We are continuing our series this week and focusing on Bulimia Nervosa. In this episode you will learn the symptoms, common findings on physical exam, risk factors, criteria to diagnose and treatment options as well as secret tips! If you want to listen to our episode now you can do so by CLICKING HERE.
♡ What is Binge Eating Disorder?
An individual with Binge eating disorder loses control over their eating as seen in Bulimia. These people will eat a very large amount of food within a short period of time. In some cases, they can eat a lot of food even when they aren’t hungry or if they are very full. Subsequently, they don’t feel well and can become embarrassed, depressed, full of shame or guilt in regards to their behavior.
Note: all of these behaviors need to affect your day to day life in order to be classified as a disorder!
Genetics, environment, peer pressure, emotional health
♡ Risk Factors?
Age (teens and early 20s)
Gender (females are more likely affected than males)
Note: In males this condition may be underdiagnosed since they are less likely to get help.
Other risk factors include:
- Family history (higher risk for those with first degree relatives who suffer from anorexia)
- Stress or major life changes
- Specific vocations and activities
i.e.: Athletes: like gymnasts, runners, wrestlers and dancers
Loss of control during the episodes of eating large amounts of food at one time
Recurrent episodes with compensation by vomiting, excessive exercise, restrictive eating, and or laxative use
Low self esteem
Feelings of being out of control
Guilt, shame and even withdrawal from family and friends
♡ Physical Exam?
Weight can vary from normal to overweight to obese
High cholesterol, high blood pressure, heart problems, diabetes, GERD and some sleep-related breathing disorders such as, OSA
You will also obtain labs similar to other eating disorders including but not limited to, a BMP and an EKG
Differentiate from other subtypes
Note: In contrast to bulimia, these individuals do not attempt to use compensatory behaviors like purging or excessive exercising
Sleep study (in a subset of patients for whom Obstructive Sleep Apnea is a concern)
Goals of treatment include: reducing eating binges, achieving healthy eating habits and treating underlying as well as co-occurring conditions.
Therapy: various psychotherapy methods like CBT, interpersonal psychotherapy or dialectical behavior therapy
Pharmacologic: Vyvanse (note this is a stimulant so it has abuse potential), Topamax (an anticonvulsant which also comes with it’s own slew of side effects) and SSRIs
Note: Vyvanse was approved for ADHD and moderate to severe binge eating disorder.
Note: Pharmacologic regimens may help with the behavior itself but not necessarily help with weight loss and also they come with side effects. Be sure to discuss the ins and outs with your provider
Side effects of Topamax: include sleepiness, dizziness, difficulty concentrating
Side effects of Vyvanse: common ones include dry mouth, insomnia; although more severe side effects may also occurs
Behavioral weight loss programs are another treatment option however, this shouldn’t be initiated until the binge eating disorder is treated because this can trigger binge eating episodes given that dieting is a risk factor
♡ Secret Tips
Stay connected with your mental health
Adapt your environment to your needs
Stick to the treatment plan
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