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Binge Eating Disorder

Written by Admin
Wednesday, 06 February 2008
In contrast to Anorexia Nervosa, where the patient is in total denial about their situation, most bulimics already know and admit that they suffer from a life-threatening illness. The facts are that the constant binging and purging over the years takes a toll on human bodies. Abusing laxatives and repeated vomiting can cause irreparable damage to the rectum and/or esophagus, resulting in heavy bleeding that can happen so quickly a patient can "bleed out" in the time it takes for an ambulance to arrive. The mindset of a bulimic is such that their denial comes in the form of hopelessness for recovery. Life to the bulimic appears to be no more than one long, endless cycle of binging and purging to lose weight or avoid gaining weight. If a bulimic reaches the age of thirty, figuring the individual started the behavior when he or she were a teen, he/she is so deeply ingrained with the bulimic mindset that the binging and purging becomes almost as second nature as breathing. Although some bulimics will try to reform themselves, they fall short in relapse prevention. Treatment Considerations for Bulimia Nervosa In contrast to Anorexia Nervosa, where the patient is in total denial about their situation, most bulimics already know and admit that they suffer from a life-threatening illness. The facts are that the constant binging and purging over the years takes a toll on human bodies. Abusing laxatives and repeated vomiting can cause irreparable damage to the rectum and/or esophagus, resulting in heavy bleeding that can happen so quickly a patient can "bleed out" in the time it takes for an ambulance to arrive. The mindset of a bulimic is such that their denial comes in the form of hopelessness for recovery. Life to the bulimic appears to be no more than one long, endless cycle of binging and purging to lose weight or avoid gaining weight. If a bulimic reaches the age of thirty, figuring the individual started the behavior when he or she were a teen, he/she is so deeply ingrained with the bulimic mindset that the binging and purging becomes almost as second nature as breathing. Although some bulimics will try to reform themselves, they fall short in relapse prevention. Because of these pervasive feelings of hopelessness, shame and self-disgust, few bulimics self-refer for treatment. It's most likely a concerned physician, friend, or family members who provide the necessary support system that helps instill hope in the suffering bulimic that there is a way out. Reluctantly, but with some trace of hope, the bulimic breaks the silence and consents to intensive treatment. For treatment to be successful, it is imperative that the bulimic be hospitalized in a special unit staffed by physicians, nurses and mental health professionals who are skilled and experienced in treating eating disorders. Treatment consists of nutritional counseling, medical care for co-existing physical problems such as electrolyte imbalance and erosion of dental enamel, nursing care that monitors the patient's vital signs for any evidence of adverse reactions to medications that may be prescribed, and mental health care for intensive individual and group therapy to assist the bulimic in overcoming shame and guilt, increasing self-esteem and gaining life coping skills to prevent relapse. If psychiatric evaluation reveals the presence of co-morbid disorders such as depression and/or anxiety, these conditions will be simultaneously treated. An essential part of in-patient treatment is the close supervision of the patient's eating behavior. Meals are carefully planned, and the patient's consumption of the meals is visibly monitored by staff members. After meals, the bulimic is closely watched to prevent purging by self-induced vomiting. Clearly, this type of treatment is not punitive or overly-intrusive in nature; it is based upon sincere compassion and belief that the binge-purge cycle must be interrupted by any means necessary. Until this has been accomplished, all other forms of treatment will be useless. Successful cessation of purging is a success a bulimic desperately needs. It's been said that medical treatment is only as good as an insurance company will pay for. Thus, the average hospital stay for a bulimic is four to six weeks. Not a preferable 90-day hospitalization, but certainly better than no hospitalization at all. Once the patient is discharged, his/her treatment plan has been largely accomplished; eating behavior has returned to acceptable, healthy practices, purging has been eliminated, and mental health therapy has provided the patient with great strides in improving self-esteem, reducing or even eliminating co-morbid depression or anxiety, and most importantly, the patient has hope that the bulimia will go into full remission. Follow-up outpatient medical and mental health care is essential for continued recovery from bulimia and relapse prevention. By this time, the recovering bulimic has true hope for a future without binge-eating and purging. For anyone suffering from the debilitating illness of Bulimia Nervosa, doing is believing.