[The story of bulimia nervosa ①] High self-esteem is a key to treat bulimia nervosa
[The story of bulimia nervosa ①] High self-esteem is a key to treat bulimia nervosa
  • Philip Choi
  • 승인 2022.08.19 10:01
  • 댓글 0
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Bulimia is caused by diet fail, mood disorders, sociocultural factors, etc.
Building high self-esteem’ is the goal of the treatment

For modern people, diet can be said to be a necessity, not an option. There are a lot of broadcasting shows that talk about how obesity has a bad effect on health, it is because modern society has begun to recognize obesity as a disease. As a result, more people are trying to lose their weight in a healthy way, but there are also people who want to lose their weight through excessive diet in a short period of time and some of them eventually suffered from eating disorders such as ‘bulimia’. It is because their physical and mental health was getting poor by excessive diet method. 

Bulimia nervosa is an abnormal eating behavior in which 2 or more servings are eaten within a short time (within about 2 hours) and loss of control while eating. Moreover, they also vomit food, take laxatives, diuretics, or exercise excessively because of their extreme fear of gaining weight. If you are obsessed with your own weight and body type, and if this behavior is repeated more than once a week for 3 months, you should suspect bulimia.

This disorder mainly occurs in the age group that starts dieting, and most of it starts in women in their late teens or early 20s, but these days, elementary school students and men also diet a lot, so the age of occurrence is getting lower, and it happens to both men and women. 

Bulimia is closely related to psychological stress, such as repeated diet fail, or mood disorders, including depression. Dr. Eunjung Yoo, a founder of Good Image Clinic, explained, “When I look at the patients I meet mainly in my clinic, the typical conditions that cause bulimia are repeated diet fail and the yo-yo dieting. Also, it happens for resolving depression or anger problem through bulimia.” 

The other cause, there is a study that it occurs when there is a problem with a neurotransmitter called serotonin, which makes you feel full, or endorphins, which make you feel euphoric when you eat food. Sometimes, it occurs when adolescents do not adequately express and satisfy their needs or when they have impulse control disorders. In particular, abnormal behaviors such as bulimia in teenagers are often found in their family troubles. 

It can also be caused by sociocultural factors that try to meet social expectations for slim body line. As the quality of life has improved with industrialization and modernization, slim body line has become a value to pursue, while being overweight has been imaged as ugly and a failure in self-management. Due to these changes and pressures in the socio-psychological environment, people have no choice but to be affected when they look at their own bodies. As a result, the fear of eating and the suppression could not be tolerated, and symptoms of repeated binge eating, and vomiting occurred. This is the reason why bulimia occurs mainly in the age group that starts a diet.

The food that binge eaters seek is often sugar, carbohydrates, and high-fat diets, so treatment for sugar addiction and carbohydrate poisoning should be done in parallel.(This image is not related to the content of the article)
The food that binge eaters seek is often sugar, carbohydrates, and high-fat diets, so treatment for sugar addiction and carbohydrate poisoning should be done in parallel.(This image is not related to the content of the article)

Bulima nervosa has various causes, it is important to find out what the cause is and to get proper treatment. About a third of people may experience bulimia symptoms even after treatment, but about half have been reported to recover completely. However, if left untreated, there is no chances of getting better even a long period of time passed. If you frequently vomit, it is easy to cause tooth damage and tooth decay, and there is also a risk of cardiac arrest due to electrolyte abnormality, dehydration, and hypokalemia. The reflux of gastric juice can cause esophagitis or hypertrophy of the salivary glands, causing the face to swell easily or the ear to bulge by parotitis.

People with bulimia can have trouble with their families, lose their efficiency at school or at work, and can interfere with social life such as avoidance of people. If you have bulimia or binge eating disorder, it is best to seek a doctor who can help you. 

The fist treatment for bulimia is medication. It is easy to prescribe appetite suppressants when binge eating occurs, but appetite suppressants have side effects that cause depression, difficulty in impulse control, and repeat fasting and binge eating. Therefore, the same type of drug treatment as a serotonin reuptake inhibitor is carried out. The food that binge eaters seek is often sugar, carbohydrates, and high-fat diets, so treatment for sugar addiction and carbohydrate poisoning should be done in parallel. Contrave is prescribed as a drug for these addictions. 

Also, cognitive behavioral therapy to correct abnormal behaviors related to binge eating is being performed. It is to discover the psychological factors and cognitive distortions that cause binge eating while keeping a food diary. Dr. Yoo wrote <49 Days Meal Diary> and is using a therapy that discovers eating behavior and psychological factors every day for 7 weeks in clinical practice. Dr. Yoo said, ”7 weeks is the optimal period to complete a new eating habit, and you can discover wrong eating habits while repeating good behaviors, and it helps you lose weight by preventing overeating or binge eating. In addition, by finding signs of hunger or satiety and adjusting your diet, you can control your habit of looking for food even when you are not hungry. In the end, they say that self-regulation by taking care of the body and mind can have the effect of increasing self-esteem.” 

Therefore, binge eating should be accompanied by psychotherapy that supports feelings of guilt, depression, and social avoidance. The psychological cause of binge eating is ultimately low self-esteem because self-esteem declines due to the appearance of not being able to control even one food.

Dr. Yoo said, “Building high self-esteem’ is the goal of the treatment.” If you do not love yourself, bulimia can come back, so you need to have an attitude to overcome bulimia through systematic treatment with a professional doctor.”
Dr. Yoo said, “Building high self-esteem’ is the goal of the treatment.” If you do not love yourself, bulimia can come back, so you need to have an attitude to overcome bulimia through systematic treatment with a professional doctor.”

Bulimia may start due to the wrong diet or the yo-yo dieting, so education on diet and balanced nutrition management are necessary. In addition, it is good to include nutrition counselling and diet education for the patient’s family, and t is desirable for the patient’s family to actively help the patient. Binge eating is often done secretly in one’s own space, and it may be helpful to try to spend time with the patient during the time the patient is binge, rather than scolding the patient for uncontrollable impulses. 

Dr. Yoo emphasized, “Building high self-esteem’ is the goal of the treatment.” If you do not love yourself, bulimia can come back, so you need to have an attitude to overcome bulimia through systematic treatment with a professional doctor.”


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