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Home Services Counselling – Psychotherapy Counselling & Treatment of Eating Disorders & Obesity

Bulimia Nervosa

What is Bulimia Nervosa?

Bulimia Nervosa is an eating disorder in which binge eating episodes often occur (at least twice a week) with the consumption of foods considered “fattening”, and therefore “forbidden”, by the person who is desperately trying to control their weight. Usually, during such an episode, large amounts of simple carbohydrates, snacks, sweets (e.g. bread, biscuits, chocolates, whole packets of breakfast cereals, many toasted breads with butter, potato chips, cakes, ice cream bowls) are consumed.

The person is eating impulsively and uncontrollably, much faster than normal while lacking the natural sense of hunger until the desire for food passes, stress is reduced, and often until she / he experiences an unbearable feeling of swelling.

After a bulimic episode the person feels guilt and disgust with herself / himself because of the excessive amount of food consumed. Subsequently she / he attempts to get rid of the consumed calories before they are absorbed by the body, through self-induced vomiting or by using laxatives, strenuous exercise and fasting for the next few days.

A description from a person with bulimia nervosa:

“It starts with thoughts of food I have forbidden myself to eat when I’m on a diet. It then changes into an intense desire to eat. At first, I feel relieved when I eat and I feel great. But then I can’t stop and I continue to eat shamefully to the point where I feel like my stomach is about to burst. After that I just feel guilty and angry with myself.” (Fairburn, 1995)

Physical and psychological impacts

Frequent purging and vomiting caused by the individual during bulimic episodes causes a disruption in the chemical balance of the body’s essential substances. For example, it may lead to an imbalance in electrolytes (necessary for the smooth functioning of the heart), including abnormal potassium levels with subsequent dehydration and irreversible damage to the heart, kidney and brain.

Fatigue, depression, aching muscles, light-headedness, sensitivity to cold, and gaining weight more easily are some of the consequences that occur due to blood sugar fluctuations as a result of eating too much simple carbohydrates (e.g., sugar, sweets etc.).

Other physical consequences of Bulimia Nervosa include:

  • irritation in the gastrointestinal tract that can even cause death
  • bloating in the salivary glands
  • tooth erosion
  • sore throat
  • severe bleeding of the oesophagus that may be caused by vomiting or by the means used to self-induce vomiting (e.g., finger)
  • stomach disorders
  • chronic bloating, constipation, and diarrhoea which persists for a long time even after the person stops using laxatives.

A common misconception by people with Bulimia is that laxatives prevent the absorption of calories consumed during Bulimia episodes, which they do not.

Read more about Bulimia here.

The treatment of Bulimia Nervosa

Excessive use of laxatives and self-induced vomiting occurring in Bulimia Nervosa, intended to compensate for Binge Eating episodes, have serious consequences for the health of the individual. These tactics, which at first are considered easy solutions to every Binge Eating episode, eventually end up becoming a real problem so the person is trapped in a prison from which she / he can’t escape. The objective of the specialised Bulimia Nervosa counselling and psychotherapy is to break free from the vicious cycle of the disorder and to adopt better defence mechanisms, a healthier lifestyle and way of thinking.

During treatment, the individual receives:

  • psycho-educationand correct explanation of the body’s functions (appetite, satiety, chemical imbalance that occurs because of bulimic episodes and the self-induced vomiting)
  • proper nutritional guidance, including acquisition of healthy behaviours towards the body and healthy eating habits
  • cognitivetherapy, for example, tracking negative thoughts, misconceptions and problematic attitudes in diet and eating habits, metabolism and the body, myths and realities
  • a strengthening of self-image
  • an improved body image, with the cultivation of positive thoughts and feelings towards the body
  • a strengthening of self-esteem and self-confidence
  • education on how to better cope with negative emotions
  • assertiveness training, with the person learning to enforce their rights and express their needs, if required
  • relaxation training and visualisation, with the person learning to relax the body and mind for the better treatment of stress, anxiety and negative thoughts and emotions
  • guidance during the stabilization phase
  • relapse prevention guidance

We may also collaborate with other specialists where necessary (e.g., doctors, nutritionists, etc.).

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