In the second blog of our series highlighting the different types of eating disorders, we are going to focus on bulimia. In this article, we look at the signs and symptoms, the treatment available, and how you can support a loved one with bulimia. Please note that some of the content discussed in this blog may be triggering.
Bulimia can be a debilitating and often isolating condition, but it is important to know that if you are suffering with Bulimia you are not alone. It is difficult to gauge the exact prevalence of bulimia and other eating disorders in the UK, as research into the area is limited, however estimates from leading eating disorder charities and specialists suggest that around 1.25 million people in the UK live with an eating disorder, and around 1% of the population as a whole are living with bulimia.
This estimate is based on research conducted in other European countries, Australia, and the United States of America. Although cultures across these countries have lots of similarities, variances in social and cultural factors and well as differences in treatment options and access mean that the research conducted across these countries cannot be applied directly to the UK, so further UK-based research is key to pinpointing a more accurate prevalence of eating disorders in this country.
Whilst we do not have an exact figure, we do know that a significant number of people are diagnosed with bulimia in the UK each year.
Bulimia nervosa is an eating disorder and mental health condition that involves a cycle of bingeing and purging.
Bingeing involves eating a large amount of food, and then to compensate for this, individuals will “purge.” Behaviours known as purging involve extreme restriction of food, vomiting, or over-exercising. It can be upsetting to know that a loved one may be experiencing these symptoms.
We can all over-indulge on occasion, particularly if we are feeling stressed, or sad. However, individuals with bulimia usually report not feeling in control of how much or how fast they are eating during bingeing, and this is an ongoing cycle. It can be really hard to know your loved one is experiencing these symptoms.
Individuals with bulimia may still be considered a healthy weight, unlike those with anorexia nervosa where a common sign may be dramatic weight loss.
Due to this, it can be difficult to know if a loved one is suffering from bulimia.
If you are worried about a loved one and are concerned that they may have an eating disorder, there are some signs to look out for that could indicate bulimia.
Changes in behaviour will often be the first noticeable signs, as they are the easiest to spot.
Behavioural changes may include eating large amounts of food, visiting the bathroom after eating for a significant amount of time (as they may be purging), secretive behaviour, especially around food, mood swings or irritability, self-harm, social withdrawal, lack of sexual interest, or excessive exercising.
Physical signs include vomiting, tiredness and difficulty sleeping, bloating or complaints of stomach pain, poor skin condition, swelling of the hands and feet, and fainting (which could be caused by swings in blood sugar levels).
Psychological signs can be a lot easier to hide and therefore much harder to spot, however some common signs include spending a lot of time thinking about food, anxiety around mealtimes or eating in front of others, trouble concentrating, a noticeable drop in confidence, and worrying about their weight and body appearance.
If you notice any of these signs in a loved one and are concerned that they may have bulimia, the first step is to have an honest conversation with them to let them know that you are worried about them. Try to encourage them to speak with their GP, as the earlier that help and support for bulimia is sought, the higher the chance of recovery. However, this does not mean that you should not seek help even if you suspect that they may have been struggling for a while.
If an individual is reluctant to visit their GP, they can self-refer to talking therapies through the NHS IAPT service.
The most common treatment for bulimia is talking therapy. Typically, evidence-based self-help and Cognitive Behavioural Therapy (CBT) are the most common types of therapy used.
These therapies aim to tackle the underlying thoughts and feelings that cause the symptoms of bulimia. Self-help is usually the first step, and is completed with support from a therapist.
Following this, if symptoms do not improve, a specialised form of CBT is available for individuals with bulimia, this is known as CBT-BN (Cognitive Behavioural Therapy – Bulimia Nervosa).
However, if these therapies do not work or are not the right fit, other forms of therapy may be offered, including Interpersonal Psychotherapy (IPT).
Interpersonal Psychotherapy focuses on examining interpersonal relationships and communication, as the belief is that symptoms can be a response to tensions in these areas of our life.
Read more on Interpersonal Psychotherapy.
In addition to the treatments offered through the NHS, there are lots of ways you can support a loved one on their journey to recovery.
Ask your loved one how they would best feel supported by you. Simply offering a listening ear can be a great support to someone with an eating disorder, or they may wish for additional support around food-based activities such as trips to the supermarket, food preparation, and mealtimes.
Some other tips to support a loved one with bulimia include:
For more information on supporting someone with an eating disorder, BEAT, an eating disorder charity, has further advice on their website.
Other organisations that offer support to individuals with bulimia and their family and friends include Talk ED, and Mind.
Photo by Annie Spratt on Unsplash.
