Clinical features and/or observable behaviours of
Bulimia Nervosa
Watch for the following observable patterns of behaviour as a clue that bulimia nervosa may be present.
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There is a sense of lack of control during binge sessions. While eating and then purging, there is a feeling of being very emotionally out of control. In contrast, the anorexic denies her feelings of being out of control.
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Vomiting decreases abdominal bloating so that bingeing can continue without any weight gain. This cycle may continue for hours over a whole day.
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Depression often follows after a binge-purge session. The nature of the depression is often quite severe. Purging affects the serotonin levels (a chemical which affects one's moods), in that there is a temporary change which makes them feel euphoric. After the serotonin wears off, they feel depressed and the cycle then starts all over again.
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Sweets and high caloric value foods are consumed during a binge. It is not uncommon for large amounts of money to be spent in preparation for a binge.
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Food is eaten secretly, rapidly and sometimes not chewed. Sometimes frozen foods are consumed.
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The weight range is within the normal weight range; some are under or over weight. (See the Body Mass Index Table).
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Sexual interest. There is sexual interest as opposed to anorexics who have no, or limited interest in sex.
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Body size. As with the anorexic there is an obsession with body size.
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Food is prepared and hoarded. There is often a ritual of feeding others but of not consuming any food for oneself. |
GENERAL COMMENTS
Some examples of compulsive behaviours include perfectionism, extreme orderliness and excessive hand washing. Remember that only when behaviour becomes so extreme that it interferes with one's daily routine, is it classified as pathological. Being neat, having standards, etc in a moderate fashion is not pathological