What is Bulimia Nervosa? – Eating Disorder Video #8

This video is about the DSM definition of Bulimia Nervosa. I feel that it is important to go over what the criteria are because many people misuse the term bulimia. I also recognize that bulimia and any other eating disorder is different to each and every person suffering, however, there has to be a DSM definition in order to properly diagnose and treat. The first criterion is that they eat more than a “normal eater” would in a short period of time. The DSM says within 2 hours, but like I said this can be different for everyone, as well as the amount eaten can vary from person to person. The second criterion is that they do some behavior to compensate for their “binge.” This can be anything from self-induced vomiting, which is the most common, to over-exercise or use of laxatives and diuretics. The different types of compensatory behaviors places people into one of two categories: purging or non-purging types. Lastly, just like every eating disorder, the person suffering places extreme focus on their weight, size, and shape and will base their entire day, mood, and what they will and will not eat on these feelings.  I hope that helps clear up some of the confusion surrounding what bulimia nervosa really is. It is my hope that leveraging social media whether it is YouTube, Twitter, Facebook, Google+ and LinkedIn can help me reach more people and spread the word about eating disorders and how destructive they can be to the people who suffer from them as well as those closest to them.

TRANSCRIPT:

Hi there, its Kati again, thanks for checking back as always I have some great information for you today and it’s pretty educational. Today’s is a little bit more clinical and the clinical side of what I do, and I’d like to talk to you about the diagnosis of bulimia nervosa. Now I know a lot of you say I already know what that is, I’ve heard it a tons of times and that’s why I just want to clarify, I know that people use eating disorder terms loosely in media, in everyday life, and I want to make sure that you know when I use the term bulimia what I mean by it. So when I diagnose someone with bulimia what am I looking for? As always I refer to my DSM. Now, the DSM is pretty much the bible for diagnosis and I know I have referred to it before; it gives me a list of criteria that someone needs to meet in order to be diagnosed because I don’t want to give a diagnosis to someone if they don’t really meet the criteria. Right? Now, when I begin, the first thing that I’m looking for in someone with bulimia is that they binge eat I know a lot of you say “I binge this, this is what I binge, how much, in this amount of time.î Everybody has something different that they do, it’s not competition. I have heard videos of people saying this person said that their binge, that’s not as much, I binge much more than they binge. It doesn’t matter. What I want to say to a client of mine is, “What feels like a binge to you?î All the diagnostic criteria says that it has to be more than a normal amount of food in a short period of time. Now the time constraint that they give is two hours. I wouldn’t even restrict it to that with my clients I want to know what feels like a binge to them. I’ve had people who eat twenty-five hamburgers, and I’ve had people who’ve eaten an apple and that can feel like a binge to them. So, you have to binge eat that’s part of the bulimia criteria. The second portion of that, is that during this binge the person feels completely out of control, and I know that doesn’t always makes sense especially if you haven’t suffered from an eating disorder. You think, “out of control? They’re just eating, they’re choosing to eat this much.î That’s not the case I had a patient who told me she used to drive along this road and get these certain fast food restaurants she’d stop and get her certain binge foods, it was kind of a ritual that she would do and she would tell me that when she reached the last fast food restaurant, she had picked up all the food that she was planning to eat for her binge would almost have a out-of-body experience.
She said it was like she came out of her body, didn’t even remember eating the food until she kind of awoke from this experience to see wrappers all over a car and receipts from what she purchased and that’s the only way she would realize what had happened. So when I say out of control I mean they feel completely out of control. The next criterion that needs to be met is following that binge and that out of control sensation they do something to “make up for the binge. Now everybody does something different, that’s the same like a binge everybody’s different the most common and the one I hear the most is self-induced vomiting now that’s the one that people throw around a lot “Oh, she went to the bathroom after eating she must be bulimic.î That’s not quite going to work, that’s not really the criterion, that’s an uneducated guess. Now, the criteria that that I’m meeting in my DSM says that they could do self-induced vomiting, they can use laxatives they can use enemas, they can use diuretics some people don’t even purge at all they actually will purge through excessive exercise or some people will even force themselves to starve for x amount of days or time following a binge to make up for it. I even had a patient once that would use the term, îIt set me back to base line. It put me to zero because she had these equations that would you know binge equals this much minus this is back to zero, and that was her goal with her eating disorder. So once these criterion have been met, what else? Well obviously, like any eating disorder the person is going to have a lot of focus on their shape and weight, and that drives the behaviors. That’s what bulimia is, someone will binge eat, they will feel out of control when they binge eat, they’ll do something to make up for it afterwards, and they’ll be horribly, horribly focused on their shape and weight at all times. I hope that helps clarify a little bit about what bulimia really is especially if you have a loved one suffering from it and you want to just understand a little more, that’s kind of the world that they live in. Now I hope that is clear and don’t forget to comment if it’s not, ask questions tell me your feedback things that you’d like to hear from me and don’t forget to subscribe as well to my videos, because when I post or if I respond to a question or anything like that you’ll know about it right away. Continue this journey with me to a healthy mind, healthy body.