10 Misconceptions about Bulimia Nervosa

When you think of bulimia, the first thing that pops into your mind is probably the stereotypical image of an underweight teenage girl hanging her head over a toilet while sticking her fingers down her throat. Sound familiar? While this stereotype is typical among societal understandings of bulimia nervosa, this doesn’t necessarily mean that it is an accurate representation of the illness. On the contrary, there are a number of misconceptions about the illness that need to be straightened out.

  1. Self-induced vomiting is the only form of bulimia

Bulimia nervosa is characterized by a binge/purge cycle in which an individual consumes abnormally large amounts of food in a relatively short period of time followed by episodes of purging. While self-induced vomiting is the most widely understood form of purging, it is not the only means of meeting the criteria for a diagnosis of bulimia nervosa. In fact, the spectrum of characteristics of bulimia nervosa is so vast that there are now two recognized forms of the disorder.

The first form of bulimia is the most commonly understood and is known as the purging subtype. This form of bulimia occurs when an individual takes compensatory measures in order to make up for a binge. These measures include anything from vomiting to abusing medications in order to make themselves sick. The goal of these behaviors is to rid the body of the previously consumed food; however, due to the efficiency of the digestive system, much of the nutrients are absorbed into the body within minutes which renders these methods of compensation quite ineffective.

The second form of bulimia is the non-purging subtype which is characterized by behaviors that are intended to make up for the consumption of food without ridding the body of the food through measures such as vomiting. Such behaviors include the restriction of caloric intake or over-exercising in order to balance out the amount of calories consumed during the binge.

  1. Bulimics are usually underweight

While the stereotypical image of individuals who suffer from bulimia tends to be emaciated teenage girls, most individuals who suffer from bulimia are not underweight. On the contrary, most bulimics tend to be of an average weight or even slightly overweight. This is because the majority of the calories consumed during a binge are absorbed into the body before the individual begins to purge. Indeed, digestion begins from the moment that a piece of food enters the mouth which means that even though bulimics rid the body of food soon after consuming it, they are still taking in a lot of calories.

According to the National Centre for Eating Disorders, the average binge results in a surplus of 1200 calories being consumed, even when purging occurs immediately after the binge. As a result, many bulimics end up gaining weight rather than losing it. This can in turn cause the individual to restrict caloric intake in order to lose weight which increases the chances of another binge due to uncontrollable hunger.

  1. The signs of bulimia are obvious

Often when individuals think about bulimia nervosa they are under the impression that the symptoms of the disorder are easily detectable; however, this is not the case. In fact, many bulimics suffer from the disorder for years without anyone—even close friends and family—having any idea. While there are many side effects of bulimia nervosa such as tooth decay, hair loss, weight gain or loss, irritability, and puffiness in the facial glands, these symptoms can be easily dismissed by the sufferer as being a result of any number of other factors such as stress or illness. Furthermore, the most serious symptoms of the illness are not obvious to individuals other than the sufferer. For example, irregular menstruation, constipation, and mineral imbalances are all serious consequences of bulimia; however, these symptoms may not be obvious to anyone other than the person who is suffering from the disorder. For this reason, many individuals who suffer from the disorder will go years without treatment.

  1. Bulimia is not often fatal

While many individuals are able to recognize the fact that bulimia can have negative side effects on an individual’s overall health, there is still a significant number of individuals who do not recognize the fact that bulimia can be a life-threatening illness. Indeed, one of the most serious complications that is associated with bulimia is an imbalance in electrolytes which can lead to more serious complications such as a heart attack or stroke. The tendency of bulimics to use purging as a means of weight loss leaves these individuals especially susceptible to electrolyte imbalances which can be difficult to detect early on and can quickly become catastrophic. In addition to this, bulimics are at risk for severe damage to their digestive system due to repeated episodes of binging and purging. Such behaviors can lead to complications such as a ruptured oesophagus which is often fatal.  As a result, individuals who suffer from eating disorders such as bulimia nervosa are at an increased risk of death.

  1. Bulimia is only about losing weight

For many bulimics, the behaviors begin as a means of losing weight and quickly morph into a full blown eating disorder. On the surface it appears as though the behaviors are focused solely on the goal of losing weight. However, disordered eating often occurs as a means of coping with unbearable emotional distress such as trauma, low self-esteem, or grief. For individuals who are struggling with issues such as these, the disordered behaviors become a means of dealing with the issues by controlling their consumption of food. Unfortunately, these efforts to gain control often backfire because the eating disorder quickly becomes an addiction. The behaviors that were once a source of comfort and control morph into a form of anxiety when they are unable to control their food intake. The individual may believe that they are in complete control of their behaviors but this control is gradually lost as the eating disorder becomes increasingly entrenched in the individual’s way of life.

