The Bulimic

Once begun, the cycles of bingeing and purging (often together with a strict diet) spiral out of control easily. Despite most cases of bulimia developing during the teens or early 20s, many bulimics conceal their symptoms successfully, usually avoiding treatment until middle-age. Actress Jane Fonda revealed that she had hidden her bulimia from age 12 until finally recovering at age 35, reporting that she had binged and purged up to 20 times daily! The late Princess Diana also confessed to being a secret bulimic, saying her disorder was a manifestation of her need for attention and help.

Many bulimics appear healthy and successful (perfectionist), with nearly normal weight. In reality, however, they often suffer from low self-esteem and depression. Bulimics may also exhibit other compulsive behaviour - one doctor reports that a third of his bulimic patients regularly engage in shoplifting while another quarter have abused or been addicted to alcohol at one time or another.

The normal food intake for women and teenagers is 2,000 to 3,000 calories daily. Bulimic binges, however, average about 3,400 calories in fifteen minutes, according to one study. Extreme cases have bulimics consuming up to 20,000 calories in binges lasting 8 hours. Some resort to stealing food or money to support their obsession, which may cost up to $50 a day.

Bulimics purge to lose the weight gained during binges by vomiting, (by self-induced gagging or with an emetic, a substance which causes vomiting) or by using laxatives (50-100 tablets at a time), diuretics (drugs that increase urination), or enemas. Periods of fasting or vigorous exercise often occur between binges.

Excessive/extreme purging quickly upsets the body's balance of sodium, potassium and other chemicals. This may lead to fatigue, seizures, irregular heartbeat and thinner bones. Repeated vomiting can damage the stomach and oesophagus (the tube that carries food to the stomach), make the gums recede and erode tooth enamel (some patients lose all their teeth prematurely. Other side effects include skin rashes, broken blood vessels in the face and irregular menstrual cycles.

Next: The Anorectic