Bulimia Nervosa is characterized by frequent binge eating. Binge eating is consuming an amount of food that is considerably larger than an average meal. The binger generally feels out of control regarding the amount of food eaten. Most frequently, the binger follows the eating-episode with some form of purging such as vomiting and/or the use of laxatives or diuretics. The typical bulimic may exercise in an attempt to counteract the calories consumed but not purged, and/or, may fast for a given period of time afterwards. Although many bulimics are weekend bingers, most binge at least twice per week. As with Anorexia Nervosa, the bulimic's self image is generally distorted and they focus much of their attention on body size and shape. Although some are very thin, many are of normal or even above normal weight.
Bulimic's are usually very ashamed of their strange eating patterns and can become very secretive about it. Some are closet eaters. This is when they arrange their binges in places and at times when they are sure they will not be discovered. This often results in bedroom bingeing, closet bingeing, or bingeing when alone. If left uninterrupted, the bulimic may eat frantically until their body cannot tolerate another bite. The bulimic may then find the will to stop eating, long enough to purge. It is not uncommon for them to resume bingeing once the purge is complete. This may occur throughout the day until the binger is exhausted.
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Some may eat more or less fervently depending on the most recent stresses experienced. As bulimics often binge as a way to avoid feelings associated with stress, the binge patterns may ebb and tide accordingly. Specific instances have been documented in which the bulimic binged beyond her stomach's ability to hold the food. Consequently she suffered a ruptured stomach cavity. Some have died from a binge and many have died from serious electrolyte imbalance and/or blood sugar fluctuations. Bulimics may suffer loss of teeth due to continual bath of stomach acids flowing out of their mouth, eroding the enamel. Their intestines can become crippled with holes created by laxative abuse. Liver damage, kidney damage and heart damage is not uncommon. Even if the bulimic is eventually treated and pulls out of the disorder, s/he may be left with serious physical impairments that can result in serious medical problems later in life.
In the case of Andrea, after suffering with anorexia for several years, she developed full bulimia. Her weight fluctuated from month to month, ranging from 80 to 108 pounds. Twice she gained to nearly normal weight levels only to loose it again when her life became hectic. Like most bulimics, she couldn't publicly admit to her binge purge behaviors and binged mostly in the evenings when her children were asleep or when they were out playing. On average she purged 6-10 times per day and although she was in denial (or oblivious) to her dwindling physical health, she was developing serious medical problems.
Over a period of four years, she lost several teeth due to the acid baths from purging. Her remaining front teeth crumbled until they were 20% shorter than normal. Her kidneys failed and she was only hours away from dialyses at one point. Her liver was damaged and her metabolism was seriously impaired, making it nearly impossible for her to readapt to healthy eating patterns and maintain a normal weight. Instead it was likely that when she recovered, her body would overcompensate and gain more than the desired weight. Her bones had lost serious amounts of calcium stores and she began to experience one broken bone after another. She lost all feeling in her limbs from the elbows and knees down, due to vitamin and supplement overdoses. Her heart rhythms were frightfully abnormal and her electrolytes were critically out of balance.
In spite of her failing physical condition, Andrea thought she felt fine. At least that is what she told herself. She was unconcerned for her physical welfare and she was unconvinced that her illness was having an adverse effect on her life. For Andrea, It would be years before she would be able to see clearly what she had done to her body. It would not be until she made a personal commitment to recover that she would begin to free herself from the web of denial she had spun for herself.