Psychology

Introduction
Bulimia, medically known as Bulimia Nervosa, is an eating disorder whereby the victims experience episodes of secretive binge eating followed by a feeling of guilt and an obsession with weight control (Medline Plus, 2010). People with bulimia use inappropriate means to control their weight like inducing vomiting, abuse of laxative substances and diuretics or punitive exercise routines. As is the case with most psychological disorders, bulimic people experience excess emotional pain (Stoppler, 2010). This research paper aims to expound on this condition its symptoms, effects and treatment options available.

Causes of bulimia nervosa
Just like is the case with anorexia, there currently exists no medical evidence to explain the exact cause of bulimia (Parker, 2006). Bulimia is a very complex psychological disorder and its dynamics are still being explored. However, it is believed to start when a person harbors extreme dissatisfaction with his or her body (Parker, 2006). Such feelings lower self-esteem and individual confidence. When a person is either overweight or underweight, he or she looks in the mirror and sees a person different from what they ideally want to be. Extreme dieting then begins, escalating to bulimic levels.

Certain neurological or medical conditions may also be present in an individual resulting into disturbed eating habits while the psychological disorders characteristic of bulimia (obsessive concern with body weight and physiological structure) are absent. For example when an individual is suffering from depressive illnesses, overeating is a common symptom (Kalapatapu, 2008). Such a person will not result to improper weight-loss activities and is not obsessively concerned with his or her physical appearance and body weight reduction as is observed in bulimic people.

Research about possible connection between bulimia and hormonal abnormalities is underway. Sufficient evidence suggests that there could be a possible link between eating disorders and abnormalities in the chemical composition in neurotransmitters within the nervous system, especially serotonin (Stoppler, 2010). Some bulimic people have exhibited fluctuations in their rates of metabolism, alterations in their perception of satiety and unusual neural endocrine regulation.

Diagnosing Bulimia
Just like anorexic people, people with bulimia keep it secret and are in denial if confronted about their condition, making the diagnosis of bulimia a complex process (Stoppler, 2010). Bulimic people do not often seek professional help until late after secondary medical or psychological effects, usually serious, begin to manifest themselves. For this reason, it is recommended that people who have this kind of disorder be truthful and seek redress as early as possible.

One of the most common symptoms of bulimia is recurrence of binge eating episodes (Medline Plus, 2010). When a person eats more food within a specific time interval that an ordinary person would eat within the same time period under the same circumstances, then this could be a sign of bulimia (Stoppler, 2010). There is also loss of control over what or how much the person eats during such an episode. After a binge eating episode, the victim will be engulfed with a feeling of guilt, resulting in indulgence in inappropriate and punitive behavioral patterns aimed at preventing weight gain including self-induced vomiting, abuse of laxatives and diuretics, enemas, weight-loss medicines and fasting or overindulgence in physical exercises (Stoppler, 2010).

People with bulimia are either overweight or underweight or even have normal body weight. However, periodic induced vomiting after meals, compulsive exercising and other physical manifestations like swollen throats and jawbones due to induced vomiting are signs that the person could be bulimic (Parker, 2006). Finally, such people will be overly concerned with their physical appearance, image or body weight.

Medical complications and effects of bulimia
Due to continuous binge eating and self-induced vomiting, bulimia harms the body of a victim in various ways. Purging exposes the throat and the mouth cavity to acidic gastric juices from the digestive system eroding the tooth enamel (Parker, 2006). This increases the sensitivity to cold or hot substances and leads to the formation of mouth cavities. The thyroid, parotid and salivary glands may swell due to repeated vomiting, causing soreness.

Purging may also cause strictures, ulcers and ruptures in the esophagus and the large intestines (Kalapatapu, 2008). When acidity backs up from the stomach through reflux, it may deteriorate pre-existing ulcerations in the digestive system. Just like in patients with anorexia nervosa, bulimic females may experience irregular menstrual periods or no menstrual periods at all, a condition known as amenorrhea (Slade  Duker, 2003). This results from the virtue that they are either malnourished or are having weight fluctuations as is characteristic of bulimia patients.

The intestines are also systematically affected. Having frequent enemas or abusing laxatives and diuretics could lead to abnormal build-up of liquids in the digestive system. When laxatives are overused, the patient could develop dependency since the normal excretion process becomes dysfunctional (Stoppler, 2010. All these side effects inhibit normal function of the colon and there may emerge the need for surgery as an intervention of restoring normality. Additionally, continued abuse of laxatives and diuretics puts the patient at a risk of suffering electrolyte imbalance thus inhibiting normal physiological and psychomotor functionalities, a condition that is life threatening. Bulimia in pregnant women poses a threat to the unborn child due to continuous bulimic tendencies of the expectant mother (Slade  Duker, 2003). Finally, bulimia leads to the manifestation of serious psychological disorders if left unchecked.

Statistics
Due to higher levels of self consciousness, bulimia is most common in young women. In fact, over 10 percent of all women in colleges or women bearing college-going ages are affected by bulimia (Medline Plus, 2010). Out of all diagnosed cases of bulimia, only about 10 percent occur in men. Due to the primary and secondary medical complications arising from bulimia as outlined above, about 10 percent of bulimic people die either from malnutrition, cardiac arrest, suicide or other related factors (Medline Plus, 2010).

Treatment of bulimia
Bulimic people develop various medical and psychological conditions which, luckily, are reversible when approached from different perspectives (Slade  Duker, 2003). The professional qualified to offer help may be a physician, a psychiatrist or a clinical psychologist. The disciplinary approach embraced in the management of bulimia depends on the severity of the complications arising. But on average, a psychiatrist with background training in medicine and psychology is best suited to help.

A variety of antidepressants have been proven to be effective while treating bulimia, mainly those that selectively inhibit the reuptake of serotonin and monoamine oxidizers like Fluoxetine and Buspirone (Parker, 2006). Serotonin inhibitors are however the most commonly used since they cause minimal side effects. Other drugs are still under development as the underlying factors leading to bulimia are being established.

Depending on the extent of physiological and psychological detriment in an individual, hospitalization is sometimes necessary but most cases are advised to seek outpatient help, particularly if diagnosis is done sufficiently early whereas beginners need only be subjected to occasional counseling or therapeutic sessions (Slade  Duker, 2003). Most doctors prefer to begin treatment by first stabilizing the patients condition physically especially if the condition has reached life threatening proportions.

Treatment of bulimia focuses on addressing both the physical and psychological requirements of the patient so that physical well-being and normal eating habits can be effectively restored (Slade  Duker, 2003). Bulimic patients need to be open to their doctors and openly bring out any internal feelings and perceptions that could have led to the acquisition of the disorder. Any issues regarding personal self-control patterns, how a person perceives him or herself and their social dynamics need to be accurately established so that the solution to the condition is appropriately tailored (Slade  Duker, 2003). The doctor then can offer advice on ensuring a correct and sufficient diet and promoting the desired behavioral and attitude management. Bulimic people should learn to perceive themselves on the positive side to increase their chances of restoring their mental and physical health. A positive attitude coupled with personal effort and patience is a very essential component if a person is to fully recover from this condition (Slade  Duker, 2003).

Conclusion
People suffering from bulimia can have a very normal outward appearance despite having a condition that is very detrimental to their health. The diagnosis of bulimia should thus begin at a personal level (Parker, 2006). If an individual notices any of the symptoms outlined above that set the criteria for positive diagnosis, he or she should seek expert help as soon as possible. However, to minimize the chances of developing bulimia, a person should always have a positive outlook and appreciate his or her appearance and body weight.