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Bulimia: Causes and Treatment Term Paper

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Updated: Mar 29th, 2022


Bulimia is an eating disorder which is portrayed by binging on food and subsequently vomiting in several attempts of purging. “removal of nutrients in form of purging entails forced vomiting, excessive exercise, laxative use, or fasting to shed weight that could have been put on from binging and eating food. Bulimia is mainly widespread amongst adolescents and young adult women” (Parker 2). Persons with bulimia will have normal weight or near-standard weight. “People with bulimia are often characterized with feelings of guilt over their behavior and a feeling of loss of control over their consumption” (Parker 2). This paper is therefore an analysis of the causes of bulimia and its treatment or management. In the paper, a case study done on bulimia will also be discussed.

Causes of bulimia

The exact causes of bulimia are not established but several factors are capable of influencing its occurrence (Parker, 2).

  • Genetics and family influences. Studies indicate that bulimia mostly occurs in relatives of persons who have had cases of bulimia than in those who have not.
  • According to researchers, altered levels of serotonin which is a chemical in the brain can cause bulimia.
  • Cultural factors to a great extent affect eating disorders particularly in contemporary society’s where people emphasize a degree of thinness, therefore, influencing people’s acceptance of self.


  • “Eating large quantities of food frequently in a short period could be in less than 2 hours” (Grohol, 1).
  • “Purging (eliminating the calories one has eaten) by excessive exercise, forced vomiting, fasting, abusing laxatives or enemas” (Grohol, 1).
  • Cases of binge-purge cycles
  • Building self-worth and self-esteem on weight and body shape.
  • Being afraid and feeling guilty of eating too much and fear of gaining weight,


Management of bulimia is pegged on behavioral therapy and counseling. Eating disorders are more often than not founded on self-perception and self-esteem. Other therapies are also pegged on emotional grounds like support groups and family support as well as self-acceptance. In this case, dialectical cognitive behavior therapy is used for Bulimia Nervosa.

Case study

The study entailed Thirty women aged between 18 and 65 years being signed up using an advert in the newspapers and clinic referrals. On average each of them had at least one purge/binge a week for the preceding three months. There was a need to widen the applicability of the study, a customized DSM-IV criterion comprising binge/purge episode a week instead of the full DSM-IV criteria of two episodes as necessary was used for treatment. Among the participants, twenty-five met the full criteria while only six met the customized criteria. The customized criteria involved

  • Use of BMI (Body mass index) of 17.5
  • Neurosis or severe depression amid suicidal schemes
  • Alcohol or substance abuse which is active
  • Synchronized involvement in psychoanalysis or simultaneous use of mood stabilizers or antidepressants

The participants were put on a 20-week waiting list and phones were used to re-examine them to determine therapeutic participation throughout the period.

Enlisted contestants were allocated to the therapy program or waiting- list randomly in masses of eight. This ensured a balanced number of members in every condition. Eight envelopes that were sealed were given to the participants. “Four of sealed envelopes contained assignments to the treatment condition and the other four, the waiting-list condition” (Safer, Telch and Agras, 633). To randomize them, the envelopes were first shuffled and numbered then given to the contestants.

“The patients assigned to the waiting-list conditions were given dialectical behavior therapy upon conclusion at the 20-week state waiting- list” (Safer, Telch and Agras, 633). Post-treatment and baseline procedures were applied which included the following;

  • “The negative mood regulation scale (14)
  • The Rosenberg self-esteem scale (18)
  • Positive and negative affect list (17)
  • Eating disorder examination (13)
  • Multidimensional personality scale (16)
  • Emotional eating scale (15) and
  • Beck depression inventory (14)” (Safer, Telch and Agras, 633)

Weekly, twenty sessions of individual psychotherapy that took 50 minutes were used to particularly instruct emotional management to cut purging or binge eating. To perform the study, the psychiatrist used a bulimia management manual from Linehan’s Skills training manual on personality disorders.

In a nutshell, this behavior therapy model for bulimia visions emotional deregulation as the heart of Bulimia Nervosa disorder. Therefore, purging and binge eating are seen as attempts to control, alter, or manage painful emotional status. Patients have trained a selection of skills to change dysfunctional emotions and behaviors.

By 20 weeks of dialectical behavior therapy, four of the patients were ascetic from purging tendencies and binge eating contrary to the none participants in the group on the waiting list. The other five members only demonstrated mild signs and a reduction of episodes of binge eating by approximately 88%. The other two in the waiting-list group patients recorded no significant fall in the purge or binging episodes while the other 12 continued with the symptoms. In dialectical therapy, five contestants continued to be indicative of the signs.


The results indicated that the levels of binging and purging reduced to a great extent after the therapy intended to train adaptive feelings regulation proficiency.

“The limitations of the study can be linked to its small sample size which limits the ability to extract concrete differences between the two groups of participants” (Safer et al, 634). Additionally, lack of comparisons between groups with more conditions except for the waiting-list condition will be difficult to conclude with certainty that dialectical behavior therapy affects bulimia symptoms. Nonetheless, as a preface account, the results of large improvements in purge behaviors and binge eating are indicative of a positive impact.

Works cited

Grohol, John. Bulimia Nervosa symptoms PsychCentral.com; 2010. Web.

Parker, David. ; emedicinehealth 1-4: 2011. Web.

Safer, Debra. L., Telch, Christy. F., and Agras, Stewart. “Dialectical Behavior Therapy for Bulimia Nervosa” Am J psychiatry (2001):158:632-634. Web.

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