Domain 1: Bulimia Nervosa

Eating disorder, Bulimia is an Axis I clinical disorder according to the Diagnostic and Statistical Manual of Mental Disorder also written as DSM-IV-TR. The story on this case analysis was performed on Wanda Hoffman a 24 year old woman who presented with the behavior since age 18 after she became a college student. She was overeating in the context of new academic and social demand then inducing vomiting and often skipping lunch meal. The behaviors she exhibited meet most criteria for a diagnosis of eating disorder, Bulimia. Because Wanda exhibits behaviors in each of the diagnostic criteria for eating, disorder, Bulimia it assists us in ruling out other diagnosis.

An equally disruptive eating disorder that has been seen in increasing numbers in recent years is Bulimia. About two percent of American women are affected by this disorder. Bulimia is characterized by a distinctive binging and purging cycle. Individuals with this disorder will often times consume large amounts of food, and the immediate throw it back up. These binging and purging actions have substantial medical risks. Additionally, some individuals consume large amounts of food and then proceed to exercise for exorbitant amounts of time. This can also be a risk to ones wellbeing. Other characteristics associated with Bulimia include the abuse of laxatives and diuretics. Individuals with this disease often times completely lose control over their dietary habits. The massive highs and lows cause emotional instability. The mood swings that

Eating disorder is a term used to describe several psychological disorders characterized by abnormal eating habits. Some of the most common eating disorders include anorexia nervosa, bulimia nervosa, and binge eating disorder. Anorexia nervosa is probably the most well-known of these. A person suffering from anorexia nervosa will obsess over weight gain and show unusual anxiety related to weight gain. Depending upon the type (binge-eating/purging type or restricting type) a person will either consume food and then attempt to “purge”, a term used to describe a method of forced removal of food from the body such as self-induced vomiting, or they will restrict the amount of food consumed. In most cases the person will be under healthy weight and often see themselves as average weight or even overweight. In bulimia nervosa and binge eating disorders the affected person will eat excessive amounts of food. People suffering from these diseases report feeling out of control during their binge eating episodes. In bulimia nervosa binge eating episodes are followed by some method of purging whereas in binge eating disorder they are not, although the person normally expresses feelings of guilt or embarrassment afterwards. People suffering from bulimia nervosa are usually average weight which can make detection difficult. Those with binge eating disorder are normally

According to the Mayo Clinic (2016), eating disorders are “conditions related to persistent eating behaviors that negatively impact your health, your emotions, and your ability to function in important areas of life.” One such eating disorder is anorexia nervosa. Not to be confused with anorexia, which is simply a general loss of appetite that can be attributed to many medical ailments, anorexia nervosa is a serious eating disorder and mental illness (Nordqvist, 2015). Anorexia nervosa is estimated to affect about .9% of women and .3% of men in their lifetime (“Eating Disorder Statistics & Research,” n.d.). In general, the disorder is commonly characterized by a distorted body image or self-concept, critically low weight (with respect to the patient’s height and age), and an irrational fear of becoming fat or an intense desire to be thin. There are two subtypes to this eating disorder: restrictive and binge/purge. In the restrictive type, the individual limits caloric intake and may compulsively over-exercise. In the binge/purge type, the individual consumes a considerable amount of food in a short period of time (binging) and then deliberately vomits (purging), takes laxatives, or fasts intensely in order to compensate for the food eaten (“General Information: Anorexia Nervosa,” n.d.). In either case, anorexia nervosa is undoubtedly a dangerous and alarming illness.

Bulimia is a cycle of binging and purging and its severity is based on the number of purges per week not on the thinness of the person (APA, 2013). They are similar in relation to body image, self-evaluation based on weight and body shape, and fear of being fat (APA, 2013). However, one of the criterion for anorexia is low body weight which is not a requirement for bulimia nervosa (APA, 2013). So to distinguish between the two, body weight is used. People with anorexia nervosa need lots of self-control and pride in what they are doing in order to get to the point they become severely underweight. This self-control explains one way that individuals with bulimia nervosa do not become

“Up to 30 million people of all ages and genders suffer from an eating disorder” (Wade, Keski- Rahkonen, & Hudson, 1995). There are many factors which contribute to the development of eating disorders including “biology, emotional health, and societal expectation, and other issues” (“Diseases and Conditions Bulimia nervosa”). One of the most prominent eating disorders in America and around the globe has been around since the Middle Ages: “Bulimia is first reliably described among the some of the wealthy in the Middle Ages who would vomit during meals so they could consume more” (“A History of Eating Disorders”). Today bulimia is more prevalent and is predicted to affect around “4% of women in the United States” (“Eating Disorder Statistics and Research”). In 1979, Gerald Russell published a description of bulimia nervosa. It was the first description of bulimia ever published. Only a year later in 1980 bulimia appeared for the first time in the Diagnostic and Statistical Manual of Mental Disorders-III.

