Bulimia is a mental illness: those affected often have binge eating, in which they ingest large amounts of food in an uncontrolled manner. They then vomit for fear of gaining weight, fast between binge eating, take additional laxatives, or do excessive exercise. How does bulimia come about, what are the signs, and what are the possible consequences?
What Makes Bulimia a Mental Illness?
The eating attacks characteristic of bulimia are psychological. Sufferers use food to regulate negative feelings such as loneliness, sadness, fear, or anger.
Who Is Primarily Affected?
Young women. But there are also men who suffer from eating disorders. The ratio between women and men is ten to one. Bulimia usually develops in late puberty, but it can also occur into old age.
Why Do Those Affected Develop Bulimia?
Various factors usually play a role in the development of bulimia. These include:
- stressful life events,
- a hereditary predisposition,
- frequent dieting
- personal factors, such as low self-esteem or perfectionism, a slim ideal of beauty,
- constant availability of high-calorie food.
The disease develops insidiously. Ultimately, the triggers are often diets that are done during puberty. Those affected eat far too little to get rid of their baby fat, for example, and then get hunger pangs. They often get positive feedback on their weight loss, and it becomes extremely important to them to be in good shape.
Unstable self-esteem usually also plays a role in the development of bulimia. Especially during puberty, one is confronted with many questions such as:
- “What am I worth?”
- “How do I get ahead professionally?”
- “How do I break away from my parents?”
Because it is often difficult to cope with such questions at a young age, an inner tension arises, a fear that those affected have to get rid of somehow. To regulate their emotions, they eat.
One of the reasons why young men are affected less often is that they regulate their frustration less with their eating behavior. The desire for perfectly built muscles is often a problem for them: They train a lot in the gym and have a very strict diet.
How About Adults Who Are Affected?
Adults can struggle with similar issues. Either they also suffer from low self-esteem, or they have psychological comorbidities such as anxiety or personality disorders. They also resort to eating habits to regulate their internal tension.
Also predestined for bulimia are people who were overweight as a child or who have overweight people in their families. You have learned to eat when you are frustrated.
What Does Bulimia Therapy Look Like?
An example: A young woman is being exploited in the workplace. Instead of fighting back, she adapts and always goes about her job. In order to withstand that, she needs a valve. She can get rid of her anger with a binge eating in the evening. This can also apply to a relationship in which a young woman feels oppressed by her partner.
Therapy is about finding out: What is hidden by your eating behavior? What are the causes of the disease? Unconscious conflicts and difficult feelings always cause bulimia. The young woman needs to understand why she has an eating disorder.
She also has to learn to assert herself better and to articulate her needs. A psychotherapist helps her perceive and classify her feelings. He or she can endure the feelings with her so that she doesn’t have to carry them around alone.
In addition, the person concerned must be given a framework for normal eating behavior. In therapy, she learns what a normal meal is and how to structure her meals on a regular basis. She also learns other coping strategies for regulating emotions.
A multi-professional team is available for this in a clinic. It usually consists of:
- Doctors who treat the physical sequelae of bulimia. In the case of comorbidities with depression (bulimia and depression often occur together), treatment with an antidepressant can also be considered.
- Psychotherapists who use cognitive behavioral therapy or a combination of behavioral therapy and another psychotherapy method, such as depth psychological therapy.
- Creative therapists who help patients express themselves through art and design.
- Sports therapists who promote healthy exercise.
- Nursing staff who structures and accompanies the meals and helps deal with eating and vomiting pressure.
- Social educators who, for example, work with role-playing games in a group.
Is Bulimia Curable?
Usually, several therapies are necessary over a period of years, but bulimia is curable. Of course, relapses cannot be ruled out, but hopefully, you have learned other coping strategies during the therapy. In addition, a lot is gained if you only rarely have binge eating.