  1. Only young women and girls suffer from bulimia

While it is true that the majority of people who suffer from bulimia nervosa are women, 10-15% of bulimics are male. In fact, the statistics could be even greater than that; however, due to the stigmatization of males who suffer from eating disorders, many of these individuals do not come forward and seek treatment.

Furthermore, the traditional notion that eating disorders such as bulimia nervosa are restricted to only young women and girls is also misguided. While it is true that the large majority of bulimic individuals are teenage girls and young adult women, there are also many older women and men who suffer from the disorder. Bulimia nervosa does not discriminate; anyone could get the disorder under certain circumstances. There are a number of biological and cultural factors which play into the development of the disorder, but age and gender are certainly not deal breaking factors.

  1. Bulimics always have a distorted perception of their bodies

We’ve all seen it before: the picture of an emaciated teenage girl staring at her much larger reflection in the mirror. The message conveyed in images such as this suggests that individuals who suffer from bulimia nervosa—or any eating disorder for that matter—are unable to perceive the reality of what they look like. The general understanding is that these individuals must have a skewed idea of what they really look like. While this may be the case for some individuals, most individuals who suffer from an eating disorder have a relatively realistic perception of what they look like, they simply are not happy with it. Indeed, disordered eaters are not delusional; they do not look in the mirror and suddenly double in size. On the contrary, the reflection staring back at them is not abnormally large, it is simply not as thin as the individual wishes. These individuals do not find faults in an inaccurate perception of themselves. The see their reflections as there are in reality but find flaws in themselves that others might perceive as looking fine.

  1. Bulimics think that their behavior is normal and acceptable

One of the most common stereotypes that tends to be portrayed in television or movie representations of bulimia is the idea that the sufferer thinks that the behavior is okay. There is a widespread misconception that bulimics are unaware of the damaging nature of their behaviors when in fact this is not the case. On the contrary, bulimics go to great lengths in order to disguise their behaviors specifically because they are aware of how abnormal and harmful their behaviors are. These individuals are aware of the risks involved in their eating disorder but the desire to continue the disordered eating is so great that they consciously decide to take precautionary measures in order to hide the truth from their loved ones. The truth of their illness is often not exposed until the behaviors begin to take a serious toll on the individual’s overall well-being. At this point the illness becomes more difficult to disguise; however, some bulimics continue to suffer in silence despite the serious risks involved. While many bulimics may be unaware of just how serious the risks of the illness can be, these individuals are by no means ignorant to the fact that there is some level of risk involved.

  1. Bulimia can be easily overcome

If you’ve ever suffered from an eating disorder you’ll surely be accustomed to hearing the phrase “well…why won’t you just eat”? However, if you have had the misfortune of experiencing bulimia nervosa, you will surely understand that it’s not quite that simple. Bulimia is a complex illness with an equally complex solution. The psychological component of the illness is tremendous and extremely difficult to overcome. Indeed, disordered eating is addictive and often requires extensive therapy in order to overcome. Support groups and individual counselling can be extremely beneficial for individuals who are recovering from bulimia; however, relapse is still a common occurrence for individuals who are recovering from the illness.

With that being said, recovery is definitely possible. It may take years of dedicated hard work, but if an individual wants to recover from their illness then there is no reason why they cannot achieve a healthy relationship with food.

  1. The side effects of bulimia are not long-term

So, you’ve come to terms with the fact that bulimia can have serious side effects, but did you know that those side effects can be long term? Even if an individual has recovered from bulimia, the physical toll that the disorder can take on the body is often a long-term struggle. Imbalances in electrolytes can have long term effects on the function of the heart, malnutrition can lead to a loss in bone density, women may become infertile, and the repeated episodes of self-induced vomiting can have a lasting impact on the oesophagus and stomach.  In addition to the physical toll on the body, individuals who have experienced bulimia may also suffer from persistent emotional problems due to brain damage caused by malnutrition. Unfortunately, these emotional difficulties can lead to the development of other mental illnesses such as depression and anxiety. Unfortunately, the latter examples are only a few of the many long-term risks involved in bulimia nervosa and often the damage is irreversible.

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