How does bulimia appear? Bulimia: symptoms and treatment. Diagnosis and treatment

Bulimia is a mental illness, the basis of which is a nervous disorder of the psyche, characterized by acute attacks of hunger, uncontrolled absorption of food, gluttony, but at the same time supplemented by over-concern with one’s body weight.

Psychiatry and psychology introduce such a definition as neurotic, nervous or neurogenic bulimia, which in the ICD-10 classification of mental disorders has code F50.2. This means that this disease occurs as a food addiction against the background of developing neurosis, depression or other mental disorders.

The word bulimia has Greek roots and is derived from the words “βοῦς”, which in Greek means bull and “λῑμός”, which means hunger. The history of the disease goes back more than one millennium. Even the ancient Egyptians artificially induced vomiting after excessive overeating, but in those days bulimia meant only gluttony, against the backdrop of a strong desire to eat large amounts of food. The psychological prerequisites for the emergence of such a disease, which is known today, began to emerge only in the nineteenth and twentieth centuries, when it began to be considered as an eating disorder that occurs on a nervous basis and in a state of increased anxiety.

However, this disease should not be completely attributed to mental dependence, because it is also based on a biological factor - the satisfaction of severe paroxysmal hunger. After all, initially, against the background of mental problems, the patient begins to eat food without feeling hungry at all, and then, due to digestive disorders, the desire to eat arises almost constantly, developing a strong biological dependence.

Classification of the disease

Today, the following types of bulimia nervosa are classified: classic or purging, as well as bulimia that occurs against the background of anorexia.

The first type of disease is characterized by getting rid of severe overeating by artificially inducing vomiting, using laxatives or diuretics, as well as administering an enema.

The second type of disease is characterized by other compensatory measures aimed at losing weight and combating uncontrolled appetite. To achieve this, strict exhausting diets and increased physical activity are used. Patients consciously fast, but do not get rid of the food they eat using medications or artificially induced vomiting. However, at some point a breakdown occurs and they again begin to absorb food in huge quantities.

Patients suffering from bulimia themselves are very similar to those suffering from anorexia. However, identifying them in a crowd is not as easy as the latter. Anorexics are quite easy to distinguish even from photographs. In addition, they are characterized by voluntary refusal of food and painful thinness. Bulimics, on the other hand, are ashamed of their addiction and, as a rule, do not suffer from obesity or increased body weight. Their weight is within the normal range or only slightly different from normal.

There is also an atypical form of bulimia nervosa, which in many ways is very similar to this type of eating disorder, however, the complete clinical picture does not make it possible to make a final diagnosis, largely due to the absence of some key signs of the disease.

For example, if there are serious problems with overeating, use of laxatives and diuretics, there is no serious concern about one’s appearance, dissatisfaction with weight and the desire to acquire an ideal figure.

Causes of the disease

The causes of this disease include both psychological or mental and physiological factors.

Physiological reasons are directly related to brain dysfunction. Most often, these are organic damage to the food center in the cerebral cortex or disturbances in metabolic processes in the body.

This includes frontal lobe syndrome, metabolic syndrome, insulin resistance, and epilepsy. This disease also appears as a result of traumatic brain injuries or various tumors.

Also, the occurrence of bulimia can be caused by a hormonal imbalance that occurs as a result of disruption of the pituitary gland and hypothalamus.

However, the largest number of cases of bulimia is associated with psychological factors, which include:

• depression;
• lack of serotonin;
• obsessive disorders;
• increased anxiety;
• low self-esteem;
• excessive perfectionism;
• neuroses;
• emotional overstrain.

The most susceptible to this disease are patients from wealthy families, in which pretentious family attitudes and great ambitions dominate. Often, a child from such a family develops inferiority complexes, fears and various phobias, fear of disgracing the family or not meeting the expectations of the parents. Low self-esteem, leading to bulimia, in such cases develops due to a lack of expression of feelings and warmth in the family, the patient’s feeling of uselessness and loneliness. Lack of closeness and strained relationships with the mother may also be to blame.

Very often this disease occurs against the background of excessive dieting, when fasting occurs for quite a long time. Having limited themselves for a long time in tasty and favorite food, such people often break down and literally attack the food, without denying themselves anything.

Symptoms of the disease

Symptoms of bulimia are characterized by changes in eating behavior, as well as various physiological signs. The psychosomatics of such a disease are usually expressed quite clearly and it is not difficult to guess that this is a person suffering from bulimia if you pay attention to such changes in behavior:

• frequent overeating and haste in eating food;
• poor chewing;
• frequent going to the toilet after eating to induce vomiting;
• signs of psychological health problems;
• isolation and secrecy;
• frequent bouts of severe hunger;
• the patient's "voracious" appetite.

Physiological symptoms of bulimia include:

• sudden changes in body weight: patients either get fat or suddenly lose weight;
• general weakness of the body;
• inflammatory processes in the larynx;
• frequent throat diseases;
• dental problems arising from artificially induced vomiting: teeth are destroyed, enamel darkens, gums become inflamed;
• metabolic disorders in the body;
• inflammatory processes in the digestive organs;
• swollen cheeks and hypertrophied salivary glands;
• severe dehydration, sagging skin, frequent dermatitis, skin rashes and acne.

The presence of this disease can also be indicated by:

• injuries on the fingers that provoke gag reflexes;
• involuntary muscle twitching, convulsive syndrome;
• dysbacteriosis and diarrhea;
• impaired renal and liver function;
• heart diseases;
• the occurrence of internal bleeding;
• menstrual irregularities, in some cases menstruation stops completely;
• neuroses and other diseases of the nervous system;
• depressive states.

Often with bulimia, negative changes occur in the patient’s appearance: arms and legs swell, hair falls out.

Clinical picture of the disease

Statistics say that young women, between the ages of thirteen and thirty years, are most susceptible to this disease. Although bulimia also occurs in men, it is quite rare. Recently, mild types of the disease have often been detected in both sexes. Signs of the disease are especially pronounced in adolescents. Teenage or childhood bulimia usually occurs as a result of a child’s dissatisfaction with his own appearance or inconsistency with certain canons of beauty. Therefore, they begin to adhere to strict diets, monitor their own weight, and in case of overeating, artificially induce vomiting.

This disease almost always begins with an increase in appetite, severe attacks of hunger and the inability to control them. Patients with bulimia very often hide the symptoms of the disease from strangers and almost never eat large amounts of food in public. But when left alone, they indulge in gluttony, after which they get rid of the food they have eaten, which is helped by artificially induced vomiting. Patients suffering from this disease typically eat food in the evening and even at night.

