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Accordingly, this would lead to unrealistically restricted eating, which may consequently induce an eventual "slip" where the individual commits a minor infraction of the strict and inflexible dietary rules.

Moreover, the cognitive distortion due to dichotomous thinking leads the individual to binge. The binge subsequently should trigger a perceived loss of control, promoting the individual to purge in hope of counteracting the binge.

However, Fairburn et al. In contrast, Byrne and Mclean's findings differed slightly from Fairburn et al. In turn, Byrne and Mclean argued that this makes the individual vulnerable to binging, indicating that it is not a binge-purge cycle but rather a purge-binge cycle in that purging comes before bingeing.

Similarly, Fairburn et al. Everyone differs from another, and taking such a complex behavior like bulimia and applying the same one theory to everyone would certainly be invalid.

In addition, the cognitive behavioral model of bulimia nervosa is very cultural bound in that it may not be necessarily applicable to cultures outside of the Western society.

To evaluate, Fairburn et al. Furthermore, it is difficult to ascertain cause and effect, because it may be that distorted eating leads to distorted cognition rather than vice versa.

A considerable amount of literature has identified a correlation between sexual abuse and the development of bulimia nervosa.

The reported incident rate of unwanted sexual contact is higher among those with bulimia nervosa than anorexia nervosa.

When exploring the etiology of bulimia through a socio-cultural perspective, the "thin ideal internalization" is significantly responsible.

The thin ideal internalization is the extent to which individuals adapt to the societal ideals of attractiveness. Studies have shown that young females that read fashion magazines tend to have more bulimic symptoms than those females who do not.

This further demonstrates the impact of media on the likelihood of developing the disorder. Kevin Thompson and Eric Stice claim that family, peers, and most evidently media reinforce the thin ideal, which may lead to an individual accepting and "buying into" the thin ideal.

In turn, Thompson and Stice assert that if the thin ideal is accepted, one could begin to feel uncomfortable with their body shape or size since it may not necessarily reflect the thin ideal set out by society.

Thus, people feeling uncomfortable with their bodies may result in suffering from body dissatisfaction and may develop a certain drive for thinness.

Consequently, body dissatisfaction coupled with a drive for thinness is thought to promote dieting and negative effects, which could eventually lead to bulimic symptoms such as purging or bingeing.

Binges lead to self-disgust which causes purging to prevent weight gain. A study dedicated to investigating the thin ideal internalization as a factor of bulimia nervosa is Thompson's and Stice's research.

The aim of their study was to investigate how and to what degree media affects the thin ideal internalization. Thompson and Stice used randomized experiments more specifically programs dedicated to teaching young women how to be more critical when it comes to media, in order to reduce thin ideal internalization.

The results showed that by creating more awareness of the media's control of the societal ideal of attractiveness, the thin ideal internalization significantly dropped.

In other words, less thin ideal images portrayed by the media resulted in less thin ideal internalization. Therefore, Thompson and Stice concluded that media greatly affected the thin ideal internalization.

People that associate themselves with thin models get in a positive attitude when they see thin models and people that associate with overweight get in a negative attitude when they see thin models.

Moreover, it can be taught to associate with thinner people. The onset of bulimia nervosa is often during adolescence, between 13 and 20 years of age, and many cases have previously suffered from obesity, with many sufferers relapsing in adulthood into episodic bingeing and purging even after initially successful treatment and remission.

Adolescents with bulimia nervosa are more likely to have self-imposed perfectionism and compulsivity issues in eating compared to their peers.

This means that the high expectations and unrealistic goals that these individuals set for themselves are internally motivated rather than by social views or expectations.

Bulimia nervosa can be difficult to detect, compared to anorexia nervosa , because bulimics tend to be of average or slightly above or below average weight.

Many bulimics may also engage in significantly disordered eating and exercise patterns without meeting the full diagnostic criteria for bulimia nervosa.

Purging often is a common characteristic of a more severe case of bulimia nervosa. There are two main types of treatment given to those suffering with bulimia nervosa; psychopharmacological and psychosocial treatments.

There are several supported psychosocial treatments for bulimia. Cognitive behavioral therapy CBT , which involves teaching a person to challenge automatic thoughts and engage in behavioral experiments for example, in session eating of "forbidden foods" has a small amount of evidence supporting its use.

By using CBT people record how much food they eat and periods of vomiting with the purpose of identifying and avoiding emotional fluctuations that bring on episodes of bulimia on a regular basis.

He states in order for the therapy to work, all parties must work together to discuss, record and develop coping strategies.

