I have some great information for you today and it's pretty educational today's is a little bit more clinical 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 and what I mean by it so when someone with bulimia what am I looking for as always I refer to 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 everybody has something different that they do it's not competition I have read articles 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 is what feels like a binge to you all the diagnosis 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 patients I want to know what feels like a binge to them I know people who eat twenty-five hamburgers, and I know 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 that's not the case I know 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 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 criteria 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 has to be bulimic that is not Quite gonna work, that isn't really the criteria that's an uneducated guess to somebody.
Now, the criteria that that I'm meeting in My DSM says that 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 know other patient once that would use the term It set me back to base line It could 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. And 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.