The stages of bulimia are often classified according to the intensity of the symptoms expressed, the degree of damage to internal organs and body systems, as well as the frequency of clinical signs.

The initial stage of bulimia is characterized by vomiting no more than one to three times a month. Its duration usually ranges from one to three years, but it may vary in each individual case. In addition, very often in the initial stages a remission occurs, characterized by the absence of behavioral symptoms of bulimia for several months. During such periods, patients suffering from this disease are deeply convinced that this is wrong, but it is possible to live with it and not dangerous.

Bulimia progresses quite quickly. Gradually, thoughts about food come to the fore and occupy every day of the patient’s life. This usually characterizes stage 2 of the disease or chronic bulimia. It happens that at this stage there are periods of exacerbation and remission. Family conflicts, problems at work, interpersonal relationships fade into the background. The priority for such people is only the absorption of food. The frequency of vomiting in chronic bulimia reaches seven times a day, and vomiting is caused daily.

The severe stage of the disease is characterized by serious disturbances in the functioning of the gastrointestinal tract. During such a period, vomiting may occur involuntarily, and when it is induced, blood often appears. Bulimia in its final stages requires hospitalization, as it provokes the development and exacerbation of many chronic diseases.

It is necessary to hospitalize the patient in the following cases:

• critical weight loss;
• severe exhaustion of the body;
• severe depression;
• severe dehydration.

Such conditions are a threat to the patient's life. There are cases where this disease led to the death of a person as a result of heart failure caused by severe dehydration and loss of a significant amount of vital minerals. Also, death is possible due to perforation of the walls of the esophagus and stomach, or mechanical damage to the intestine.

Bulimia significantly affects the patient’s psyche, so as the disease progresses, the depressive syndrome may increase. Multiple facts indicate that even in the initial stages of the disease, serious mental disorders, neurasthenia and other pathologies of the nervous system can occur.

Diagnosis and treatment of bulimia

Diagnosis of this disease is quite simple. The diagnosis of bulimia can be made based only on changes in the patient's behavioral signs and appearance. If within two hours the patient cannot resist frequent and excessive consumption of food, and also completely loses control over himself during such attacks, then it is quite possible to talk about the presence of such a disease.

Treatment of bulimia is a rather lengthy process and requires an integrated approach. It includes work with, and drug therapy and some cognitive-behavioral methods.

Psychotherapy for this disease helps to understand the cause that led to the occurrence of the disease and direct all means to fight it.

Cognitive behavioral therapy aims to identify and change patients' dysfunctional thoughts regarding their appearance and eating. This treatment also makes it possible to identify and correct anxious and negative thoughts, against which strong emotions arise that cause the progression of bulimia attacks.

Family therapy shows very good results in the treatment of bulimia. In such cases, recovery occurs much faster, because in any mental disorder, the support of loved ones plays a very important role.

Equally important is a competent combination of psychotherapeutic treatment and drug therapy, which will include the use of antidepressants. The most popular tablets for treating bulimia are Fluoxetine, which can reduce the frequency of bouts of overeating and dull the desire to get rid of food through vomiting or laxatives.

If bulimia provokes metabolic disorders in the body or digestive disorders, then in such cases serious diet therapy is used with the use of medications aimed at treating the developed pathologies.

Self-treatment of bulimia involves regular physical activity, long walks and other wellness procedures. However, this process is long and in any case requires the supervision of a psychologist.

Also, in the early stages, various folk remedies will help get rid of this disease, including various decoctions and infusions that help normalize the functioning of internal organs and body systems affected by bulimia.

Preventive measures for bulimia and nutrition

Preventive measures for bulimia are:

• improving the patient's self-esteem;
• setting the sick person to a positive mood and thinking;
• healthy psychological environment in the family;
• timely consultations with a psychotherapist and nutritionist;
• awareness of one’s intrapersonal conflicts and the fight against them;
• a safe and stable environment for the patient.

In addition, the most important measure to prevent the occurrence and development of this disease is adherence to the principles of a healthy and rational diet. The diet for bulimia requires the consumption of breakfast and lunch. Since without this in the evening you will really have a ravenous appetite, and it will be quite difficult not to overeat.

Prevention of bulimia also involves the use of fractional feeding methods. In order to improve nutrition during this disease, it is necessary to eat small portions, slowly and chew food thoroughly. This helps improve digestion and also helps make the body feel fuller to a greater extent. In such cases, food is digested faster, and nutrients are much better absorbed by the body.

You should also forget about snacking or overeating at the holiday table, or eating while watching TV or on the computer. You should also not abuse spicy and salty foods, various marinades, as they provoke a strong increase in appetite. You should not often eat fatty foods that contain calories that are dangerous for bulimics.

Also, the patient’s menu for bulimia should be varied so that it contains many vitamins and minerals that enter the body in a timely manner and in the quantities necessary for it. Such food should be rich in vitamins.

Proper nutrition and diet for this disease will help to sufficiently alleviate the course of the disease and significantly speed up the patient’s recovery.

Consequences of bulimia

Often on the Internet you can read that people live with this diagnosis all their lives, and that such a disease even has its advantages. However, this is not the case. The consequences of bulimia come down not only to physiological and emotional disruptions in the functioning of the body. In particularly severe conditions, this disease is dangerous because it causes unexpected negative side effects and serious complications that can lead to cancer, heart problems and other pathological processes.

Bulimia is also scary because in especially advanced cases it leads to death, usually caused by prolonged depression or severe dehydration. Also, with bulimia and the obesity that develops against it, there is a huge load on the heart, leading to acute heart failure, which can also cause the death of the patient.

Other consequences of this disease include:

• hypertrophy of the esophagus, frequent diarrhea and bleeding from the rectum, after constant use of laxative medications;
• stomach ulcer;
• neurasthenia and prolonged depression;
• drug and drug addiction;
• severe dehydration due to constant vomiting and taking diuretics;
• water-electrolyte imbalance;
• irritation of the esophagus and pharynx due to frequent vomiting;
• irregular menstruation or complete cessation of the cycle;
• stomach rupture.

Bulimia also threatens changes in the patient's appearance;

• yellowing of the skin;
• tooth decay;
• hair loss;
• premature aging and the appearance of wrinkles.

This disease is very dangerous for pregnant women, however, for many women, pregnancy is not an obstacle to the progression of this disease. The fact is that in such cases, not only the mother’s body suffers, but also the body of the unborn child, who does not fully receive nutrients and various intrauterine pathologies develop. But if the expectant mother approaches the issue responsibly and begins treatment for this disease in a timely manner, then the prognosis for the health of both the baby and the mother herself is quite optimistic.

