abuse is a common comorbidity with bulimia with a third of all bulimics having alcoholism. PTSD is another common comorbidity. There are physical aspects and side effects to living with bulimia nervosa. These include blood sugar imbalances, nausea, vomiting, bloating, constipation, and abdominal pain. Hormones can be affected and sex hormones can decrease, leading to osteoporosis. There may be a decrease in thyroid hormones, affecting metabolism. There is no particular cure for bulimia but it can be treated. Therapy, medications, nutritional counseling, and medical/psychiatric monitoring need to take place. Treatment includes cognitive-behavioral therapy, acceptance and commitment therapy, dialectical behavioral therapy, psychodynamic psychotherapy, and family-based therapy. SSRIs are commonly used to treat things like depression, anxiety, and social phobia. Tricyclic antidepressants and topiramate can be used to decrease bingeing and purging cycles. About half of patients are symptom-free after five years following initiation of treatment.
BINGE-EATING DISORDER (307.51) This is an eating disorder that has compulsive overeating as the main symptom. The patient will eat long after they are full and when they aren’t even hungry. There are no purging behaviors; the patients may be normal weight, slightly overweight, and even obese. This is a new diagnosis under the DSM-V and involves a lack of self-control, usually starting in adolescence or early adulthood. Self-esteem and other psychological factors differentiate it from simple overeating. The episodes can occur several times per day or for several hours in any given day. Patients often have self-hatred over their inability to control their eating habits. The patient will often feel uncomfortably full and will be anxious or depressed, often refusing to eat in front of others. They will often say that they will diet after an episode and return to their destructive patterns of eating shortly after they quit eating. The patient often denies their behavior and lives in secrecy, being ashamed of their behavior. There is no simple diagnosis for the disorder
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