The 4 types of Bulimia (causes, symptoms and treatment)

Far from being a simple process, eating, which after all is the way to fulfill the vital function of nutrition, is very complex at both a physiological and, and here comes the important, psychological part. And considering that the mind can play many tricks on us and can even make us sick, it is possible that our relationship with food becomes something toxic to our emotional and physical health.

And this is where eating disorders come into play, unfortunately, serious mental health pathologies related to dangerous behaviors adopted with food, which, due to their impact on both psychological and physical health due to the nutritional problems they entail, have an enormous impact on the life of the patient.

And if we add to this that, in some sectors of the population, especially among adolescents, these eating disorders can have a prevalence of 4.5%, it becomes more than evident that, no matter how much stigma there is around mental health, it is necessary to talk about them openly, clearly and concisely.

And this is precisely what we will do in today's article. Hand in hand with the most prestigious scientific publications, we will investigate the clinical and psychological bases of what, together with anorexia, is the most common eating disorder: bulimia. We will analyze its characteristics and the particularities of the different forms of bulimia that exist.

What is bulimia?

Bulimia nervosa, known simply as bulimia, is a mental illness encompassed within eating disorders in which the person, after binge eating, you feel an unrelenting, unhealthy urge to get rid of the calories ingested, so he resorts to any means or route that allows him to do it, which, as we well know, tends to be the induction of vomiting.

Thus, bulimia is a psychological disorder with a very intense compulsive component in which there is no restriction of caloric intake as is the case with anorexia, quite the opposite. And it is that more or less frequently, the patient has moments of eating excessive amounts of food, with a more than evident loss of control.

And to this already dangerous eating behavior, is added the total fear of gaining weight, so that the person will feel an uncontrollable need to quickly expel the ingested nutrients to avoid calories. It is for this reason that a person with bulimia, after these binges, tends to vomit.

This induction of vomiting means that to all the psychological and physical impact due to the nutritional problems derived from the disorder, we have to add the damages and complications that vomiting brings to the digestive system, putting the person at risk of developing serious health problems .

Clinically and generally, bulimia is diagnosed and It is considered that the person suffers from this pathology when they carry out these purges after a binge at least once a week. It is considered that, at this point, we are facing a mental illness as such whose impact on both physical and emotional health, due to nutritional, psychological problems and derived from the act of vomiting, can, due to its severity and destructiveness, endanger the person's life.

Even so, there is a big problem for its diagnosis. And it is that unlike anorexia, where there is a clear underweight and the person looks extremely thin (the BMI is below 17'5 when the optimum is between 18'5 and 25), surprising as it may seem, a bulimic person usually has a body weight within this range considered adequate.

We must also highlight that, together with anorexia, the incidence of these two disorders (it is difficult to find individual figures for each of them, although statistics suggest that anorexia is somewhat more frequent than bulimia) can reach 8 cases per 100,000 inhabitants, with an especially high prevalence among young women (This group includes up to 90% of the cases) and a maximum affectation in the age group between 12 and 18 years.

It is estimated that 3 out of every 1,000 girls this age suffer from bulimia or anorexia at some point in their teens. In any case, it is also true that bulimia tends to manifest later than anorexia, because unlike this, which is more common among minors, bulimia is particularly affected between the ages of 18 and 25.

Hospital admissions are more frequent in anorexic patients than in bulimics, but that does not mean, at all, that bulimia cannot seriously compromise the emotional and physical health of the person who suffers from it. And it is that, in fact, due to its complications, the death rate for bulimia is around 5%. This horrible fact, together with its incidence, makes knowing its manifestations a total necessity.

What kinds of bulimia nervosa are there?

After this extensive but necessary introduction where we have established the general clinical bases of bulimia, it is time to contemplate nuances. And is that bulimia is not always expressed in the same way. And knowing how it does it is essential to provide correct treatment and psychological support to the person. Therefore, below we are going to investigate the characteristics of the different types of bulimia that exist.

1. purgative bulimia

Purgative bulimia is that form of this eating behavior disorder in which purgative attitudes occur, thus complying with the general definition that we have seen and being, of course, the most frequent manifestation of bulimia. Its main characteristic is that binge eating is accompanied by a purging phase, that is, behaviors to get rid of ingested calories.

And although sometimes purging is based on the consumption of diuretics or laxatives, the most common is that it consists of the induction of vomiting. So that, vomiting is the most common purgative attitude, being a desperate measure to reverse the effects of the binge and suppress the guilt for having eaten so much at once.

This purgative bulimia is especially destructive to the emotional and physical health of the person, since vomiting so frequently can cause serious gastrointestinal damage, gastroesophageal reflux, chronic dehydration, breakage of blood capillaries, metabolic disorders, tooth erosion, etc. These effects can be long-lasting and continue even after the purgative acts associated with bulimia have ended.

2. Non-purgative bulimia

Non-purgative bulimia is that manifestation of the disorder in which purging behaviors do not occur. Instead of purges through the induction of vomiting, the binge eating typical of this pathology is accompanied by the practice of excessive physical exercise or days of fasting to compensate for this excessive caloric intake.

In other words, the binge is not followed by purging through vomiting, but by compensatory behaviors such as sports or fasting. People with this type of bulimia are aware that purging does not prevent calories from being assimilated once digestion has begun, so to compensate for this, engage in long hours of cardiovascular exercise or spend long periods (even days) fasting or with a very restricted dietary intake.

3. Bulimia associated with variable weight

Bulimia associated with variable weight refers to that manifestation of the disease in which, whether or not there are purgative acts, the patient is constantly gaining and losing weight. Thus, the bulimic person experiences exaggerated weight changes, believing that, when he wants, he will be able to return to his normal weight.

People with this form of bulimia are rarely aware of their problem, making it more difficult for them to seek professional help. And it is that they believe that, although they feel bad both physically and emotionally, their true identity is that of "me with little weight". And because you gain weight easily, you think you can regain optimal fat and muscle mass whenever you want.

Four. Bulimia associated with obesity

Bulimia associated with obesity refers to that manifestation of the disease in which, whether or not there are purgative acts, the patient is overweight or obese. The problem lies, although many factors are involved, in the emotional discomfort he feels about his weight and physical appearance, something that triggers dangerous behaviors with food.

The bulimic person begins to alleviate this psychological discomfort due to being overweight with compulsive behaviors with food in the form of binges to, after them, compensate for their acts with purgation through the induction of vomiting or with behaviors such as excessive practice of sports or fasting. All this has, as we see, a clear component of low self-esteem.