That is why advice on the Internet that bulimia is not a dangerous disease is far from harmless. And untimely treatment of such a disease leads to serious and dangerous consequences.

Summing up

Bulimia is a serious illness classified as a mental disorder, which is characterized by constant overeating and subsequent disposal of the eaten food through artificially induced vomiting, as well as by taking diuretics and laxatives. Most often, this disease affects teenagers and young women between the ages of thirteen and thirty, who are characterized by dissatisfaction with their own appearance and the desire to achieve an ideal figure. But untimely treatment of such a disease is fraught with serious and severe consequences for the body, including death. That is why it is necessary to consult a specialist at the first signs of the disease to identify the severity of the disease and, depending on this, prescribe appropriate therapy.

With timely treatment and adequate preventative measures, the prognosis for recovery is quite optimistic. However, you should aim for the fact that restoration of health will take a long period of time. And if you strive for this and make great efforts, tuning in only to positive emotions, then this process can be significantly accelerated.

Bulimia (bulimia nervosa) is an eating disorder that is classified as a mental disorder. It manifests itself in attacks of overeating, during which a person absorbs a huge amount of food in 1-2 hours, sometimes up to 2.5 kg. At the same time, he does not feel its taste and does not experience a feeling of satiety. Following such an eating breakdown comes a feeling of remorse, and the bulimic tries to correct the situation. To do this, he induces vomiting, takes laxatives or diuretics, uses enemas, actively plays sports, or adheres to a strict diet. As a result, the body becomes depleted and a whole bunch of diseases develop, which can lead to death.

People find themselves in a vicious circle. Hunger strikes, chronic stress, and overwork place a heavy burden on our shoulders. When the stress becomes unbearable, a nervous breakdown occurs, which causes an attack of overeating. While eating, there is euphoria, a feeling of lightness and release. But after this there is a feeling of guilt, physical discomfort and a panicky fear of gaining weight. This causes a new wave of stress and an attempt to lose weight.

Like most other mental disorders, bulimia is not perceived by people as a serious problem. He does not seek help from a doctor or psychologist. The illusion is created that the attacks can be stopped at any time. Bulimia seems to be a shameful habit that brings a lot of inconvenience. Attacks of overeating and “purging” are carefully hidden, believing that people, even relatives, do not need to know about it.

According to statistics, 10-15% of women aged 15 to 40 years suffer from bulimia. After all, it is the fair sex who are constantly concerned about their appearance and excess weight. This problem is less common among men. They make up only 5% of the total number of bulimics.

Some professions are conducive to the development of bulimia. For example, it is very important for dancers, actors, models and track and field athletes not to be overweight. Therefore, among these people the disease occurs 8-10 times more often than among representatives of other professions.

Interestingly, this problem is most relevant in developed countries such as the USA, Great Britain, and Switzerland. But among people with low incomes, bulimia is rare.

Bulimia, like any other problem, rarely comes alone. It is accompanied by self-destructive sexual behavior, depression, suicide attempts, alcoholism and drug use.

Despite all the efforts of doctors, approximately 50% of patients manage to achieve complete recovery, 30% experience relapses of the disease after a few years, and in 20% of cases treatment does not have an effect. The success of the fight against bulimia largely depends on the willpower and life position of a person.

What shapes our appetite?

Appetite or the desire to eat is an emotion that arises when we feel hungry.

Appetite is a pleasant expectation, anticipation of pleasure from delicious food. Thanks to it, a person develops food-procuring behavior: buy food, cook, set the table, eat. The food center is responsible for this activity. It includes several areas located in the cerebral cortex, hypothalamus, and spinal cord. It contains sensitive cells that respond to the concentration of glucose and hormones of the digestive system in the blood. As soon as their level drops, a feeling of hunger arises, followed by an appetite.

Commands from the food center are transmitted along a chain of nerve cells to the digestive organs and they begin to work actively. Saliva, gastric juice, bile and pancreatic secretions are released. These fluids ensure digestion and good absorption of food. Intestinal peristalsis increases - its muscles contract to ensure the passage of food through the gastrointestinal tract. At this stage, the feeling of hunger intensifies even more.

When food enters the stomach, it irritates special receptors. They transmit this information to the food center and there a feeling of fullness and pleasure from eating arises. We understand that we have eaten enough and it’s time to stop.

If the functioning of the food center is disrupted, bulimia develops. Scientists put forward several hypotheses for the development of the disease:

• Receptors in the food center are too sensitive to low blood sugar levels - appetite appears too early.
• The impulse from the receptors in the stomach does not pass well along the chain of nerve cells due to problems at the point of their connection (synapse) - a feeling of satiety does not occur.
• The various structures of the food center do not work coherently.

There are 2 manifestations of appetite:

1. General appetite– you react positively to any food. It arises from the fact that “hungry” blood, which has few nutrients, washes sensitive nerve cells (receptors) in the brain in the hypothalamus region. Violations of this mechanism lead to the appearance of a form of bulimia, in which a person absorbs everything and has a constant appetite.


2. Selective appetite– you want something specific: sweet, sour, salty. This form is associated with a lack of some nutrients in the body: glucose, mineral salts, vitamins. This form of appetite comes from the cerebral cortex. On its surface there are areas responsible for the formation of eating behavior. A failure in this area causes periodic bouts of overeating certain foods.

Causes of bulimia

Bulimia is a mental illness. Often it is based on psychological trauma, as a result of which the functioning of the food center is disrupted.

1. Psychological trauma in childhood
   • the baby in infancy often experienced hunger;
   • the child did not receive enough parental love and attention in childhood;
   • the teenager does not have good relationships with peers;
   • parents rewarded the child with food for good behavior or excellent grades.
   In such situations, the child formed the concept that the main way to obtain pleasure is food. Eating is safe, pleasant, accessible. But such an attitude violates the basic rule of healthy eating: you need to eat only when you are hungry, otherwise the food center begins to fail.
2. Low self-esteem, which is based on flaws in appearance
   • parents convinced the child that he was too fat and needed to lose weight to become beautiful;
   • criticism from peers or a coach about appearance and excess weight;
   • A teenage girl's realization that her body is not like that of a magazine cover model.
   Many girls overly strive to have a model appearance. They are sure that a thin figure is the key to a successful career and personal life. Therefore, they resort to various methods of losing weight.
   A high risk of developing bulimia exists in suspicious people who try to control all events.
3. Effects of stress and high anxiety

   Bulimia attacks can occur after stressful situations. During this period, a person tries to forget with the help of food, to give himself at least a little pleasure. Often this can be done. After all, after eating, a large amount of glucose enters the brain and the concentration of “pleasure hormones” increases.