Barker claims by making people aware of their actions they will think of alternatives. Maudsley family therapy , developed at the Maudsley Hospital in London for the treatment of anorexia has been shown promising results in bulimia.

The use of Cognitive Behavioral Therapy CBT has been shown to be quite effective for treating bulimia nervosa BN in adults, but little research has been done on effective treatments of BN for adolescents.

Adolescents are at the stage where their brains are still quite malleable and developing gradually. Antidepressants of the selective serotonin reuptake inhibitors SSRI class may have a modest benefit.

Topiramate may also be useful but has greater side effects. It is not known if combining medication with counseling improves the outcomes.

Any trials which originally suggested that such combinations should improve the outcome have not proven to be exceptionally powerful.

Some positive outcomes of treatments can include: Some researchers have also claimed positive outcomes in hypnotherapy. There is little data on the percentage of people with bulimia in general populations.

Most studies conducted thus far have been on convenience samples from hospital patients, high school or university students. These have yielded a wide range of results: Bulimia nervosa occurs more frequently in developed countries [58] and in cities, with one study finding that bulimia is five times more prevalent in cities than in rural areas.

There are higher rates of eating disorders in groups involved in activities which idealize a slim physique, such as dance, [74] gymnastics, modeling, cheerleading , running, acting, swimming, diving, rowing and figure skating.

Bulimia is thought to be more prevalent among Caucasians ; [75] however, a more recent study showed that African-American teenage girls were 50 percent more likely than white girls to exhibit bulimic behavior, including both binging and purging.

Although diagnostic criteria for bulimia nervosa did not appear until , evidence suggests that binging and purging were popular in certain ancient cultures.

The first documented account of behavior resembling bulimia nervosa was recorded in Xenophon's Anabasis around B.

C, in which Greek soldiers purged themselves in the mountains of Asia Minor. It is unclear whether this purging was preceded by binging.

In ancient Rome, elite society members would vomit in order to "make room" in their stomachs for more food at all day banquets. Historical records also suggest that some saints who developed anorexia as a result of a life of asceticism may also have displayed bulimic behaviors.

Catherine died from starvation at age thirty-three. While the psychological disorder "bulimia nervosa" is relatively new, the word "bulimia," signifying overeating, has been present for centuries.

There was no evidence of deliberate vomiting or an attempt to control weight. At the turn of the century, bulimia overeating was described as a clinical symptom, but rarely in the context of weight control.

In , admissions of anorexia nervosa patients to the Mayo Clinic from to were compiled. Fifty-five to sixty-five percent of these patients were reported to be voluntarily vomiting in order to relieve weight anxiety.

Several case studies from this era reveal patients suffering from the modern description of bulimia nervosa. Ellen West , a patient described by Ludwig Binswanger in , was teased by friends for being fat and excessively took thyroid pills to lose weight, later using laxatives and vomiting.

After being admitted to a psychiatric facility for depression, Ellen ate ravenously yet lost weight, presumably due to self-induced vomiting.

An explanation for the increased instances of bulimic symptoms may be due to the 20th century's new ideals of thinness. The s, however, truly introduced the trend of an aspiration for thinness.

In , Gerald Russell first published a description of bulimia nervosa, in which he studied patients with a "morbid fear of becoming fat" who overate and purged afterwards.

In , Kendler et al. From Wikipedia, the free encyclopedia. Bulimia nervosa Synonyms Bulimia Loss of enamel acid erosion from the inside of the upper front teeth as a result of bulimia Specialty Psychiatry Symptoms Eating a large amount of food in a short amount of time followed by vomiting or the use of laxatives , often normal weight [1] [2] Complications Breakdown of the teeth, depression , anxiety , problems with drugs, suicide [2] [3] Causes Genetic and environmental factors [2] [4] Diagnostic method Based on person's medical history [5] Differential diagnosis Anorexia , binge eating disorder , Kleine-Levin syndrome , borderline personality disorder [5] Treatment Cognitive behavioral therapy [2] [6] Medication Selective serotonin reuptake inhibitors , tricyclic antidepressant [4] [7] Prognosis Half recover over 10 years with treatment [4] Frequency 3.

The American Journal of Psychiatry. Office on Women's Health. Archived from the original on 19 June Retrieved 27 June The International Journal of Eating Disorders.

Expert Opinion on Pharmacotherapy. An ominous variant of anorexia nervosa". The British Journal of Psychiatry. Retrieved 13 September The New England Journal of Medicine.

J Womens Health Larchmt. Oral Health Topics A—Z. Archived from the original on February 3, Archived from the original on February 21, The National Eating Disorders Association.

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