Disease, bulimia nervosa .. How can he be treated
Disease, bulimia (excessive eating) nervous (bulimia nervosa) is characterized by a cycle of eating followed by continuous acts kind of «disinfection» to prevent weight gain. The researchers estimated that between one woman and three women out of every 100 women, are exposed to disease bulimia nervosa in the period of Heaouthn. As for men, the levels of diagnosis does not constitute more than a dozen rates among women.
* Between the waste and cleansing
* Despite the fact that many Americans increased their high intake of calories a day (which explains the injury and one out of every three of whom were obese), the indulgence in food includes addressing the very large amounts of food during a very limited period, usually within two hours. When the patient is excessive, it might deal with in accordance with full of cake instead of eating a piece or two pieces of it, or deals with several liters of ice cream (ice cream) instead of the pot and one of them.
Describes the «Diagnostic and Statistical Manual of Neurological Disorders» in the fourth edition of The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM IV) two subtypes of HIV bulimia nervosa, in accordance with the strategy employed by the patient to get rid of excess calories. Patients diagnosed with type sub named «Altthiri» (purging subtype), which is the most common types of the disease, they may search their bodies themselves to vomit involuntarily vomiting or using laxatives or diuretics. In the second type called «non-Altthiri» (nonpurging subtype) patients who may exercise a power to stop eating for a day or more.
* Difficulties in diagnosis
* Thus begins a cycle of indulgence in food and deprivation, which the patient is eating to the point of feeling physical pain, and then compensate for that dramatically, so feel hungry onslaught. And when the session such as waste and cleansing these, at least twice a week and continue for three months, the situation be newly bulimia nervosa as a disease according to the manual of neurological disorders mentioned above. However, the diagnosis is difficult in some cases, because people with bulimia nervosa feel ashamed of their behavior, food and indulge in secret, in the exercise of the processes of waste and cleansing. Because they dispose of excess calories that they have acquired as a result of excess, the majority of patients maintain their weight as it is.
However, the harsh cleansing strategies - especially the continuing operations of vomiting or use laxatives - straining the body. In the long run, people with bulimia nervosa are exposed to the risk of serious health complications, including menstrual irregularity (irregular menses) or Antvawh (amenorrhea), drought due to lack of fluids, damage to teeth and gums because of vomiting, lack of balance in electrolytic solutions which may stimulate the irregular heart rate, and various types of digestive diseases. And partly, because of these complications, the disease bulimia nervosa has acquired 24 per cent of the periods in hospital admissions in all cases of conduct disorder diet in 2005 and 2006, it came in second place after anorexia nervosa anorexia nervosa.
* Biological and psychological factors
* Studies have suggested the family and the twins to bulimia nervosa, a disease inherited by 55 per cent, which means that the threats of inherited genetic factors play a slightly larger role of factors surrounding medium, such as child growth amid cultural rights in favor of a weak structure. Also contribute to the occurrence of disease psychological aspects of personality.
As is the case with anorexia nervosa, the girls threatened with more disease bulimia nervosa be among more oriented towards perfection, but they at the same time enjoy the lowest level of appreciation for the self-esteem, and photographs (especially in relation to their weight and forms of their bodies). They may also suffer from problems in Omzjtahn or to control their behavior. Patients who have been subjected to physical or sexual abuse in the past, or who live in families bicker members criticize each other, they are more vulnerable to the risk of developing bulimia nervosa, conduct disorder, as well as other food. The disease often appears bulimia nervosa in late adolescence and early youth, as age is 18 years of the most common onset of the disease. The record, the disease appears in times of transition, from high school to university, for example. Is often stimulate excessive eating, because of the tension, or depressed mood, or hunger-Dari (after the deprivation of calorie intake), or feeling bad in relation to body weight and shape.
* Treatment Options
* Treatment usually involves a multi-faceted approach to a number of doctors. The aim is not to restore normal behavior to normal food only, but also in the treatment of health complications and treatment of any psychological problems result from the disease.