   Stress can be negative: loss of a loved one, divorce, illness, failure at work. In this case, food remains the only pleasure that helps to calm down. Sometimes pleasant events can trigger bulimia: a promotion on the career ladder, a new romance. In this case, overeating is a feast of joy, rewarding oneself for one’s merits.

4. Nutrient deficiencies

   Among bulimics there are a lot of women who constantly adhere to a diet. Such a restriction in food leads to the fact that a person cannot think about anything other than food. At a certain point, there is no more strength left to endure. The subconscious mind gains control of the situation and gives permission to eat in reserve. The body seems to understand that soon you will repent, and then hungry times will begin again.

   Episodes of uncontrolled binge eating occur in patients with anorexia. In this case, refusal to eat and aversion to foods is replaced by an attack of bulimia. Thus, the body, bypassing consciousness, tries to replenish the reserves of useful substances that were depleted during the hunger strike. Some psychologists believe that bulimia is a mild version of anorexia, when a person cannot completely refuse food.

5. Protection from pleasures

   It happens that a person is not used to giving himself pleasure. He considers himself unworthy of happiness or is convinced that pleasant moments are always followed by retribution. In this case, bulimia attacks play the role of self-punishment after sexual pleasure, relaxation or pleasant shopping.

6. Heredity

   If several generations of one family suffer from bulimia, then they talk about a genetic predisposition to this disease. The reason may be that the tendency to periodically overeat is inherited. It is caused by the peculiarity of the endocrine system and the lack of hormones that control appetite or the increased sensitivity of the receptors of the food center in the hypothalamus.

   In most cases, a person suffering from bulimia cannot realize what is driving him to an attack. If you find this trigger, you can take measures to keep your appetite in check, preventing attacks.

What happens during a bulimia attack

Before an attack, severe hunger or rather a craving for food appears. It happens that a person wants to eat only with his brain, although his stomach is full. This manifests itself in the form of obsessive thoughts about certain dishes, prolonged examination of products in the store, and dreams about food. The person loses the ability to concentrate on school, work or personal life.

Left alone, the patient pounces on food. He eats quickly, not paying attention to the taste of foods, which sometimes do not fit together at all or may be spoiled. Usually preference is given to sweets and other high-calorie foods. Due to the fact that the feeling of fullness disappears, the feast can continue until the food runs out.

After eating, bulimics feel that their stomach is full. It puts pressure on the internal organs, props up the diaphragm, compresses the lungs, preventing breathing. A huge amount of food causes spasms in the intestines, which are accompanied by severe pain. Euphoria is replaced by a feeling of remorse and shame, as well as fear of gaining a little weight.

In order to prevent the calories eaten from being absorbed, there is a desire to induce vomiting. Getting rid of excess food brings physical relief. To lose weight, sometimes a decision is made to take diuretics or laxatives. They remove from the body not only water, which is vital, but also mineral elements.

If at the initial stage bulimics overeat only after stress, then the situation worsens. Attacks become more and more frequent, 2-4 times a day.

Most victims of bulimia suffer greatly, but cannot give up their habit and carefully hide their secret from others.

Symptoms and signs of bulimia

Bulimia is a disease, like alcoholism and drug addiction, and not just bad behavior. It was officially recognized as a disease relatively recently, 20 years ago. The diagnosis of bulimia is made based on a thorough interview. Additional research methods (ultrasound of the abdominal organs, electrocardiography, computed tomography of the head) are necessary if there are disturbances in the functioning of the internal organs. A biochemical blood test allows you to determine whether the water-salt balance is disturbed.

There are 3 clear criteria on which it is based Diagnosis of bulimia.

1. Food cravings that a person cannot control and result in eating large amounts of food in a short period of time. However, he does not control the amount he eats and cannot stop
2. To avoid obesity, a person takes inadequate measures: induces vomiting, takes laxatives, diuretics, or hormones that reduce appetite. This happens about 2 times a week for 3 months.
3. A person develops low body weight.
4. Self-esteem is based on body weight and shape.

Bulimia has many manifestations. They will help determine if you or someone you love is suffering from this disease.
Signs of bulimia:

• Conversations about excess weight and healthy eating. Since people's figure becomes the center of self-esteem, all attention is concentrated around this problem. Although bulimics often do not suffer from excess weight.
• Obsessive thoughts about food. A person, as a rule, does not advertise that he likes to eat. On the contrary, he carefully hides this fact and officially adheres to a healthy diet or some newfangled diet.
• Periodic weight fluctuations. Bulimics can gain 5-10 kilograms, and then lose weight quite quickly. These results are not due to the fact that overeating has stopped, but to the fact that measures are being taken to get rid of the calories eaten.
• Lethargy, drowsiness, deterioration of memory and attention, depression. The brain experiences a glucose deficiency, and nerve cells suffer from a lack of nutrients. In addition, worries about excess weight and bouts of overeating place a heavy burden on the psyche.
• Deterioration of the condition of teeth and gums, ulcers in the corners of the mouth. Gastric juice contains hydrochloric acid. During attacks of vomiting, it eats away the mucous membrane of the mouth and ulcers appear on it. Tooth enamel turns yellow and erodes.
• Hoarseness of voice, frequent pharyngitis, sore throats. The vocal cords, pharynx and tonsils become inflamed after injuries that occur during bouts of vomiting.
• Esophageal spasm, heartburn. Frequent vomiting damages the surface layer of the esophagus and impairs the functioning of the muscles that prevent food from rising up from the stomach (sphincters). In this case, the acidic gastric juice burns the inner lining of the esophagus.
• Burst blood vessels in the eyes. Red spots or streaks on the white of the eye under the conjunctiva appear after blood vessels rupture during vomiting, when blood pressure temporarily increases.
• Nausea, constipation or intestinal disorders. These disorders are associated with overeating. Frequent vomiting or taking laxatives disrupts bowel function.
• Inflammation of the parotid salivary gland as a result of frequent vomiting. High blood pressure interferes with the normal outflow of saliva, and stomatitis and other damage to the oral mucosa contribute to the penetration of microbes into the salivary gland.
• Seizures, heart and kidney problems associated with a deficiency of sodium, chlorine, potassium, phosphorus, and calcium salts. They are washed out in the urine when taking diuretics or do not have time to be absorbed due to vomiting and diarrhea, depriving cells of the ability to function normally.
• The skin becomes dry, premature wrinkles appear, and the condition of hair and nails deteriorates. This is due to dehydration and mineral deficiency.
• Menstrual irregularities and decreased libido, erection problems in men. Deterioration of metabolism leads to hormonal disruptions and disruption of the genital organs.

