Consequences of the Binge-Purge Cycle of Bulimia
During their binges most bulimics felt immediate relief
from anxiety and depression. Bulimics may be using
binging as a means of coping with stress. If this is the
case, teaching them alternative coping strategy should be
an important part of therapy.
In the post binge period most bulimics feel disgust
and anger at their lack of self-control, over having
eaten "forbidden" foods that violate their strict and unrealistic
diet standards, and depression At their inability
to stop binging. These negative post binge feelings are
thought to serve as a cue for purging which undoes the
eating act and leads to a decrease in negative feelings
(Rosen). Post binge purging in the form of vomiting has been
reported by over 90 percent of bulimics (Mizes). Purging alone
often is not enough to produce a better mood, however.
In one study 70 percent of bulimic individuals reported thoughts
about suicide at the conclusion of the
binge purge cycle. (Abraham and Beaumont).
This negative state can serve as a precipitating factor for another
cycle. Bulimia is not just an eating problem. It is associated
with poor overall adjustment. (Johnson and Berndt).
This means that not only do bulimics have poor
skills for coping with depression and anxiety but they
also experience these feelings usually strongly.
In addition to the psychological consequences of anxiety,
repression, and guilt, the binge-purge cycle can also
have distressing physical results. The most serious of
these are due to the potassium imbalance from frequent
vomiting, which can lead to muscle weakness and also
heart problems. Vomiting can also increase
tooth decay and damage to tooth enamel.
Treatment of bulimia can be focused either on preventing
binges or on preventing purging. Many of the studies
that has been reported deal with single suspects, so
a clear picture of the general process is lacking relaxation
training seems to be helpful in preventing the binge
from starting.
For instance, in one study, subjects were asked to
eat until a strong urge to vomit occurred (Leitenberg).
While they were eating, the therapist focused subjects'
attention on negative thoughts about feeling full, ugly, and rejected.
The therapist also helped them focus on three positive thoughts:
(1) the physical sensations after eating were abnormal and
could be relieved without vomiting; (2) the strict diets
they set for themselves were unrealistic and set them up
to "blow it" and binge; (3) the post binge anxiety would
decrease and not be as unpleasant as they feared. After
eating, the patients stayed with the therapist for at least
an hour until they felt sure they were not going to
vomit. Four of the five patients treated either stopped
vomiting or showed a definite improvement. One patient
showed no change.
Antidepressant Drugs
Antidepressant drugs are also used to treat bulimia.
In some cases these are initially helpful in reducing
of binging , but relapses may occur when the
medication is stopped. In some cases binges occur even
when the drug therapy is continued (Stewart-and others).
Bulimia may be related to mood disorders, as is
suggested by the higher incidence of both mood disorders
and alcoholism in relatives of bulimic individuals.
However, other psychological factors may also contribute
to bulimic behavior. It seems likely that certain personality
factors that may be genetically determined make
some people more vulnerable to and social experiences
that have a negative effect on self-esteem and
feelings of self-efficacy (Strober and Humphrey).
Therefore, a behavioral treatment may be more effective
than the use of antidepressant drugs in enhancing coping
skills and thereby preventing relapse. Research programs
for the treatment of bulimics are quite structured
and focus on eating behavior. In general, such treatment
Has been successful (Mitchell and Eckhart).
from anxiety and depression. Bulimics may be using
binging as a means of coping with stress. If this is the
case, teaching them alternative coping strategy should be
an important part of therapy.
In the post binge period most bulimics feel disgust
and anger at their lack of self-control, over having
eaten "forbidden" foods that violate their strict and unrealistic
diet standards, and depression At their inability
to stop binging. These negative post binge feelings are
thought to serve as a cue for purging which undoes the
eating act and leads to a decrease in negative feelings
(Rosen). Post binge purging in the form of vomiting has been
reported by over 90 percent of bulimics (Mizes). Purging alone
often is not enough to produce a better mood, however.
In one study 70 percent of bulimic individuals reported thoughts
about suicide at the conclusion of the
binge purge cycle. (Abraham and Beaumont).
This negative state can serve as a precipitating factor for another
cycle. Bulimia is not just an eating problem. It is associated
with poor overall adjustment. (Johnson and Berndt).
