binge—purge syndrome
An eating disorder characterized by sequences of excessive eating followed by purging. Self-induced vomiting is the most common purging behaviour, but others include fasting, excessive exercise, laxative abuse, and diuretic abuse. Individuals who develop bulimia are convinced that they are overweight and that their body shape is abnormal. Bulimics begin restrictive dieting in an effort to lose weight, but this induces hunger and thoughts of food which leads to binge eating. In an effort to undo the excessive eating, the bulimic vomits or purges what he or, more commonly, she has eaten. Bulimia may become chronic if an individual develops a psychological need to binge.
Bulimic behaviour may become a means through which emotional problems are regulated and managed. Binge eating may help to release pent-up emotions and enable the bulimic to be distracted temporarily from unpleasant problems. However, the bulimic then has to purge to remove the feelings of guilt associated with the bingeing.
A number of medical complications can occur as a direct or indirect result of bulimic behaviour. Dental problems, including erosion of tooth enamel and gum disease, may occur if there is frequent vomiting of the acidic contents of the stomach. Gastrointestinal problems are common, including abdominal cramps, constipation and diarrhoea. Laxative abuse may lead to loss of normal bowel function. An imbalance of electrolytes, caused by loss of body fluids, may result in cardiovascular complications. Most of these effects of bulimia are reversible once the sufferer resumes a normal eating pattern.
Bulimia nervosa may occur as a phase of anorexia nervosa, and bulimics often share the same psychological problems as anorexics. Both disorders must be treated seriously and medical advice sought. However, it is not easy to identify bulimics. They may show few symptoms until late in the course of the illness, and, unlike anorexics, they may be of normal weight. In addition, bulimics are very secretive about their condition and usually deny vehemently that they have a problem.