Complications of bulimia can be very dangerous. Victims of the disease die from cardiac arrest in their sleep due to salt imbalance, from stomach contents entering the respiratory system, from rupture of the stomach and esophagus, or from kidney failure. Severe alcohol and drug addiction and severe depression often develop.

Treatment for bulimia

Bulimia is treated by a psychotherapist or psychiatrist. He decides whether it is necessary to go to the hospital or to be treated at home.

Indications for inpatient treatment of bulimia:

• thoughts of suicide;
• severe exhaustion and severe concomitant diseases;
• depression;
• severe dehydration;
• bulimia that cannot be treated at home;
• during pregnancy, when there is a threat to the life of the child.

The best results in the fight against bulimia nervosa are achieved by an integrated approach that combines psychotherapy and drug treatments. In this case, it is possible to restore a person’s mental and physical health within several months.

Treatment with a psychologist

The treatment plan is drawn up individually for each patient. In most cases, it is necessary to undergo 10-20 psychotherapy sessions 1-2 times a week. In severe cases, meetings with a psychotherapist will be necessary several times a week for 6-9 months.

Psychoanalysis of bulimia. The psychoanalyst identifies the reasons that caused the change in eating behavior and helps to understand them. These may be conflicts that occurred in early childhood or contradictions between unconscious attractions and conscious beliefs. The psychologist analyzes dreams, fantasies and associations. Based on this material, he reveals the mechanisms of the disease and gives advice on how to resist attacks.

Cognitive behavioral therapy in the treatment of bulimia it is considered one of the most effective methods. This method helps to change thoughts, behavior and your attitude towards bulimia and everything that happens around you. In classes, a person learns to recognize the approach of an attack and resist obsessive thoughts about food. This method is perfect for anxious and suspicious people for whom bulimia brings constant mental suffering.

Interpersonal psychotherapy. This treatment method is suitable for those people whose bulimia is associated with depression. It is based on identifying hidden problems in communicating with other people. A psychologist will teach you how to get out of conflict situations correctly.

Family therapy Bulimia helps improve family relationships, eliminate conflicts and establish proper communication. For a person suffering from bulimia, the help of loved ones is very important, and any carelessly thrown word can cause a new attack of overeating.

Group therapy bulimia. A specially trained psychotherapist creates a group of people suffering from eating disorders. People share their medical history and experience of dealing with it. This gives a person the opportunity to increase their self-esteem and realize that they are not alone and others also overcome similar difficulties. Group therapy is especially effective at the final stage to prevent recurrent episodes of overeating.

Monitoring food intake. The doctor adjusts the menu so that the person receives all the necessary nutrients. Those foods that the patient previously considered prohibited for himself are introduced in small quantities. This is necessary in order to form the right attitude towards food.

It is recommended to keep a diary. There you need to write down the amount of food eaten and indicate whether there is a desire to sit down again or the urge to vomit. At the same time, it is advised to increase physical activity and engage in play sports, which help to have fun and get rid of depression.

Remote Internet treatment for bulimia. Work with a psychotherapist can take place via Skype or email. In this case, methods of cognitive and behavioral therapy are used.

Treatment of bulimia with medications

Used to treat bulimia antidepressants, which improve the conduction of a signal from one nerve cell to another through special connections (synapses). Remember that these drugs slow down your reaction time, so do not drive and avoid jobs that require high concentration during treatment. Antidepressants do not mix with alcohol and can be very dangerous when taken together with other medications. Therefore, tell your doctor about all the drugs you use.

Selective serotonin reuptake inhibitors

They improve the conduction of nerve impulses from the cerebral cortex to the food center and further to the digestive organs. They relieve symptoms of depression and help to objectively assess your appearance. But the effect of taking these medications occurs after 10-20 days. Do not stop treatment on your own or increase the dose without your doctor's approval.

Prozac . This drug is considered the most effective treatment for bulimia. Take 1 capsule (20 mg) 3 times a day, regardless of meals. The daily dose is 60 mg. The capsule should not be chewed and should not be taken with sufficient water. The duration of the course is determined by the doctor individually.

Fluoxetine . 1 tablet 3 times a day after meals. Minimum course 3-4 weeks.

Tricyclic antidepressants ,

They increase the concentration of adrenaline and serotonin in synapses, improve the transmission of impulses between nerve cells. They have a strong calming effect, help get rid of depression, and reduce bouts of overeating. A lasting effect occurs after 2-4 weeks. Unlike the previous group of drugs, they can cause heart problems.

Amitriptyline . The first days take 1 tablet 3 times a day with meals. Then the dose is doubled, 2 tablets 3 times a day. Duration of treatment is 4 weeks.

Imizin . Begin treatment with 25 mg 3-4 times a day after meals. The dose is increased daily by 25 mg. The doctor sets the daily dose for each patient individually; it can reach 200 mg. Course duration is 4-6 weeks. Then the dose is gradually reduced to the minimum (75 mg) and treatment is continued for another 4 weeks.

Antiemetics (antiemetics) in the treatment of bulimia

At the initial stages of treatment, it is recommended to take antiemetics to quickly suppress the gag reflex while antidepressants have not yet begun to act. Antiemetics disrupt signal transmission from the vomiting center, which is located in the medulla oblongata to the stomach, and block dopamine and serotonin receptors. Thanks to this, it is possible to avoid vomiting, which can be caused by certain types of food in bulimics.

Cerucal . Take half an hour before meals 3-4 times a day. The course of treatment is from 2 weeks. The drug not only reduces nausea, but also normalizes the functioning of the digestive system.

Zofran . Does not have a sedative effect and does not cause drowsiness. Take 1 tablet (8 mg) 2 times a day for 5 days.

Remember, treating bulimia is a long process that requires patience and faith in success. Learn to accept your body as it is and lead an active and fulfilling life. You will achieve the final victory over the disease when you learn to rejoice and get pleasure not only from eating food.

Appetite forms the hunger center, which includes 3 sections. Here, with the help of special cells, the concentration of glucose and other elements is controlled. But under the influence of certain factors, the disease bulimia nervosa develops, in which the patient consumes an unlimited number of foods and regularly takes laxatives.

