Bulimia Nervosa: Abnormal Psychology One

Bulimia Nervosa: Abnormal Psychology

One of the most well-publicized, yet little known disorders of abnormal psychology is that of bulimia nervosa. Although jokes about bulimia, particularly in the regards to slender young models and actresses, are common, the causes and methods of treatment of the disease remain elusive. Also, sufferers of eating disorders are notoriously unreliable in terms of reporting their behaviors accurately to therapists, and may only be placed into treatment under duress or pressure from friends and family. They may be ambivalent about abandoning their behaviors unlike many other people suffering from mental illnesses. This makes effectively diagnosing and treating bulimia even more difficult.

According to the DSM-IV, the "Diagnostic criteria for 307.51 Bulimia Nervosa" are as follows:

Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following: eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances a sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating) Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, enemas, or other medications; fasting; or excessive exercise. The binge eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for 3 months. Self-evaluation is unduly influenced by body shape and weight.

The disturbance does not occur exclusively during episodes of Anorexia Nervosa.

Specify type:

Purging Type: during the current episode of Bulimia Nervosa, the person has regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas

Nonpurging Type: during the current episode of Bulimia Nervosa, the personas used other inappropriate compensatory behaviors, such as fasting or excessive exercise, but has not regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas. ("Bulimia Nervosa," DSM-IV, 2000)

The qualifications regarding Bulimia Nervosa in terms of "type" are meant to distinguish it from a diagnosis of Anorexia Nervosa, an eating disorder characterized by self-starvation. A purging anorexic may engage in inappropriate compensatory behaviors, but there is no time frame as for bulimia nervosa, as to be diagnosed with bulimia, the person must engage in purging or inappropriate compensatory behavior at least twice a week for 3 months. Anorexics also refuse to maintain a normal body weight (below 85% of normal body weight, according to the DSM-IV entry on the diagnosis of "Anorexia Nervosa"). Bulimics can be under, over, or of normal weight. Bulimia is also distinguished from binge eaters who do not engage in compensatory behavior afterwards.

The numbers of people suffering from bulimia is difficult to determine. "Research suggests that about four percent (4%), or four out of one hundred, college-aged women have bulimia. About 50% of people who have been anorexic develop bulimia or bulimic patterns" ("Statistics: How many people have eating disorders?" ANRED, 2007). Other estimates range around 3% (Rowan, 2006). The causes of Bulimia Nervosa are even more difficult to pinpoint. Some therapists believe that "the pressure to be thin and resulting abnormal eating patterns that are regarded as normal are probably partly to blame," and individuals in appearance-conscious jobs or weight-conscious sports such as wrestling, gymnastics, and running, have a higher incidence of bulimia (Rowan, 2006). Also, Western countries have higher rates of eating disorders than non-Western countries, and exposure to Western media correlates to a higher incidence of eating disorders in non-Western countries (Statistics: How many people have eating disorders?" ANRED, 2007).