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Bulimia nerviosa, hoja de datos

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It was ten years ago when I became bulimic. I had always worried about my weight and how I looked. I thought I looked fat, no matter what the scale showed or anyone said. But I had never made myself throw up - not until after college. I felt stressed out after graduating from college. I was very overwhelmed with my new job and turned to food to feel more in control of my life. Sometimes, I'd eat a lot of food and throw it up. Other times, I'd throw up a normal meal. At the time, it seemed like the only way I could cope with my stress. Luckily, I got help from a doctor, after a friend talked to me about the problem. It took a lot of work, but I am better now.

What is bulimia?

Bulimia nervosa (buh-LEE-me-ah nur-VOH-suh), often called bulimia, is a type of eating disorder. A person with bulimia eats a lot of food in a short amount of time (binging) and then tries to prevent weight gain by getting rid of the food (purging). Purging might be done by:

  • Making yourself throw up
  • Taking laxatives (pills or liquids that speed up the movement of food through your body and lead to a bowel movement)

A person with bulimia feels he or she cannot control the amount of food eaten. Also, bulimics might exercise a lot, eat very little or not at all, or take pills to pass urine often to prevent weight gain.

Unlike anorexia, people with bulimia can fall within the normal range for their age and weight. But like people with anorexia, bulimics:

  • Fear gaining weight
  • Want desperately to lose weight
  • Are very unhappy with their body size and shape

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Who becomes bulimic?

Many people think that eating disorders affect only young, upper-class white females. It is true that most bulimics are women (around 85-90 percent). But bulimia affects people from all walks of life, including males, women of color, and even older women. It is not known for sure whether African American, Latina, Asian/Pacific Islander, and American Indian and Alaska Native people develop eating disorders because American culture values thin people. People with different cultural backgrounds may develop eating disorders because it's hard to adapt to a new culture (a theory called "culture clash"). The stress of trying to live in two different cultures may cause some minorities to develop their eating disorders.

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What causes bulimia?

La bulimia no es simplemente un problema con la comida. A binge can be triggered by dieting, stress, or uncomfortable emotions, such as anger or sadness. Purging and other actions to prevent weight gain are ways for people with bulimia to feel more in control of their lives and ease stress and anxiety. There is no single known cause of bulimia, but there are some factors that may play a part.

  • La cultura. Women in the U.S. are under constant pressure to fit a certain ideal of beauty. Seeing images of flawless, thin females everywhere makes it hard for women to feel good about their bodies.
  • Las familias. If you have a mother or sister with bulimia, you are more likely to also have bulimia. Parents who think looks are important, diet themselves, or criticize their children's bodies are more likely to have a child with bulimia. 
  • Life changes or stressful events. Traumatic events (like rape), as well as stressful things (like starting a new job), can lead to bulimia.
  • Personality traits. A person with bulimia may not like herself, hate the way she looks, or feel hopeless. She may be very moody, have problems expressing anger, or have a hard time controlling impulsive behaviors.
  • Biología. Genes, hormones, and chemicals in the brain may be factors in developing bulimia.

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What are signs of bulimia?

A person with bulimia may be thin, overweight, or have a normal weight. Also, bulimic behavior, such as throwing up, is often done in private because the person with bulimia feels shame or disgust. This makes it hard to know if someone has bulimia. But there are warning signs to look out for. Someone with bulimia may use extreme measures to lose weight by:

  • Using diet pills, or taking pills to urinate or have a bowel movement
  • Going to the bathroom all the time after eating (to throw up)
  • Exercising a lot, even in bad weather or when hurt or tired

Someone with bulimia may show signs of throwing up, such as:

  • Swollen cheeks or jaw area
  • Calluses or scrapes on the knuckles (if using fingers to induce vomiting)
  • Teeth that look clear
  • Broken blood vessels in the eyes

People with bulimia often have other mental health conditions, including:

  • Depresión
  • Ansiedad
  • Substance abuse problems

Someone with bulimia may also have a distorted body image, shown by thinking she or he is fat, hating her or his body, and fearing weight gain.

Bulimia can also cause someone to not act like her or himself. She or he may be moody or sad, or may not want to go out with friends.

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What happens to someone who has bulimia?

Bulimia can be very harmful to the body. Look at the picture to find out how bulimia affects your health.

Diagram of how bulumia affect the body

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Can someone with bulimia get better?

Is it safe for young people to take antidepressants for bulimia?

Es posible que sea seguro tratar a las personas jóvenes con antidepresivos. Sin embargo, las compañías farmacéuticas que hacen antidepresivos tienen la obligación de colocar una etiqueta de advertencia de "caja negra" en los medicamentos. Una advertencia de "caja negra" es el tipo de advertencia más grave en medicamentos con receta.

