Bulimia

Definition

Bulimia literally means “ox hunger” and is short for bulimia nervosa—an eating disorder characterized by binge eating episodes in which an individual feels a loss of control over eating and eats very large amounts of food. The individual reacts to binge episodes by using extreme measures to prevent weight gain, such as self-induced vomiting, laxative abuse, diuretic abuse, fasting, or excessive exercise. Within the United States, self-induced vomiting is the most common method for avoiding weight gain among individuals with bulimia nervosa. Importantly, research has shown that vomiting is not effective in getting rid of the calories consumed during binge-eating episodes. Vomiting only eliminates approximately 25% of the calories consumed during a typical binge-eating episode. Similar to individuals with anorexia nervosa, individuals with bulimia nervosa base their self-worth on their weight and shape. Like all eating disorders, bulimia nervosa is a form of mental disorder recognized by the fields of psychology, social work, nutrition, and medicine. Bulimia nervosa is an important subject in the field of social psychology because social factors play an important role in causing the disorder.

Bulimia nervosa most often occurs in adolescent and young adult females, affecting 0.5% to 3.0% of women (or 1 in 200 to 1 in 33) at some point in their lifetimes. Bulimia nervosa is far less common in males. Estimates suggest that 0.05% to 0.3% of men (or 1 in 2000 to 1 in 300) suffer from bulimia nervosa at some point in their lifetimes. Bulimia nervosa appears to be a modern problem. A British physician first used the term bulimia nervosa in 1979 to describe [Page 129]normal-weight female patients who regularly binged and vomited. Rates of bulimia nervosa increased dramatically over a very short period of time in the second half of the 20th century. In addition to being a modern problem, bulimia nervosa appears to be a problem restricted to Western cultures such as the United States and England or individuals who have been exposed to Western ideals.

Western Ideals and Bulimia Nervosa

The increasing idealization of thinness for women in Western culture provides one explanation for increasing rates of bulimia nervosa over the second half of the 20th century and the increased rates of the disorder in women compared to men. In modern, Western culture, being thin has been equated with being beautiful. The idealization of thinness has created associations between thinness and other positive qualities, such as success, intelligence, motivation, likeability, and strength. In contrast, fatness has been associated with many negative qualities, such as laziness, stupidity, loneliness, ineptitude, weakness, and dependence.

The thin ideal contrasts sharply with the reality of what most women's bodies look like, leaving most women dissatisfied with their own body weight and shape. In bulimia nervosa, dissatisfaction with weight and shape influence self-esteem, and the potential impact of weight gain on self-esteem motivates extreme attempts to control weight. Ironically, extreme attempts to control weight may trigger binge-eating episodes, locking individuals with bulimia nervosa in a vicious cycle of dieting, binge eating, and purging. The processes by which attempts to control weight lead to behaviors that cause weight gain are similar to processes described in social psychology in the area of self-regulation. Further, work by Vohs and colleagues has shown that low self-esteem is directly linked to binge eating among individuals who perceive themselves as overweight and have high levels of perfectionism. Although binge eating would increase the chasm between actual weight and perfectionistic weight ideals, it temporarily reduces painful selfawareness in individuals with low self-esteem. This explanation is consistent with models put forth by Baumeister and colleagues for other self-destructive behaviors as being motivated by a desire to escape the self.

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