Somewhere across the globe there are children waking up with empty stomachs, scavenging for any scrap of food they can find. For some people in America though, ironically enough, there are those who purposefully do not eat, or push back up what they have eaten. Women and men in the American society are influenced by a beauty ideal so powerful that has taken peoples lives through starvation, despite being surrounded by food. This phenomenon is known as bulimia. Bulimia, as defined by the Merriam Webster dictionary, is “a serious eating disorder … characterized by compulsive overeating usually followed

Most people with bulimia nervosa will become preoccupied with food and keep their habits a secret. Laura became so preoccupied with food and her weight that it affected her ability to complete her homework for college. She also spent great amounts of money to replenish the food she ate at night in an attempt to keep her problem from her roommates. Those with bulimia nervosa are almost always perfectionists that hold themselves to a very high standard, but lack confidence. This can be seen in Laura with the high expectations that her father has always put on her. Bulimia nervosa also tends to be genetic and it is easy to tell that her mother has struggled with eating disorders and body image issues. The only trouble I experienced while trying to diagnosis Laura is that eating disorders are usually co-morbid, but I haven’t been able to say for sure if she has

Bulimia nervosa is an eating disorder distinguished by its psychological, physiological, developmental, and social components. The disorder is characterized by binge eating shortly followed by harmful compensatory behaviors, such as abuse of laxatives, diuretics or enemas, stimulants, vomiting, fasting, or excessive exercise. This is known as the “Binge-Purge Cycle”. Unlike anorexia nervosa, those with bulimia nervosa fall within a normal or slightly overweight weight range and usually perform their eating disordered behaviors in secret due to the severe feelings of shame and disgust which accompany the binge-purge cycle. Due to the intensity of the combined mental and physical assault bulimia has on the body, complications of bulimia can stay with a patient long after recovery is achieved. Such complications include, but are not limited to: Decaying tooth enamel (tooth rot) due to the stomach acid constantly eroding the protective layering on the teeth; those who have suffered from this eating disorder for more than seven years (the average time of recovery for those with bulimia nervosa) have a great likelihood of rupturing either their stomach or

Purging Disorder is characterized by recurrent purging (self -induced vomiting, misuse of laxatives, diuretics, or enemas) to control weight or shape in the absence of binge eating episodes. (Forney, Haedt-Matt, & Keel, 2014) There are many behaviors associated with purging disorder such as binge eating which leads to loss of control, or overeating in anorexia nervosa. (Goldschmidt et al., 2015) Sociocultural and psychiatric factors are also believed to be important in the subject of weight concerns, dieting, and unhealthy weight control practices. (Simone et al., 1996; Symth et al., 2008)

Bulimia nirvana also called bulimia is a serious eating disorder that is mainly marked by binge eating and throwing up after to avoid weight gain. This eating disorder can start with someone not liking the way they look so they take matter in their own hands and start dieting as well as exercising but when that fails and they brake their diet they start eating excessive and then feel bad and make themselves throw up. When vomit “the body releases endorphins that is a natural chemical that makes you feel good after throwing up”. After going back to this over and over after binge eating it ends up becoming a habit. This habit now doesn't happen after eating excessively but just after regularly eating. Doesn't matter if they ate anything anymore

The first criterion defined in the DSM-V, the diagnostic and statistical manual of mental disorders, is the “restriction of energy intake relative to requirements, leading to a significantly low body weight in the contact of age, sex, developmental trajectory, and physical health. Significantly low weight is defined as a weight that is less than minimally normal or, for children and adolescents, less than that minimally expected” (Davison, Blankstein, Flett, & Neale, 2013). In other words, the energy intake would be lower than the energy needed for the body to function and assure normal activities of an individual. It results in the weight of the individual to fall below a normal weight when different characteristics as the age, sex, developmental trajectory and physical health are taken into consideration. Karen Carpenter respects the first criteria of anorexia nervosa. Indeed, as a child, Karen Carpenter was overweight and was worried about her weight but seemed to love sugar and eating more than

A second diagnosis for Kathie is Mild Binge Eating Disorder (BED) (F50.8). BED is characterized by recurrent episodes of binge eating in which the client eats a large amount of food in a two-hour period that most people would consume in a similar situation. There is sense of lack of control over the eating. The binge episodes one to three times a week for three months. The client must meet three of the five criteria listed in the DSM-V for BED which include eating more rapidly than normal, feeling uncomfortably full after binge eating (BE), eating when not hungry, feeling embarrassed, and feeling guilty, disgusted, or depressed after the binge eating episode. Additionally, there is a feeling of marked distress over the binge eating episode. There are no compensatory behaviors such as vomiting, using laxatives, medications or excessive exercise (APA, 2013). Kathie has been secretly struggling with an eating disorder (ED) for the last six months. She has meets 3 of the 5 criteria listed in the DSM-V including eating excessively until she feels uncomfortably full. After binge eating, she feels ashamed and helpless, which makes her more depressed. She feels a loss of control over her eating. She eats alone and feels guilty after binge

Brandy is a 21-year-old from Oklahoma City, Oklahoma. She is the oldest of four children and her parents have been married for the past twenty-two years. After suffering for the past seven years in silence, Brandy has finally sought out treatment for bulimia nervosa. Brandy is a textbook case of a patient suffering from bulimia. The Diagnostic and Statistical Manual of Mental Disorders (5th ed., DSM-5; American Psychiatric Association, 2013) diagnostic criteria includes: Persisting binge eating episodes, reoccurring behaviors to prevent weight gain, both harmful purging behaviors and binge eating episodes occurring at least once a week for a minimum for three months, evaluating oneself solely or predominantly influenced by one’s body shape and weight, and finally the patient must not exhibit the aforementioned symptoms during an episode of anorexia nervosa. Her difficulty with her weight started in high school with binge eating. Soon after starting to binge eat, she starting purging by forcing herself to puke. The roots of her disorder is in her persistent stress and anxiety as a result of her trying to strive to success.

I find your post very interesting and I really enjoyed how everything flows together. You made it very easy for me to understand how bulimia nervosa and anorexia nervosa are similar and how they are different. I was able to fully understand the concept of comorbid with the example that you included about your friend. I think this is a great example because it shows how more than one disorder can be present and it just informs how difficult it may be for someone who has to deal with such horrible symptoms and effects. You mentioned that “not only was she anorexic/bulimic, but she had depression tied to her condition” and this just shows the complexity of the human body and how we are vulnerable to disorders and abnormalities.