This means that not only do bulimics have poor
skills for coping with depression and anxiety but they
also experience these feelings usually strongly.
In addition to the psychological consequences of anxiety,
repression, and guilt, the binge-purge cycle can also
have distressing physical results. The most serious of
these are due to the potassium imbalance from frequent
vomiting, which can lead to muscle weakness and also
heart problems. Vomiting can also increase
tooth decay and damage to tooth enamel.
Treatment of bulimia can be focused either on preventing
binges or on preventing purging. Many of the studies
that has been reported deal with single suspects, so
a clear picture of the general process is lacking relaxation
training seems to be helpful in preventing the binge
from starting.
For instance, in one study, subjects were asked to
eat until a strong urge to vomit occurred (Leitenberg).
While they were eating, the therapist focused subjects'
attention on negative thoughts about feeling full, ugly, and rejected.
The therapist also helped them focus on three positive thoughts:
(1) the physical sensations after eating were abnormal and
could be relieved without vomiting; (2) the strict diets
they set for themselves were unrealistic and set them up
to "blow it" and binge; (3) the post binge anxiety would
decrease and not be as unpleasant as they feared. After
eating, the patients stayed with the therapist for at least
an hour until they felt sure they were not going to
vomit. Four of the five patients treated either stopped
vomiting or showed a definite improvement. One patient
showed no change.
Antidepressant Drugs
Antidepressant drugs are also used to treat bulimia.
In some cases these are initially helpful in reducing
of binging , but relapses may occur when the
medication is stopped. In some cases binges occur even
when the drug therapy is continued (Stewart-and others).
Bulimia may be related to mood disorders, as is
suggested by the higher incidence of both mood disorders
and alcoholism in relatives of bulimic individuals.
However, other psychological factors may also contribute
to bulimic behavior. It seems likely that certain personality
factors that may be genetically determined make
some people more vulnerable to and social experiences
that have a negative effect on self-esteem and
feelings of self-efficacy (Strober and Humphrey).
Therefore, a behavioral treatment may be more effective
than the use of antidepressant drugs in enhancing coping
skills and thereby preventing relapse. Research programs
for the treatment of bulimics are quite structured
and focus on eating behavior. In general, such treatment
Has been successful (Mitchell and Eckhart).
If you are serious about changing,
I encourage you to schedule a FREE CONSULTATION with the treatment method I recommend:
http://www.theliberatormethod.com/Welcome.html
+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
NOTES:
I encourage you to schedule a FREE CONSULTATION with the treatment method I recommend:
http://www.theliberatormethod.com/Welcome.html
+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
NOTES:
Diagnostic tools for eating disorders
Body Satisfaction Scale (BSS)
Body Shape Questionnaire (BSQ)
Child Eating Disorder Examination (ChEDE)
Children's Eating Attitudes Test (ChEAT)
DSM-IV
Eating Attitudes Test (EAT)
Eating Disorder Examination (EDE)
Eating Disorder Examination Questionnaire (EDE-Q)
Eating Disorder Inventory (EDI-3)
Eating Disorder Inventory-2 (EDI-2)
Eating Disorders Inventory for Children (EDI-C)
Kids' Eating Disorders Survey (KEDS)
Questionnaire for Eating Disorder Diagnosis (Q-EDD)
Setting Conditions for Anorexia Nervosa Scale (SCANS)
Stirling Eating Disorders Scales (SEDS)
Yale-Brown-Cornell Eating Disorder
Body Satisfaction Scale (BSS)
Body Shape Questionnaire (BSQ)
Child Eating Disorder Examination (ChEDE)
Children's Eating Attitudes Test (ChEAT)
DSM-IV
Eating Attitudes Test (EAT)
Eating Disorder Examination (EDE)
Eating Disorder Examination Questionnaire (EDE-Q)
Eating Disorder Inventory (EDI-3)
Eating Disorder Inventory-2 (EDI-2)
Eating Disorders Inventory for Children (EDI-C)
Kids' Eating Disorders Survey (KEDS)
Questionnaire for Eating Disorder Diagnosis (Q-EDD)
Setting Conditions for Anorexia Nervosa Scale (SCANS)
Stirling Eating Disorders Scales (SEDS)
Yale-Brown-Cornell Eating Disorder