Understanding the characteristics of bulimia, what it is, what causes the disease, allows you to prevent its development.

What is bulimia?

Bulimia is a pathology caused by a neuropsychiatric disorder. The disease manifests itself in the form of a person’s uncontrollable desire to constantly consume large amounts of food. Bulimic neurosis is characterized by several symptoms:

• frequent attacks of insatiable hunger;
• a person’s desire to get rid of what he has eaten by taking laxatives;
• attempts to induce vomiting;
• self-critical attitude towards oneself, low self-esteem, constant feeling of guilt.

The course of the disease is accompanied by depression. Due to a person’s desire to normalize body weight and get rid of gained kilograms, pathologies such as bulimia often develop simultaneously.

Malnutrition provokes swelling of the parotid shell. Frequent vomiting causes chronic irritation of the throat, and taking medications and insufficient intake of nutrients leads to tooth loss, muscle pain and constant fatigue.

During treatment for bulimia, it is important to establish the cause of the pathology. This disease can be provoked by organic damage to the brain or factors affecting the state of the nervous system. If we consider everything about bulimia, we can say that this pathology is one of the varieties of obsessive-compulsive disorder (more precisely, addiction).

An important sign of the disease is a lack of feeling of satiety or a constant feeling of hunger.

Types of bulimia

Bulimia nervosa is divided into:

1. Primary. Develops due to exposure to provoking factors.
2. Bulimia, which occurs against the background of anorexia, which also often causes an uncontrollable desire to eat, but there is no feeling of satiety.

The disease is classified into two types, determined by the patient’s behavior:

1. After another excessive consumption of food, he takes measures aimed at cleansing the stomach (taking laxatives, inducing vomiting).
2. Instead of cleansing the stomach, he adheres to a special diet, through which he controls his own weight.

The pathology has several stages.

Initially, the disease manifests itself in the form of uncontrolled bouts of gluttony (no more than 1-2 times a month).

Later, the frequency of such episodes increases, leading to chronic bulimia.

Causes of the disease

To fully understand the characteristics of bulimic neurosis, it is necessary to address the causes of the development of the disease. Factors causing bulimia are often hidden in childhood psychological trauma. In particular, the following reasons can lead to the development of pathology:

All this contributes to the development of an inferiority complex, which is relieved through food. This condition is most typical for women aged 15-28 years. However, in recent years, bulimia has been increasingly diagnosed in male patients.

Often, bulimic neurosis occurs when a person limits himself to food for a long time.

Among the possible causes of the disorder are low self-esteem, which is developed both by the teenager himself and his environment. Moreover, the patient begins to be critical only of his own appearance, not always affecting other aspects of mental activity. For example, a girl has a strong desire to get a figure like a model. This leads to constant dieting, which is often accompanied by “breakdowns.”

Another factor of low self-esteem is attempts to protect oneself from pleasures, through self-punishment to refuse joyful and pleasant events. In this case, a person tries to normalize his mental state by eating large amounts of food.

Possible causes of the disease include micronutrient deficiency. The brain gives a signal about the need to accumulate reserves and a person begins to consume food in unlimited quantities, thereby trying to protect himself from possible hunger. This is why frequent and strict diets are dangerous.

In some cases, bulimia develops due to a hereditary predisposition. Some genetic disorders cause endocrine system dysfunction, resulting in a deficiency of hormones that control appetite.

Symptoms

The disease usually develops under the influence of factors affecting mental and physical health, so bulimic neurosis is diagnosed by the following symptoms:

1. Uncontrollable food cravings. The patient does not monitor the amount of food consumed.
2. Taking laxatives or vomiting frequently to lose weight (more than twice a week for three months).
3. Switching to a strict diet, using hormones that reduce appetite.
4. Body weight does not correspond to normal values.

In addition to the listed signs of bulimia nervosa, symptoms of this disorder include a preoccupation with one's own shape and body weight. The patient constantly talks about food and the need for a healthy diet. He has obsessive thoughts related to the need for food. Moreover, he carefully hides this fact. The patient also experiences weight fluctuations ranging from 5-10 kg.

The presence of bulimia is indicated by indiscriminate eating. The patient even consumes spoiled foods, preferring high-calorie dishes. Overeating causes intense pain in the abdominal area. At this moment, the euphoria that arose due to saturation is replaced by a feeling of guilt (the patient becomes depressed). The patient then induces vomiting or takes laxatives and other drugs.

What diseases can bulimia nervosa cause?

Due to a lack of nutrients and frequent vomiting, the following phenomena begin to worry over time:

• pathologies of the oral cavity;
• decreased concentration and memory;
• persistent fatigue;
• frequent sore throats, colds;
• hoarse voice;
• heartburn, stomach cramps;
• burst blood vessels in the eyes;
• constipation, intestinal upset;
• enlargement of the parotid gland due to the course of the inflammatory process;
• limb spasms;
• dysfunction of the kidneys and heart muscle;
• dry skin, hair loss;
• decreased libido (in men);
• menstrual irregularities (in women).

A person suffering from the disease is diagnosed with mumps, chronic pathologies of the gastrointestinal tract, and endocrine diseases.

Therapy

Bulimic neurosis is treated by a psychotherapist or psychiatrist after identifying the reasons why bulimia occurs. In advanced cases, the participation of specialized specialists is required. Treatment for bulimia is mainly carried out at home.

Medicines taken as part of the chosen therapy are prescribed by the doctor.

If bulimia cannot be cured with medications or the disease poses a threat to the health and life of the patient (the child when therapy is carried out for a pregnant woman), the doctor decides to place the patient in a hospital.

Drug treatment

Antidepressants for bulimia form the basis of treatment. These drugs improve the conduction of nerve impulses between cells.

In most cases, selective serotonin reuptake inhibitors are used in treatment for bulimia. Medicines in this group improve the passage of nerve impulses from the brain to the centers responsible for the functioning of the digestive organs. Below is a list of over-the-counter pills:

An attack of bulimia can be stopped with the help of tricyclic antidepressants (Amitriptyline, Imizin). Medicines in this group increase the concentration of adrenaline and serotonin, thereby accelerating the transmission of impulses between cells. Also, tricyclic antidepressants calm the nervous system, eliminate depression and reduce the craving for gluttony. A lasting effect of treatment with these drugs is achieved within 2-4 weeks.

Antidepressants for bulimia should be prescribed by a doctor. Uncontrolled use of drugs provokes heart pathologies and other serious complications.

