Bulimia Nervosa - Causes, Symptoms and Treatment .MF .
Bulimia - it's an eating disorder, consisting of a series of episodes of gluttony and vomiting, use of laxatives, etc.Uncontrolled relationship to food, and increase weight loss - only the visible symptoms of the disease.In fact, it is the result of severe mental health problems.
Bulimia is considered a relatively young disease and its relatively recent attributed to mental disorders.This is perhaps the main reason why this disease is still poorly understood.
bulimia Modern has different shape.For example: the use of laxatives, diuretics, exhausting exercises, intense diet or starvation in between bouts of overeating.Read more about the causes of disease and the differences from the usual gluttony in the article "The uncontrolled gluttony, insatiable hunger" & gt; & gt;
To better understand the causes of the disease, we should remember history.Bulimia - a term derived from Greek and means a morbid gluttony.
In ancient Rome, a relatively common phenomenon was "vomitoria" - artificially induced vomitin
complete refusal to eat in the 70 years of the twentieth century began to be regarded separately as anorexia.It had nothing to do with the modern trend to losing weight.For our ancestors thinness it is repulsive.In 80 years, epidemiological studies have shown that bulimia is much more common than anorexia.
Symptoms and diagnosis of bulimia
Please understand, if bulimia independent disease.
believed that bulimia typically begins with a dissatisfaction with their appearance.Consequence - failed, leading to gluttony, trying to lose weight.Fear of getting fat is replaced by a feeling of guilt from taking large quantities of food, and the state temporarily facilitated vomiting, obtained by "vicious circle."
Sometimes, to justify their condition, patients come up with various explanations for their actions.For example, the ideology of the recognition of bulimia (and other eating disorders), as a way of life rather than the disease.These ideas have been applied in online communities, forums, blogs.Most of these topics, developing teenage girls obsessed with losing weight.
Girls, describe themselves as «pro - mia» - tending to thinness, invent diets and fasting, occasionally allowing himself to violate the strict rules of supply.That would not ruin the diet immediately after binge eating, completely get rid of eaten, causing vomiting.Overeating is usually spontaneous, when hunger becomes unbearable, but it can be planned (special buy sweets during the festival).
Another direction «pro - ana», believe that vomiting is dirty, fetid, and binge eating attacks are a sign of weakness and imperfection, lack of willpower.Girls discuss your lifestyle, share tips, publish pictures of thin models and celebrities, advise how to whiten your teeth, increase the volume of hair, clear skin, "cleanse the body" (enemas, starvation).
Diagnostic signs of bulimia:
- Repeated episodes of overeating (at least 2 times a week for 3 months) in a short period of time consumed large amounts of food.
- Patient focused on food and hunger.
- Confrontation "weight gain" with one of the following ways: vomiting, fasting, dieting, excessive exercise.Used drugs, reducing appetite, thyroid hormones, diuretics, enemas or laxatives.
- Low self-esteem due to weight changes and body shape.
It is worth noting that the current classification updated.Planned changes include such things as:
- obsession with healthy eating (ortoreksiya) 'healthy lifestyles';
- eternal life on a diet,
- permanent loss in weight due to the established limit for food,
- food ceases to be delicious and the patient is only a means to meet the needs of the body;
- the patient to eat more dietary kits, vitamins, slimming, in the alternative to the "normal food";
- most thought the sick person that he eats or eats;
- scornful attitude to food;
- no accidental over-eating, the patient "does not remember how it was before," and does not allow the thought of "returning to normal eating habits."
Distinctive features in the diagnosis of bulimia
Most of the information on bulimia is based on American studies.There are important features of the disease, which is distinguished from other bulimia eating disorders.
- women are more susceptible to bulimia than anorexia, this is due to hormonal changes during the menstrual cycle;
- uncontrolled overeating differs from anorexia.Although significant fluctuations in body weight, with bulimic patient weight often remains normal;
- overeating - compensatory behavior, less constant than anorexia (about 2 times per week);
- used regularly vomiting or spitting large amounts of food without swallowing.
It is important to distinguish normal from overeating binge eating (compulsive overeating).This in itself is not overeating disease.Here is a brief description of these concepts, with a focus on the differences between them.
