Running head: BULIMIA NERVOSA

Bulimia Nervosa: A Mental Disorder Jasmine McKenzie 3/18/2013

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According to the Diagnostic and Statistical Manual of Mental Disorders Four Edition (2004) (DSM-IV-TR) bulimia nervosa is binge eating and inappropriate compensatory methods to prevent weight gain. Binge eating is when an individual eats an abnormally large amount of food in a short period time and feeling unable to control the eating. Binge eating is negatively reinforced because it allows the individual to provide momentary relief for an emotion. Bulimia nervosa is an eating disorder that involves the emotional, behavioral and cognitive development of an individual. Bulimics usually result in compensatory behaviors such as vomiting, use of laxatives, fasting, and extreme dieting and over exercising (APA, 2000). Individuals who suffer from bulimia nervosa experience a great deal of lacking self-esteem, self-worth and depression issues. Individuals suffering from this disorder also have problems with self image. There is some significant changes proposed dealing with eating disorders from the old DSM-IV to the new DSM-V. One proposal is adding Binge Eating Disorder as a separate diagnosis. The second proposal is changing the criteria of anorexia nervosa by removing amenorrhea. The last proposing change is to the central criteria of bulimia nervosa to no longer having to have a certain number of episodes per week to be diagnosis. The current paper will help guide in the understanding of the symptoms, causes, useful treatments and prognosis based off those treatments of bulimia nervosa. Researchers have suggested that bulimia nervosa evolves from all aspects such as biological, psychological and sociological causes. According to (Phillips, Greydanus, Pratt and Patel, 2003) the theory of this etiology, often referred to as biosociopsychological theory, is more comprehensive than earlier theories that attempted to explain this disorder in a manner that today appears blaming and simplistic. The onset of bulimia nervosa usually begins in late adolescence

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or early adult life (DSM-IV-TR; APA, 2000). Bulimia nervosa in a population sample, at least 90% can be found in females with only a small number of men diagnosed (APA, 2000). This disorder is reported more in Westernized societies and industrialized countries, such as the United States, Canada, Europe, Australia, Japan, New Zealand, and South Africa (APA, 2000). Studies have shown that bulimia nervosa is most prominent in white females in the United States (APA, 2000). Some reports also suggest that males with bulimia nervosa have a higher prevalence of premorbid obesity than do females with bulimia nervosa (APA, 2000). Researchers have linked biological, psychological, and sociological causes to bulimia nervosa. Primary biological causes of bulimia nervosa suggest that there is a strong relationship between depression and bulimia. Even though some studies have made this suggestion there is little to no evidence to prove that there is a true biological link to bulimia. However, psychological and sociological factors can be associated with bulimia. The psychological factors are obvious. An individual, who suffers from any eating disorder, but specifically bulimia nervosa, has a self-image issue. The need to look and portray a certain image is what some researchers are calling perfectionism. The whole idea where in order to be perfect in todays society one must be thin and have an eating disorder. The term perfectionism floats around dealing with individuals who have any eating disorder. Bulimics deal with a distorted body image, fragile sense of self, negative sense of self, low self esteem, and a sense of worthlessness or unable to have a power over oneself. One of the most suggested treatments for individuals who have an eating disorder is the cognitive-behavioral therapy (CBT) or the interpersonal psychotherapy (IPT). Sociological factors play a tremendous role in bulimics. The two most important factors are family and culture. Researchers suggest a strong relationship between the role of the family and eating disorders. Family can cause the psychological factors dealing with

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bulimia. The relationship between mothers and daughters, a distant father-daughter relationship or the separation of parents can all be detrimental in aiding to the cause of bulimia. Culturally we are obsessed with the image of being thin. As a culture we are focused on looking perfect regardless of the cost or harm it can cause ourselves. Our society was founded on the precepts life, liberty, and the pursuit of happiness, has been transcended to life, liberty and the pursuit of thinness (Murray, 2003). The advertising industry plays a significant role in designing the cultural ideas of how both men and women should look. As a future clinician and having to assess/diagnosis a patient with bulimia nervosa, I would take the psychological approach for treatment. To diagnose a person with bulimia nervosa most clinicians use a clinical interview developed by them. A clinician should take into account the affects the disorder may have on their thinking, mood, behavior, and physical well-being. As a clinician, obtaining information by asking questions in these areas will guarantee best results for treatment. Questions pertaining to a person well-being are not going to be that in depth as others are designed to be. Simple questions just to make sure immediate medical attention isnt required and to monitor progress as treatments continue.