If the disease is diagnosed at the initial stage of development, antiemetic drugs (antiemetics) are used. These drugs (Zofran, Cerucal) are recommended for use during a period when treatment with antidepressants has not produced a lasting effect.

Psychotherapy

Treatment of bulimic neurosis by a psychologist is carried out according to an individual program, which is drawn up taking into account the characteristics of each specific case. Typically, 10-20 sessions are enough for the patient to fully recover.

Bulimic neurosis is treated with:

1. Psychoanalysis. The method involves identifying the causes of the development of bulimia.
2. Cognitive behavioral therapy. It is considered one of the most effective techniques. Such therapy involves changing the patient’s attitude towards himself and his own environment, current events and other factors that provoke cravings for food.
3. Interpersonal psychotherapy. The method is indicated for cases where bulimia occurs simultaneously with depression.
4. Family therapy. Within the framework of this approach, contradictions and conflicts between close people are eliminated.
5. Group therapy. This method is effective at the final stage of general treatment.

During treatment, the doctor adjusts the patient’s daily diet, including healthy foods and dishes (in small quantities) in which the patient limited himself.

Prevention and prognosis

Bulimia nervosa is treatable. However, the effectiveness of therapy directly depends on the patient's behavior. If the patient refuses the prescribed treatment or stops taking antidepressants prematurely, severe consequences of bulimia develop: cardiovascular disorders, depression, internal bleeding. In advanced cases, the patient dies from kidney failure or other pathologies.

An illness such as bulimia requires correction of the psycho-emotional state. In most cases, pathology develops due to nervous disorders associated with childhood trauma or stress. In this regard, to prevent the disease, it is necessary to eliminate provoking factors through psychotherapy.

Bulimia or kinorexia is a type of mental illness. It is based on an eating disorder expressed in the form of uncontrolled overeating. To relieve the consequences of excess food consumption, patients resort to the use of various compensatory mechanisms: they take laxatives, induce vomiting, and resort to heavy physical activity. Most of the life of patients is focused on their own attitude towards food, counting calories, analyzing their nutrition, and controlling body weight.

Kinorexia refers to disorders of neuropsychic activity, and the disease directly affects the functioning of the digestive tract. Patients suffering from this disorder experience frequent breakdowns. During such crises, the patient consumes huge amounts of food in a short time. Sometimes the amount of food eaten is so large that a person begins to vomit. In other cases, the patient himself tries to immediately remove food masses from the gastrointestinal tract. For this purpose, laxatives and diuretics, cleansing enemas, and various methods for inducing vomiting are used.

After overeating, the patient experiences a strong feeling of guilt, which forces the person to engage in excessive physical activity, sharply reduce the amount of food consumed, and take all kinds of weight loss measures. This period usually ranges from several days to 5-6 months, after which another crisis follows. As the disease progresses, eating disorders occur more frequently.

Attention! This lifestyle quickly depletes the patient’s body, which leads to disruption of various systems. Without treatment, death can occur.

Bulimia occurs as a result of the patient developing one of two types of disorders:

• organic pathologies in which polyphagia develops, that is, uncontrolled hunger: deviations of the hypothalamic-pituitary function, epileptoid disorders, endocrine pathologies, brain tumors and various lesions of the central nervous system;

• mental illnesses: psychopathy, various forms of neuroses, depression and schizoid disorders.

Kinorexia is an addictive disorder. If the disease has developed as a result of mental pathologies, then there is an extremely high probability that it has social roots and is determined by the ideas of a certain social group about beauty standards.

Attention! Addictive disorders are forms of deviant behavior caused by the presence of obsessive ideas in the patient.

Kinorexia is diagnosed several times more often in women than in men. At the same time, the number of cases is increasing every year. When examined, patients are shown to be fixated on two main ideas: food and the need to reduce their body weight. Patients may spend several hours in a row thinking about their favorite dishes or spend a long time in stores, choosing the products they like. At the same time, people suffering from bulimia experience an obsessive feeling of guilt after every meal, and are constantly engaged in the selection of diets, exercises and procedures to lose weight.

Kinorexia causes rapid depletion of the body's resources. Therefore, the patient’s health deteriorates sharply against the background of stress, lack of food and excess stress. Bulimia is dangerous due to the development of a large number of complications: dysfunction of the immune system, severe forms of anemia, hypovitaminosis, destruction of bone tissue, etc.

As the disease progresses, the patient develops a pathological addiction to certain foods. Only when eating food does he release a large amount of endorphins. As a result, a psychological fixation is formed: pleasure can be obtained from food. The patient begins to increase the volume of dishes in order to prolong the pleasant sensations. Over time, the quality and taste of food gradually lose their paramount importance; for the patient, the quantity of food begins to play a major role. In this case, the patient uses food as a way to relieve discomfort.

The biological disorder of kinorexia occurs when the mechanism for regulating hunger and satiety is disrupted. The patient's appetite ceases to be based on natural physiological parameters: the content of sugars in the blood plasma, the presence of chyme in the digestive tract, and the fullness of the stomach. In people suffering from bulimia, hunger persists almost constantly and increases significantly as a result of stress or psychological experiences.

Classification of bulimia

Today in medical practice there are several types of kinorexia.

Types of filmrexia

Type	Image	Characteristics of the disease	Features of the pathology
		It occurs in the form of frequent attacks of uncontrolled overeating and constant hunger. Seizures are usually weakly related to changes in the patient’s psychological state	Often organic in nature
		Patients due to mental disorders periodically experience “breakdowns”, which are accompanied by excessive absorption of food, after which the patient develops a strong feeling of guilt	Formed against the background of anorexia nervosa

In this case, kinorexia nervosa can be expressed in two ways:

1. Forced cleansing of the gastrointestinal tract. After eating, patients provoke attacks of vomiting, take laxatives, and give enemas.
2. Diets. Patients try to lose weight by following a diet. However, dietary restrictions lead to bouts of compulsive overeating. After this, patients try to make their diet even more meager, which ultimately again leads to uncontrolled gluttony.

Attention! Depending on the form of kinorexia, the specialist selects the therapy regimen necessary for a particular patient.

Symptoms of the disease

Bulimia was identified as an independent disease about 25 years ago. It refers to eating disorders, that is, a condition in which the patient cannot independently control his or her eating. When diagnosing, the pronounced symptoms of this pathology are of paramount importance, since the presence of the disease is established based on the results of interviewing the patient and monitoring his condition.

Attention! Auxiliary examination methods for diagnosing kinorexia are ultrasound examination of the abdominal organs, computed tomography, ECG, and FGDS. These procedures make it possible to determine the presence of pathologies of the gastrointestinal tract and cardiovascular system.

