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Bulimia Nervosa: The Binge-Purge Cycle

The binge-purge cycle as found in bulimia nervosa has the ability to perpetuate itself, making this eating disorder a dangerous and debilitating illness.

Bulimia nervosa is a chronic eating disorder that affects an estimated 1 to 4 percent of the female population in the United States, according to studies from The American Journal of Psychiatry. A smaller percentage of men also suffer from the illness.

The Binge Purge Cycle, Bulimia Nervosa

The binge/purge cycle is at the heart of the bulimia disorder. A bulimic will take part in a binge, which consists of eating an unusually large amount of food in one sitting. The binge is followed by a purging behavior, in which the bulimic tries to counteract the binge by ridding the body of the food consumed.

Self-Esteem and Bulimia

To understand how the binge-purge cycle works, it is important to understand the underlying psychological issues that can trigger this cycle in bulimia nervosa.

Self-esteem is the key to the binge/purge cycle. Although sometimes viewed as a modern pop-psychology catch-phrase, self-esteem is serious business. The National Association for Self-Esteem defines self-esteem as “The experience of being capable of meeting life’s challenges and being worthy of happiness.

Over the years studies have shown that low self-esteem and eating disorders go hand in hand. Those with eating disorder express feelings of poor body image, loneliness, depression, helplessness, loss of control and an inability to adapt to stress or change. These factors are often seen within eating disorder patients and also are the components of low self-esteem.

Therefore, for bulimics, the defining aspects of self-esteem—accepting self-worth and dealing with stress—is difficult and often aids in the fueling the binge-purge cycle.

Binging and Purging

The trigger for a binge is different for each patient. A bad day at work, a fight with a family member, or a comment about weight from a stranger can play upon the inherent existence of low self-esteem within the patient.

A binger can consume as many as 3,400 calories in one sitting, as cited by Psychology Today. Once the binge is over, the overwhelming feelings of guilt begin to take hold. To try and “fix” the damage done from the binge, the bulimic will then attempt to purge the body of the food and calories just consumed.

The purge can be from self-induced vomiting, taking laxatives, diuretics or enemas or participating in excessive exercise or periods of fasting.

Laxatives and diuretics are common aids to purging - Bulimia Nervosa - The Binge-Purge Cycle
Bulimia Nervosa: Laxatives and diuretics are common aids to purging

The entire binge-purge experience leaves intense emotional reactions, which are filtered into the category of low-self esteem. In order to deal with existing feelings of loneliness, helplessness, and isolation, the patient binged.

To deal with the negative feelings from the binge, the patient purged. But after the cycle ends, the patient is still left with feelings of low self-esteem from the inability to control the behavior, and the binge-purge cycle begins again.

The Effects of Binge and Purge

Without treatment, bulimia nervosa can go on for years and have serious physiological effects. The National Eating Disorders Association sites that those who partake in the binge/purge cycle can increase the risk for:

  • Dental problems such as tooth decay and damage to tooth enamel from self-induced vomiting.
  • Irregular bowel movements from abuse of laxatives.
  • Electrolyte imbalances from dehydration and a lack of sodium and potassium in the body.
  • Esophageal and/or gastric rupture from vomiting.

There are treatments available to stop the binge-purge cycle and recover from bulimia.

For more information on bulimia nervosa and the binge-purge cycle, try the NEDA website or the American Psychological Association’s section on eating disorders.

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