 85.7% probability of exhibiting a morbid fear of weight gain, and a 55.2% probability of having extreme awareness and sensitivity towards weight gain (Baeur et al).  These factors can increase the chances of establishing an eating disorder. By reducing media usage, as well as helping those who have experienced negative mentality and environmental risks, bulimia nervosa can be prevented. 

Although the demographics of typical patients and typical causes of bulimia are well defined, it is often difficult to diagnose this disorder. The DSM 5 is the diagnosis method used for eating disorders. According to this diagnostic tool, there are numerous requirements to be diagnosed as bulimic. First, the patient must have “recurrent episodes of binge eating”, as well as “inappropriate compensatory behaviors in order to prevent weight gain” (Robinson and Fornari 33). These behaviors include, but are not limited to, vomiting, using laxatives, and excessive exercising. Next, these behaviors “must occur at least once a week for three months”. (Robinson and Fornari 33). The consistency of the patient’s behavior is a deciding factor in the diagnosis because it’s possible that the binging and purging could be a lone event. Finally, the patient must have their self-worth “influenced by body shape and weight” and the patient must not “meet the criteria for anorexia nervosa” (Robinson and Fornari 33). Since those affected by bulimia often hide their disorder, it can take months for the patient to admit to these behaviors and be diagnosed with bulimia, and it is often under-diagnosed. The specific diagnostic requirements make diagnosing bulimia more complicated, which illustrates the importance of preventing bulimia. 

While all cases of bulimia are different, they often have similarities. An example of this is a patient named Karen that feels the need to “binge/purge 2 to 3 times a day”, and “has also used laxatives” (Bauer et al.) to continue losing weight. This patient has a lack of control in her family life, therefore attempts to regain control by unhealthily managing their weight. Similarly, a patient named Diane has a usual pattern of “vomiting four times a day” (Beresin). This patient has a negative body image and wants to control her weight, leading to serious health consequences. She often complains of “fatigue, weakness, coldness, and muscle pains” (Beresin). Although many patients who have bulimia are women, men can suffer from this disorder as well. John Prescott, “the former deputy prime minister for Hull East” (Jones), suffered from bulimia. He hid his disorder out of shame, and after 30 years, confessed to suffering from bulimia. These patient cases contain just some of the many consequences of bulimia, which illustrates the need for treatment and prevention. 

Oftentimes, people compare bulimia nervosa to other eating disorders such as anorexia nervosa. Although they are both eating disorders, they have different appearances and health risks. It is important to understand the differences between these disorders because they present themselves differently and require different approaches during treatment. The medical director of Healthy Place, Harry Croft, explains the differences between anorexia and bulimia in a video he created. He states that while anorexia is an “avoidance of food”, those with bulimia indulge on food and attempt to lose the weight in an unhealthy way. Additionally, you often cannot identify those with bulimia with physical appearance alone. While anorexics are usually very thin or underweight, bulimics can be a normal, healthy weight (“What are the Differences Between Anorexia and Bulimia?”). The treatment for these eating disorders are similar, but they need to be tailored to every patient in order to be successful.   

Unfortunately, there is no cure for bulimia. However, there are many treatments that are available for those with this disorder. The treatments are often decided based on how long the patient has had an eating disorder, and how severe it is. Fluoxetine is a medication that is often used in cases of bulimia. This medication helps prevent unwanted negative thoughts regarding eating, as well as helps the patient’s anxiety and depression. Along with medication, when patients attend counseling such as psychotherapy, it can “help them change harmful thoughts or behaviors”. (“Bulimia Nervosa”) In addition, many patients attend nutritional counseling to help them “eat in a healthier way than binging and purging” (“Bulimia Nervosa”). Throughout these treatments, the patients identify what triggers their bulimia, what emotions are related to their binging and purging, and how to avoid future unhealthy eating behaviors. Sometimes if typical treatment doesn’t help or a patient’s condition gets worse, they can be hospitalized as a form of treatment. Hospitalization typically occurs in extreme scenarios, and is not a normal treatment for everyone with bulimia. Ultimately. these treatments are often successful in improving the unhealthy behaviors associated with bulimia.  

Since there is no cure to bulimia, preventing it is the most effective method. From a clinical perspective, “increasing knowledge of the illness” (Beresin) and reducing the importance of body image in children are ways to prevent future eating disorders. Introducing healthy foods and eating patterns to children is also helpful. Many health experts are attempting to establish “school based initiatives” to create awareness about disorders such as bulimia, since eating disorders “kill more Americans than any other psychiatric illness” (Olivero). These health experts want to reach out to students in grades five through twelve and increase their knowledge in order to prevent future eating disorders. In addition, teaching the teachers, faculty, and coaches about the warning signs of eating disorders could help with early intervention. The early warning signs of bulimia include skipping meals, going to the bathroom shortly after eating, and having negative body image. When teachers or parents notice these warning signs, they should immediately discuss the issues with the child and their healthcare provider. By being aware of a possible eating disorder before it has developed, the dangerous health risks diminish. 

The risks of having bulimia nervosa are immensely dangerous, therefore this disorder should be treated and prevented. Bulimia nervosa can lead to mental health issues such as depression and anxiety, and physical health issues such as infertility, gastrointestinal issues, and tooth decay. Diagnosing bulimia is a complicated process and requires the patient to have a specific list of consistent issues. The treatment of bulimia does not cure the disorder, but can lead to patients going into remission. The most effective treatment for bulimia is prevention. Changes could be made in the future to prevent eating disorders and improve healthy eating. Changing the diagnostic method could help reduce the chances of bulimia being under diagnosed.  Also, by creating awareness of bulimia as well as reducing the cultural obsession with being thin, the mental and physical impacts of bulimia could be prevented. If teachers and parents teach children healthy eating habits at a young age, they are more likely to establish those habits. In sum, the treatment and prevention of bulimia nervosa helps reduce the unhealthy risks the disorder creates.