There are four main signs, the presence of which allows us to determine the presence of kinorexia in a patient:

1. Pathological cravings for food. In this case, the patient is not able to control his need for food, which is why he consumes an abnormally large amount of food over a short period of time.
2. Reluctance to eat in the presence of other people. In some cases, patients can physically eat food only alone. Otherwise, due to spasm of the muscles of the esophagus and stomach, they begin to vomit.
3. A person takes inadequate measures to combat excess weight. Instead of giving up excess nutrition, the patient engages in excessive physical activity, tries to follow strict diets, and takes laxatives or appetite suppressants.
4. The patient's self-esteem directly depends on his body weight. Moreover, even a slight increase in weight can lead to a nervous breakdown.

There are also many secondary signs on the basis of which we can talk about the development of kinorexia in a patient. They can be divided into two groups: behavioral and physiological.

Behavioral symptoms

1. Eating a large amount of food at one time, hastily devouring food.
2. Desire to leave the table immediately after eating. Typically this behavior is driven by the need to induce vomiting as quickly as possible.
3. Closedness, secrecy, nervousness when trying to discuss the patient’s psychological state.
4. Constant passion for diets, discussion of various weight loss techniques, counting calories.
5. Exhausting physical exercise. Often, after an attack of overeating, bulimics, tormented by feelings of guilt, can engage in running, gymnastics or swimming for several hours.
6. The use of drugs for weight loss, laxatives and diuretics, emetics, etc.
7. Decreased libido, refusal of romantic relationships and sexual activity.

Physiological symptoms

Physiological signs occur when the patient completely loses control over his eating behavior. As the disease progresses, symptoms become more pronounced:

• lesions of the gastrointestinal tract: gastritis, duodenitis, diarrhea or constipation, pharyngitis and stomatitis;
• tooth decay, the appearance of wounds and abrasions on the oral mucosa;
• women experience menstrual irregularities, most often amenorrhea;

Attention! Amenorrhea is the absence of menstruation for several months. In patients with bulimia, a similar condition appears as a result of hormonal imbalance or critical weight loss.

• frequent fluctuations in body weight within 5-10 kilograms;
• lymphadenitis - enlarged lymph nodes behind the ears and in the neck;
• proliferation of the salivary glands, drooling;
• constant vomiting that occurs even after eating a small amount of liquid food;
• dehydration, which is manifested by dry skin and hair, brittle nails, and the appearance of acne;
• skin rash;
• anemia as a result of a deficiency of protein and B vitamins in the body.

Patients with bulimia are often diagnosed with co-occurring mental disorders, such as depression or obsessive-compulsive disorder.

Signs of a bulimia attack

With kinorexia nervosa, a characteristic symptom of the disease is bouts of overeating. As the disease progresses, the patient experiences such breakdowns more and more often. The impetus for uncontrolled absorption of food is the growing need for food. It can manifest itself as obsessive thoughts about favorite foods, dreams, deterioration in well-being, and irritability.

As a result, the patient acquires a large number of products, which he eats when left alone. When eating food, a person pays little attention to its taste, taste and quality. The patient eats until he runs out of food.

After the attack ends, the person feels a sharp deterioration in health. His stomach is full, which puts pressure on other organs and the anterior wall of the abdominal cavity. In order to somehow normalize his condition, the patient provokes vomiting. In this case, the patient’s euphoric state is quickly replaced by a feeling of guilt and fear of gaining weight.

Attention! As the disease progresses, bouts of overeating become more frequent. In patients in serious condition they reach 4-5 times a day.

Bulimia requires complex treatment. The basis of therapy is determined by the psychotherapist. However, to relieve the consequences of the disease, patients also need the supervision of a gastroenterologist, endocrinologist and neurologist. At the same time, kinorexia can be treated both on an outpatient basis and in a hospital setting.

Indications for hospitalization are the presence of the following abnormalities in the patient:

• suicidal thoughts or suicide attempts;
• the presence of severe secondary diseases;
• severe hypovitaminosis and dehydration;
• lack of effect from outpatient treatment of pathology;
• bulimia diagnosed in the patient during gestation.

Therapy for kinorexia involves a combination of pharmacological agents and psychotherapeutic methods. On average, such treatment takes from one month to a year. After recovery, the patient is recommended to visit a psychotherapist or psychologist for several years.

Therapy with a psychotherapist

Psychotherapy is selected individually for each patient. On average, patients are advised to undergo consultations 2-3 times a week for 4-5 months.

Treatment includes both individual sessions and group classes using the following methods:

Therapy with pharmacological drugs

Pharmacological treatment of kinorexia involves the use of antidepressants, drugs for the treatment of gastritis and peptic ulcers, and antiemetics.

Attention! The vast majority of antidepressants cannot be combined with alcohol-containing drinks. These medications also impair attention, so you should avoid driving during treatment.

Patients with kinorexia can be prescribed the following groups of pharmacological agents.

Drugs for the treatment of kinorexia

Group	Action	Drugs	Image
SSRIs - antidepressants	Relieves depression, improves overall well-being and promotes an adequate perception of one’s own body	Fluoxetine: prescribed 1 tablet 2-3 times a day for 3-4 weeks; Fluvoxamine: take 1-2 tablets per day, treatment period is up to 6 months; Citalopram: should be used 1 tablet per day for six months or more
Tricyclic antidepressants	Have a strong sedative effect, help minimize bulimic attacks	Amitriptyline: dosage is on average 1 tablet three times a day for a month; Imizin: prescribed 1 tablet 3-4 times a day for 4-8 weeks; Clomipramine: take 1 tablet three times a day for 1-3 months
Antiemetic drugs	Relieves attacks of nausea and vomiting and helps improve nutrition for patients with bulimia	Cerucal: take 1-2 tablets 2-4 times a day, the course of treatment is at least two weeks; Zofran: use 1 tablet twice a day for 5 days
Antacids	Agents that neutralize hydrochloric acid. Necessary for erosive changes in the gastric mucosa	Almagel: take 1 measuring spoon 3-4 times a day for three months; Maalox: use one tablespoon 3-4 times a day for no more than 90 days

Attention! The selection of drugs to relieve bulimia is prescribed individually, taking into account the psychological and physiological state of the patient. Please note that some medications cannot be combined with each other.

Bulimia is a psycho-neurological disorder that leads to eating disorders in the patient. The disease requires complex treatment using both psychotherapy and pharmacological drugs.

Video – Bulimia Nervosa

Video - Bulimia