A:

Bulimia Nervosa and Anorexia Nervosa are closely related disorders. Although both are commonly known as "eating disorders", they are technically classified as "emotional disorders" (See DSMV-IV). Studies show that these disorders are rarely triggered by a real need to lose weight, but are actually extreme reactions to "out of control" family or social situations. The main difference between anorexia and bulimia is simple; anorexics starve themselves, bulimics binge and purge.

Since you asked about bulimia, lets look at the most obvious features of this disorder. Things to look for when identifying bulimia are:

1. Periods of withholding food (starvation) followed by eating binges ("pig outs").
2. Eating binges in response to a stressful or disappointing event.
3. Binge eating followed by purging, either by induced vomiting, or regular use of laxatives.
4. Guilt and "self punishment" (in the form of starvation) after a binge.

Since bulimics are rarely obese to begin with, the initial weight loss often goes unnoticed by others. But bulimics do lose weight, and like anorexics, they lose it quickly and dangerously. The rapid weight loss associated with both the disorders can cause electrolyte depletion, jaundice, low blood pressure, vitamin deficiency, and irregular menstruation in girls. Bulimics often have; dry skin, white heads, yellow eyes, bad breath, weak or brittle nails and hair, cold hands and feet, rotten teeth or teeth with little or no enamel (caused by vomiting), problems controlling bowel movements and urination (if laxatives are used).

The starvation associated with both bulimia and anorexia put tremendous strain on the body's internal organs. In an estimated 2 - 5% of cases the disorders cause the body to shut down completely, resulting in death. Both disorders are more common in girls than in boys, but they do occur in both sexes. As stated earlier, these are emotional disorders and are thought to be a passive aggressive attempt to reclaim a sense of control over one's life.

Bulimia is twofold; it's a course of action and an emotional state. It is impossible to properly diagnose this disorder by yourself. However, sufferers of bulimia and anorexia share certain traits (or causes). These conditions characteristically affect girls of middle and upper middle-class families. The disorders usually first appear between the ages of 10 and 20, although both conditions can persist well into adulthood. Bulimics and anorexics are normally good students who obey the rules and are generally cooperative and complacent. Please note that these are generalizations based on controlled studies; as with any "rule" there are exceptions (as noted above, males can suffer from these disorders).

As to treatment, you must get professional help. You do not need to tell your family until you feel ready to, but you must tell somebody. You can start getting treatment in support groups, free clinics and crisis lines. You can even find help online, in virtual support groups, chat sessions, and bulletin boards. There are lots of places you can turn to for help while still remaining anonymous. The only reason you may have to tell your parents is if you seek medical treatment that you need to pay for or for which you need to file an insurance claim. If you want to avoid this, your best bet is a free clinic. Most people find that once they start treatment they want to share their stories with others. If and when you reach this point, it would be a very good idea to tell your family and loved ones what you are going through so they can better support your recovery.

At the very least, you must stop the cycle of starvation, binging and purging. If you can't go to your family doctor for help , you must find a support group. You must eat normally and safely gain weight. It is best if you get medical attention as soon as possible since there are medications that can help you in your recovery. Bulimia is a mental disorder that affects you physically, for this reason a doctor must be involved in any recovery effort. Bulimia is not like a cold, you can not take care of it yourself. You need help, support and medical attention. Depending on the degree of your bulimia, it could be dangerous to rapidly put on the weight that you lost. If you do attempt to treat yourself there will likely come a time when you will need and want outside help. Don't be afraid to reach out to those closest to you since they are most likely to notice if you start to slip or if the bulimic behavior returns.

A big part of both bulimia and anorexia is denial. People who suffer from these disorders are in denial about what they are doing to their bodies and what is going on in their lives. Since this type of emotional disorder is normally brought on by a desire to control some part of a seemingly out of control life, it is very easy for sufferers to feel vindicated by what they are doing to their bodies. If you suspect that you are bulimic, I strongly urge you to get a medical opinion. Go to a free clinic, go to a family doctor, see your school nurse, see somebody in the medical profession, and find a reliable support system that includes a psychiatrist or therapist. You can not get over bulimia alone.

To determine if you may need treatment or suffer from an eating disorder take this SELF ASSESSMENT TEST from the Eating Disorder Referral and Information Center. (about these tests - technical information)

Find a Treatment Facility in your area - from SomethingFishy.org

More Teen Life Q & A > Past Questions