Hi there, it’s Kati again, thanks for checking back
as always I have some great information for you today and it's pretty educational
today's is
a little bit more clinical and the clinical side of what I do
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 I diagnose someone with bulimia what am I looking for
as always I refer to my 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 heard videos 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
to a client of mine 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 my clients I want to know what feels like a binge
to them
I've had people who eat
twenty-five hamburgers, and I’ve had 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 had 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 That’s
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 must be bulimic”
that's not
Quite going to work, that's not really the criteria that's
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 even had a 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 and don't forget to comment if it's not ask questions
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