Es posible que los antidepresivos causen que los niños, adolescentes y adultos jóvenes piensen más en el suicidio o que comentan el suicidio.

La FDA ofrece la información más reciente, como qué medicamentos están incluidos en esta advertencia y qué signos de peligro buscar, en su sitio web http://www.fda.gov.

Yes. Someone with bulimia can get better. Un equipo de atención médica compuesto por médicos, nutricionistas y terapeutas pueden ayudar al paciente a recuperarse. Ayudarán a la persona a incorporar patrones de alimentación saludables y a lidiar con sus pensamientos y sentimientos. El tratamiento de la bulimia utiliza una combinación de opciones. Que el tratamiento funcione depende de cada paciente.

Para evitar que una persona siga dándose atracones y vomitando, probablemente el médico recomiende que:

  • Reciba asesoramiento nutricional y psicoterapia, especialmente terapia conductual cognitiva (CBT, por sus siglas en inglés)
  • Se le indiquen medicamentos

CBT es una forma de psicoterapia que se enfoca en el importante rol de pensar en cómo nos sentimos y qué hacemos. Se ha demostrado que la CBT adaptada para el tratamiento de la bulimia resulta efectiva para modificar los hábitos de atracones y vómitos, y las actitudes frente a la comida. La terapia para una persona con bulimia puede ser individual con un terapeuta o grupal.

Algunos antidepresivos, como la fluoxetina (Prozac), que es el único medicamento aprobado por la Administración de Alimentos y Medicamentos (FDA) de EE. UU. para tratar la bulimia, pueden ayudar a pacientes que también sufren depresión y/o ansiedad. También parece reducir el hábito de darse atracones y luego vomitar, reduce las probabilidades de una recaída y mejora la actitud frente a la comida. ("Recaída" significa volver a enfermarse después de haber mejorado durante un tiempo).

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Can women who had bulimia in the past still get pregnant?

Active bulimia can cause a woman to miss her period sometimes. Or, she may never get her period. If this happens, she usually does not ovulate. This makes it hard to get pregnant. Women who have recovered from bulimia have a better chance of getting pregnant once their monthly cycle is normal. If you're having a hard time getting pregnant, see your doctor.

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How does bulimia affect pregnancy?

If a woman with active bulimia gets pregnant, these problems may result:

  • Aborto espontáneo
  • High blood pressure in the mother
  • Baby isn't born alive
  • Baby tries to come out with feet or bottom first
  • Birth by C-section
  • Baby is born early
  • Bajo peso al nacer
  • Birth defects, such as blindness or mental retardation
  • Problems breastfeeding
  • Depression in the mother after the baby is born
  • Diabetes in the mother during pregnancy

If a woman takes laxatives or diuretics during pregnancy, her baby could be harmed. These things take away nutrients and fluids from a woman before they are able to feed and nourish the baby. It is possible they may lead to birth defects as well, particularly if they are used regularly.

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What should I do if I think someone I know has bulimia?

If someone you know is showing signs of bulimia, you may be able to help.

  1. Set a time to talk. Set aside a time to talk privately with your friend.  Make sure you talk in a quiet place where you won't be distracted.
  2. Tell your friend about your concerns. Be honest. Tell your friend about your worries about his or her eating or exercising habits. Tell your friend you are concerned and that you think these things may be a sign of a problem that needs professional help.
  3. Ask your friend to talk to a professional. Your friend can talk to a counselor or doctor who knows about eating issues. Offer to help your friend find a counselor or doctor and make an appointment, and offer to go with him or her to the appointment.
  4. Avoid conflicts. If your friend won't admit that he or she has a problem, don't push. Be sure to tell your friend you are always there to listen if he or she wants to talk.
  5. Don't place shame, blame, or guilt on your friend.  Don't say, "You just need to eat." Instead, say things like, "I'm concerned about you because you won't eat breakfast or lunch." Or, "It makes me afraid to hear you throwing up."
  6. Don't give simple solutions. Don't say, "If you'd just stop, then things would be fine!"
  7. Dile que siempre la apoyarás sin importar lo que haga.

Adapted from "What Should I Say? Tips for Talking to a Friend Who May Be Struggling with an Eating Disorder" from the National Eating Disorders Association.

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Más información sobre bulimia nerviosa

For more information about bulimia nervosa, call womenshealth.gov at 800-994-9662 (TDD: 888-220-5446) or contact the following organizations:

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Última actualización del contenido: 16 de julio de 2012.

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