Total painful between overeating and gluttony:
- eat a lot;
- trapeznichayut faster and more casually than usual;
- attacks occur mainly on "their" territory, away from prying;
- after eating people feel embarrassed and ashamed;
- both disorders can lead to overweight and obesity;
- both disorders depend on the emotional sphere;
- associated with other eating disorders;
Features of bulimia:
- attacks depend on stress, boredom, sadness, grief, and are a form of
reactions to different feelings and emotions;
- overeating is planned and organized;
- the patient is present negative attitude to food;
- people eat in isolation, are ashamed of the act of eating;
- suffering from bulimia, excluded from society because eating alone;
- is compensated by another form of behavior (physical exercise, vomiting, use of laxatives)
- women overeat twice as often than men;
-raznovidnost and aesthetic appearance of food consumed during a meal, not a big deal.
Treatment of bulimia
With self-treatment of bulimia in the home is usually very high risk of failure.Effective treatment is necessary to have multiple conditions.The most important of them - is the motivation (disposition) of the patient and physician experienced in the treatment of this disease.Professional treatment of bulimia must include psychotherapy (cognitive-behavioral or family therapy) and medication.
Universally recognized standards of treatment of bulimia indicate that drug therapy should be the only or the dominant form of treatment.Many studies show that patients key violation - lack of the neurotransmitter serotonin.Serotonin plays an important role in mood regulation, it is expressed as a deficiency of affective mood disorders that often cause eating disorders.The logical conclusion is that the most effective in the treatment of bulimia is antidepressants.Treatment is carried out strictly under the supervision of a psychiatrist.
Antidepressants modern class proven effective in the treatment of bulimia, and the new generation of drugs in this group are characterized by fewer side effects.
Best of all proven selective serotonin reuptake inhibitor (SSRI).In addition to the antidepressant effect, it reduces appetite - the effect is permanent, but it is very important in the initial stages of treatment.Drugs in this group: Citalopram (Celexa), Escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine, paroxetine (Paxil), sertraline (Zoloft), venlafaxine - (Velaksin, Velafaks, Efevelon, Venlaksor).
Other atidepressanty that can be used in the treatment of bulimia:
Tricyclic.Amitriptyline (Elavil), clomipramine (Anafranil), desipramine (Norpramin, Pertofrane), imipramine (Janimine, Tofranil), nortriptyline (Aventyl, Pamelor)
Monoamine oxidase inhibitors.Brofaromine (Consonar), Isocarboxazide (Benazide), moclobemide (Manerix), Phenelzine (Nardil), Tranylcipromine (Parnate), Tetracyclics, mianserin (Bolvidon), mirtazapine (Remeron)
tetracyclic antidepressants or other groups.Trazodone (Desyrel), Aminoketonea, Bupropion (Zyban)
reuptake inhibitor of serotonin and norepinephrine.Venlafaxine (Effexor)
inhibitor of serotonin and noradrenaline reuptake.Duloxetine (Cymbalta)
There are reports on the effectiveness of other drugs , such as topiramate (Maksitopir, Topreal, Topamax, Topsaver) - preparations for the treatment of seizure disorders.When bulimia helps normalize mood and reduce the urge to not controlled absorption of food.
Means for treatment of dependency (alcohol, drugs) - Naltrexone (Nalorex, Vivitrol) cnizhaet risk of depending on bulimia.
antiemetic - ondansetron (Zofran) (used to give a feeling of satiety and fullness.)
Other. lithium carbonate (Carbolith, Cibalith-S, Duralith, Eskalith, Lithane, Lithizine, Lithobid, Lithonate, Lithotabs)
There are many types of psychotherapy, each doctor sees in his own personality, emotions and problems of the patient.Different doctors different treatments.One can not determine which method is the best and most effective.Different approaches, depending on the nature of the problem will be more or less effective.
Cognitive - behavioral therapy
Based on eradicating negative thoughts about themselves and their bodies, which are fundamental in the formation of disease and negative attitudes towards food.
About 4-6 months, the patient learns to eat 3 times a day, including products that previously did not use.
During this period, the patient describes his daily diet, any cases of overeating and calories, as well as negative thoughts about food, if any.
Over time, the patient will be able to detect a distorted and false picture of their appearance.
Gradually expanding the type of food, and the patient with the help of a therapist begins to struggle with pathological reflexes and automatic behavior.Former beliefs challenged, and begin to dominate conclusions based on reasonable and realistic expectations.
believed that interpersonal therapy is less effective in the treatment of bulimia than cognitive - behavioral.Of course, because this type of therapy takes much longer!