In spite of the therapy depends on the exact requirements of each sick person, the instructions American Medical Association, for the treatment of mental illness bulimia nervosa recommends starting with a combination of dietary advice and methods of psychotherapy, cognitive behavioral therapy best.
* Nutritional advice. To enable patients to break the cycle of excessive eating and cleansing, they must be trained on how to install elements of meals and the timing of the periods between them, and to regulate calorie intake necessary for their daily needs in order to maintain their weight.
* Cognitive behavioral therapy. The research consistently found that this treatment is the most effective methods of psychological treatment for adults suffering from bulimia nervosa. This method helps patients to identify the distorted ideas have - about themselves and their food - and then change it. Those ideas and lead to distorted compulsive behavior. It also helps the way in the search for ways to deal with everyday situations of tension. Include a full course of cognitive behavioral treatment of 20 meetings last 5 months. And did not show any improvement after 10 sessions of them, the American Psychiatric Association recommends adding to the way medicine. In fact, the majority of doctors believe that a combination of cognitive behavioral therapy with medication or with the way the therapeutic effect of other psychological play very well.
* «Treat personal relations». A treatment called «interpersonal therapy» which defines the problems as a result of personal relationships with other individuals, and therefore it is trying to improve those relations in order to get rid of the turmoil in dietary behaviors. Can this treatment be effective psychological treatment for adults.
* Self-help. Include strategies to help the patient to the same, and to participate in treatments over the Internet, and registration in support groups and assistance. However, research does not refer to the effectiveness of these methods compared to other methods.
* Medicines «SS». Inhibitors are retrieved «serotonin» selectivity (selective serotonin reuptake inhibitors). And the only medicine approved use by the Food and Drug Administration for the treatment of behavior disorders, food is the «inhibitors» (fluoxetine) ( «Prozac» (Prozac. Although the majority of research conducted by the adults diagnosed with bulimia nervosa, the experience of small open and found it useful for the treatment of adolescents as well. have not been much research on the drug «Sertralin» sertraline ( «Zoloft» (Zoloft, but that the study of random monitoring and found that it is also effective in the treatment of bulimia nervosa in adults. When the treatment of bulimia nervosa, the dose of medication «SSRI »be higher than the dose of the treatment of depression. and often described drugs for a period of nine months or even a full year to prevent the possible return of the disease.
Research indicates consistently that these medicines reduce the speed of a repeat cycle of excessive eating and cleansing, as it improves the mood. However, it also found that patients who stop taking medication only for the most early on dealt with, and therefore recommended that medication treatment is one of the methods of psychological treatment together. There are several other drugs are still in the process of research.
* Family therapy for individuals young. So far, the majority of studies conducted on the methods of treatment for psychological illness bulimia nervosa in adults. However, the success of family therapy, known as «How Mawdsley» was to help in the treatment of young people with anorexia nervosa, it has taken researchers in the evaluation of forms of this method for the treatment of children and adolescents suffering from bulimia nervosa. A recent study has shown that most children and adolescents between the ages of 12 and 19 years who responded more than others to this therapeutic method, were living with mild form of disease bulimia nervosa.
* Looking to the Future
* Although there are many options for treatment of bulimia nervosa, the good responses to treatment in the short term remain few and not encouraging. A study has found a review of the Foundation «Cochran» that between 19 and 42 per cent of patients with bulimia nervosa have managed to overcome the disease for a short period after treatment with a combination of psychological therapies and medicines, while managed between 36 and 39 per cent, depending on the method of psychotherapy alone , and between 20 and 23 per cent with medication, anti-depressant alone. However, the long-term prospects are encouraging, studies that have followed the cases of people with bulimia nervosa for 10 years from the beginning of treatment and found that 70 per cent of them had recovered from it.
* Cures disease bulimia nervosa
* The recommended treatment of all disease bulimia nervosa, is a combination of dietary counseling sessions with the psychological methods of treatment, which is cognitive behavioral therapy of the best.
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