Where previously bulimia was nearly exclusively a 'white woman’s disease', statistics are showing that more and more bulimics are black teenagers who are caught between their traditional culture, which accepts womanly, rounded bodies as attractive, and western pop-culture, which hails extreme thinness or even emaciation, as ‘beautiful’.
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What is bulimia?
Bulimia nervosa is defined as “an illness, characterised by repeated episodes of binge eating followed by inappropriate compensatory methods such as purging including self-induced vomiting or misuse of laxatives, diuretics, or enemas, or non-purging including fasting or engaging in excessive exercise.” (Krause, 2000).
Thus a patient with bulimia will alternate between bouts of excessive eating and episodes of ridding the body of this mountain of food by using laxatives, or diuretics, or vomiting. Some bulimics resort to periods of fasting or exercise to the point of exhaustion to counteract the vast amounts of food they eat. In most cases, the act of gorging arouses extreme feelings of guilt in bulimics, who punish themselves by using self-degrading methods to ‘cleanse themselves of their sin (i.e. overeating)’.
The hidden scourge
Although bulimia and anorexia nervosa often overlap, bulimia can be much more difficult to detect than anorexia. Patients are usually masters at concealing their disorder, going to extreme lengths to cover up their binges and subsequent purging. In some cases bulimics are also not as thin and emaciated as patients suffering from anorexia, so that most observers, including parents and loved ones, are not aware of the tragedy that is playing out in their families. The best example of this hidden scourge, was Diana, Princess of Wales, who dazzled the world with her beauty and charm while suffering the secret agonies of bulimia.
How to detect bulimia
Many parents worry about their children’s diets and eating habits, but tend to rationalise their fears. ‘Oh, Mary has always been thin, but she has such a wonderful appetite. You know how these girls are always fussing about their figures. And they won’t listen to any advice. But she assures me that she is fine. So what can I do?'
You should start worrying if:
You suspect that your child is binging (i.e. eating an abnormal amount of food in a short period such as two hours) and she does not really gain weight or starts losing weight alarmingly;
Your child is continually using laxatives or disappearing into the bathroom for hours after meals;
Her teeth show signs of erosion caused by repeated exposure to stomach acid during bouts of self-induced vomiting;
Her behaviour is anxious or out of control;
She exercises to exhaustion or fasts in between bouts of gorging;
You feel she is trying to cover up something.
Getting help
Bulimics are excellent at duping both themselves and significant others about the severity of their illness. You may find that any overtures you make, any attempt to even suggest that your child has an eating disorder is met with denial, anger and evasion. But if you, as a parent, feel that there is something seriously wrong with your child, you need to take drastic steps to bring this hidden scourge out into the open.
Bulimia and anorexia are serious psychological illnesses, and you and your child are going to need expert help to win the battle against the disease. Since eating disorders have a large psychological component, your first step should be to get the assistance of a clinical psychologist or psychiatrist.
Ask your family doctor to refer you, or contact Tara Hospital in Johannesburg (Phone: 011 - 783-2010), or the Kenilworth Clinic in Cape Town (Phone: 021- 797?1400).
To address the eating component of bulimia it is also important to consult a clinical dietician. Check the List of Dieticians on this website, or phone 082?593?0276, or send an e?mail to sscharf@nhcltd.com or look in your local telephone directory or Yellow Pages, to find a dietician in your area.
Patients with bulimia need to be guided and counselled by a professional to correct their disordered eating patterns. In addition, bulimics may have a variety of nutrient deficiencies due to long periods of vomiting, or abuse of laxatives and/or diuretics. These deficiencies need to be eliminated by implementing balanced eating habits and supplements.
The important thing is to be aware of potential bulimia and/or anorexia in teenagers and young adults – both black and white, male and female – and do something about their problem before it is too late. – (Dr I.V. van Heerden, DietDoc)
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