Interpersonal therapy is designed to deal with depression and anxiety, which are basic to the formation of an eating disorder.This type of therapy does not affect the weight of the issues of food and body image.When a patient during a session refers to this, the therapist quietly changing the direction of the conversation.
Goals interpersonal therapy:
- expression of feelings,
- to adapt the patient to uncertainty and changes in life,
- create a sense of individuality and independence,
- to deal with all the negative events of the past (sexual violence or other traumatic events that have contributed to thethe formation of an eating disorder).
This type of therapy is based on the assumption that the main role in the development of eating disorders are playing the wrong family relationships.Family therapy can be effective for both young people and older people.
Involves parents in the treatment of adolescent patients with bulimia.Treatment involves restoring the child's weight under control parents, solving the problems associated with the period of maturation and gender identity, empowerment of the family.The approach is good because it encourages parents to participate in the treatment process, prevents the development of their "guilt complex" in front of the child.
In psychodynamic therapy, an important role is played by a single glance of the doctor and the patient to traumatic events from the past.The therapist explains the events and the behavior of the patient.Under the guidance of a doctor the patient begins to solve problems, which reinforce the (feed) his illness.
In connection with a personal touch is very difficult to assess the real effectiveness of this therapy in the treatment of bulimia.If the patient is convinced that his illness - a reflection of the internal problems and emotions, psychodynamic therapy is extremely effective.
Some doctors are individually suited to each case and use a combination of several types of treatment.For example, logging power and emotion, combined with elements of psychodynamic therapy has a positive interaction in many manifestations of eating disorders, including bulimia.
bulimia nervosa For treatment uses a combination of soothing herbs, stimulants of the nervous and brain activity and natural andedepressantov.
Sedatives: rosemary, hawthorn, valerian, mint, oregano, tarragon, motherwort, hops.
Stimulants nervous activity: calamus swamp, aloe, Rhodiola rosea, Eleutherococcus.
Antidepressants: Aralia, ginseng, St. John's Wort, Saffron, St. John's wort herbs
normalizing metabolism and appetite: buckthorn bark, heather ordinary, sage, brown seaweed, bladder wrack.
Below are three of the best tested and proven herbal mixture.Do not use them for a long time, as the body can occur addictive.It is necessary to make a break in treatment or change the recipe.
1. rosehips - 100 g source of vitamins.
2. daisy flowers - 100g - treatment of acute and chronic inflammation of the gastric mucosa.
3. balm leaves - 50 g
4. yarrow herb - 50 g
5. angelica root - 50 g - calms the nervous system.
6. St. John's wort 50 g of hop cones
7. 7 - 20 g of valerian root
8. 8 - 20 g
9. peppermint leaves - 20 g Recipe
1. yarrow herb - 50 g
2. angelica root - 50 g
3. valerian root - 50 g
4. rhizome calamus - 50 g
5. hop cones - 50g
6. lavender flowers - 50 g -uspokaivayutimprove cerebral blood flow.
7. peppermint leaves - 50 g
8. rosemary leaves - 50 g
9. lemon balm leaves - 50 g
10. thyme herb - 50 g
Mix all herbs, spoon 1 tablespoon of herbs, pour a glass of boiling water and cook in a waterbath for 20 minutes.Drink warm strained infusion twice a day for half a cup.
1. daisy flowers - 50 g
2. balm leaves - 50 g
3. St. John's Wort - 50 g
4. nettle - 50g - tonic, multivitamin property.
5. hop cones - 50g
6. chicory root - 50 g
7. lovage root - 50 g - antiemetic
8. 8 valerian root - 50 g
9. lavender flower - 50 g
All herbs mix thoroughly, if necessary grind.One tablespoon of the mixture, pour a glass of boiling water.Allow to stand for three hours.Drink 2-3 times a day for half a glass before a meal.
bioenergy therapy in the treatment of bulimia
very popular form of alternative medicine.This is one of the oldest methods of health recovery.Therapy has been known since ancient times in China, India, Egypt, Mesopotamia.Most diseases in humans begins with thoughts about the disease, and then the disease appears in the physical body.In the case of bulimia patient is constantly dissatisfied with body proportions, he is concerned about an increased appetite.
Bioenergy activates the natural defenses of the body, suggesting an "order" in the body of the patient.When the energy source of the problem is eliminated, the disease stops.This treatment option is very good if you can not defeat the disease in the classical way.
Acupuncture - a treatment technique, which came from the ancient East.Not used as an independent method of treatment, but only as a supplement to traditional medicine.Acupuncture points are stimulated with needles.