In this type of bulimia nervosa, usual forms of purging (self- induced vomiting) are not used regularly.
Unlike people with anorexia nervosa, who are dangerously thin, people with bulimia nervosa are thin, average weight, or overweight. They often hide their pattern of binging and purging (Lyness, 2019). may not be completely accurate (National Institute of Mental Health, n.d.; National Eating Disorders Association, 2016). Healthcare consideration : Only 10% of persons with eating disorders receive treatment. Two common myths that often prevent males from seeking help for eating disorders are that males are more secure with their bodies, no matter their size, and eating disorders are women’s diseases (Malcore, 2016). Healthcare professionals must work to help dispel these myths and facilitate recognition and treatment of eating disorders for both males and females. The National Association of Anorexia Nervosa and Associated Disorders (ANAD) (2019) cited the following bulimia nervosa statistics: ● 1.5% of American women suffer from bulimia nervosa in their lifetime. ● The standard mortality rate (SMR) for bulimia nervosa is 1.93. ● Nearly 50% of bulimia nervosa clients have a comorbid mood disorder. ● Nearly 1 in 10 bulimia nervosa clients has a comorbid substance abuse disorder, usually alcohol use. and parents who want to see young athletes succeed encourage weight loss and maintenance of a low weight because they believe that this will enhance their ability as athletes. This is especially true of female athletes such as gymnasts, runners, and skaters (Mayo Clinic, 2018d). Clinical Presentation Gerald and Jeanne have always been proud of the accomplishments of their daughter Diane, especially her ● Sports-related expectations: Athletes are often under pressure to lose weight and restrict caloric intake. Coaches performance as a high school gymnast. Diane is now a freshman at a large university where she is a member of the gymnastics team. Gerald and Jeanne frequently travel long distances to attend Diane’s competitive events and often visit her at school. Lately they have noticed that Diane’s hands and knuckles are bruised and scarred. She is often hoarse and complains of stomach pains. When they dine out at restaurants or spend time in her dormitory room, her parents notice that Diane seems to spend an unusual amount of time in the bathroom, especially after meals. Gerald and Jeanne begin to wonder if something is wrong, but Diane appears to be so happy and is performing so well as a gymnast that they decide they are being overprotective. Some of Diane’s friends, however, are concerned about her. They suspect that Diane is suffering from an eating disorder. In the preceding scenario, Diane’s friends are correct. She is displaying some of the symptoms of someone who is affected by an eating disorder, most likely bulimia nervosa. It can be difficult for family, friends, and even healthcare professionals to recognize bulimia nervosa because the person affected is often of normal or slightly above normal weight. Clients often come up with plausible explanations for injuries to their knuckles and hands. In Diane’s case, she may tell her parents that her injuries were acquired during gymnastics practice or at gymnastic competitions. Her stomach pains may be attributed to anxiety over competitions. Clients become quite clever about hiding the behaviors associated with bulimia nervosa. They know their binging and purging behaviors are abnormal and go to great lengths to prevent others from finding out about them.
Incidence and Prevalence of Bulimia Nervosa The onset of bulimia nervosa usually begins in adolescence or young adulthood and peaks in young adulthood. Onset before puberty and after the age of 40 is uncommon. It is estimated that 3% of the population meets the diagnostic criteria for bulimia nervosa. However as much as 5% to 15% of the population may have some symptoms of the disorder (Gersch et al., 2016). Bulimia nervosa affects both females and males. The estimated ratio often cited is a 10:1 female to male (Gersch et al., 2016). However, the number of males with bulimia nervosa and other eating disorders is increasing significantly (Malcore, 2016): ● One in four eating disorders occurs in males. ● 31% of male teens reported binge eating, purging, or overeating. ● 2% of teen males intentionally vomited or took laxatives to lose weight or to prevent weight gain. Binging and purging behaviors are done in secret because clients are often ashamed and disgusted by their own actions. Because of the secrecy surrounding these actions, as well as the fact that clients with bulimia nervosa usually can be of normal weight, exact statistics pertaining to incidence and prevalence Possible Causes and Risk Factors of Bulimia Nervosa As with anorexia nervosa, the exact cause of bulimia nervosa is not known. Experts hypothesize that its development occurs as a result of the interaction among genetic, biological, behavioral, environmental, family, and psychosocial factors (Gersch et al., 2016). A number of risk factors are associated with an increased risk for the development of bulimia nervosa: ● Genetic factors: Family history of eating disorders increases the risk for developing bulimia nervosa and other eating disorders. People who have a first-degree relative (siblings or parents) with an eating disorder are at particular risk (Mayo Clinic, 2018d). Some research has suggested that more than 50% of the risk of developing an eating disorder is based on genetics (Eating Recovery Center, 2018). Additionally, researchers have associated a specific chromosome, 10p, with families with a history of bulimia nervosa (Gersch et al., 2016). ● Physiological factors: Childhood obesity and early puberty increase risk for the disease (Mayo Clinic, 2018d). ● Psychological issues: Low self-esteem, depression, social anxiety disorder, obsessive-compulsive disorder, and overanxious disorder of childhood are associated with increased risk for bulimia nervosa. Impulsiveness and problems managing anger are also linked to a greater risk for disease development. Experiencing traumatic events may also contribute to its occurrence (Gersch et al., 2016; Mayo Clinic, 2018d). ● Experiencing abuse: People who experienced childhood sexual or physical abuse are at greater risk for developing bulimia nervosa. Family conflict and disturbances also increase the risk of developing bulimia nervosa (Eating Recover Center, 2018; Gersch et al., 2016). ● Social and cultural pressures: Societal and peer pressure to be thin makes some people more vulnerable to the disease. The appearance of people in the media (models, actors) adds to these pressures (Gersch et al., 2016; National Eating Disorders Association, 2016). ● Career factors: People whose size and appearance affect their livelihood are at higher risk for bulimia nervosa and other eating disorders. Examples of such people are dancers, actors, and models (Eating Recovery Center, 2018; Gersch et al., 2016; National Eating Disorders Association, 2016).
Page 127
Book Code: PYMA2024
EliteLearning.com/Psychology
Powered by FlippingBook