Nursing perspective  – Part 2

This is information to help you spot this disorder in yourself or others. Prompt treatment is necessary before this becomes a “habit”.   It is more common in females but it is also seen in males.  The important thing to know is that people can have many potentially dangerous side effects but only 3% of the population are known to have this disorder.   Many people with this disorder appear happy and successful.  Their weight is usually considered normal. The cycle is binging then purging by self-induced vomiting or laxative and or diuretic misuse.   We will tell you what to look for and why this is a very unhealthy path.

This is a disorder usually done in secret, so the actual number of people with this disorder may be higher.


Once again genetics may come into play.   Maybe there was a struggle with childhood obesity.  Add to this list anxiety, depression, and traumatic life events.  You can see why I want to share some information about this disorder.    Think about the stress that is placed on people today. Especially in sports and the self-imposed pressure to “fit in”.  The warped belief of how we must look to be liked, successful, and accepted. From the last post remember many people with eating disorders have low self-esteem and often see themselves in a negative light. They compare themselves to the retouched photos in social media TV, movies, etc.   And as in the last post, they often do not see themselves as others see them.

It is important to recognize what eating disorders are.  Healthy eating can go a long way in helping you feel better, sleep better, have more energy, and be more productive.

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Friends and family may be at fault for encouraging someone’s obsession with weight control. They make comments such as – I wish I could eat like you and look that good….  They may even make comments as to how well you are doing in your sport.  This may just reinforce the affected person’s decision to continue with binging and purging. They may give praise to someone else and all the affected person sees – is that person is smaller than them.

Bulimia Nervosa most often begins in the upper teens or young adults.   It is not common to see before then or after the age of 40. As this is often done in secret –  if you have a panic or anxiety attacks, could your attacks be misdiagnosed and actually be an eating disorder?    Could those suffering from eating disorders label themselves with panic or anxiety attacks ….  They are more common and much more socially acceptable.  Especially if they are in denial.

I will list just a few of the side effects associated with eating disorders:

  • Weakness in muscles especially legs,
  • Tingling: pins and needles sensation,
  • Muscle cramps,
  • Heart rate changes and irregular heartbeat, irregular, rapid or weak, pulse,
  • Resp rate changes,
  • Abd pain and generalized body pain,
  • Irritability,
  • Agitation,
  • Mental changes, confusion,
  • Nausea and vomiting.

Trigger warning  – is noted below. If you feel you are at risk and can not read it ask someone who can give you objective supportive care. This may mean a therapist.  Cognitive Behavior Therapy seems to be a good fit for this eating disorder. CBT will help you change your pattern of thinking and thus change your behavior.  Most of it revolves around getting rid of negative unhealthy thoughts and replace them with a healthy and positive lifestyle.

Trigger warning starts here –  skip to the last paragraph

What you may observe if someone has bulimia nervosa.      

Taken from the list of (Eating Disorder Hope,2018b; Gersch, Heimgartner, Rebar & Willis, 016: Videbeck, 1017)

  • You may find supplies of laxatives, diuretics, and enemas. Sometimes they are hidden.  You may find receipts for these items,
  • After vomiting the individual often uses mouth wash to freshen their breath and clean out their mouth, so you may also find mouthwash or mints,
  • Affected persons may eat to the point of discomfort and epigastric pain, they may eat rapidly during periods of binging, (The characteristic of binging  is eating a large amount of food within  2 hours )
  • Affected persons may exercise excessively,
  • Affected persons may spend an excessive amount of time in the bathroom especially after eating,
  • Affected persons are preoccupied with body shape and weight,
  • Affected persons are obsessed with and fearful of the idea of gaining weight,
  •  Affected persons may eat high fat and high-calorie foods that are soft. Soft foods are easier on an irritated throat,
  • Affected persons may dislike eating in front of other people or in public,
  • Affected persons may abuse alcohol or drugs,
  • You may notice scarred or bruised knuckles and hands,
  • They may experience stomach pain and their voice maybe horse.

The list of complications from binging and purging.  

Your fluid and electrolyte balance can become severely compromised. When this happens your labs get wacky and can cause as many symptoms as panic or anxiety attacks.

As you make yourself vomit the acid can ruin your teeth and irritate the esophagus to the point of bleeding.   You will feel like you have a sore throat. Your voice may be horse.

The acid can also cause a variety of stomach ailments and discomfort.

Most are unaware that you can also have cardiac problems.   Fluids – in and out  -cause electrolyte imbalances which can cause palpitations and irregular heartbeat. (If the palpitations experienced just after purging happen more frequently seek medical help.)

And any repetitive unnormal action can that unnaturally irritates your body causes the body to keep making cells trying to replace that which was lost. When this happens you could open the door to abnormal cell growth…


This can be a topic in itself, but I will spend just a few moments here. Our bodies are wonderfully made and the thought of “needing to clean out your bowel” just because does not make sense.  It does not take long for your body to become “addicted” to laxatives and your normal functions will diminish.  Most of the weight loss with laxative use is from fluids and electrolytes that are flushed out of your body. 

Depending on your eating habits your regularity may be very vastly from others. 

My big point is that in the hospital I have seen many a young woman come in for a colostomy because of a history of laxative abuse ! After a while, the bowel ceases to function and the only hope is to let your bowels rest and empty into a bag attached to your abdomen.  I am not kidding!  Some times this must become permanent because they can not reattach the rested intestines because muscle tone is totally gone. So before you get the idea to cleanse your bowel…. think if you would want a colostomy!

In closing, a healthy diet and wise nutrition choices will help prevent you from a malady of physical symptoms.  The goal should be a lifestyle that will allow you to achieve and maintain a healthy weight.

A healthy body can ward off anxiety much better than one that is fatigued, poorly nourished, and out of balance.


To learn how :

In  Panic Attacks Calming the Storm read chapters

  • 11    Taking Back Control of  Your Mind
  • 12    Establishing Thought Boundaries
  • 14   “Nutrition” for Healthy Thought Patterns
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