Bulimia in Males

Bulimia Nervosa is commonly referred to as bulimia. Bulimia is a common eating disorder among individuals of a normal or nearly normal weigh. Bulimia is characterized by episodic binge eating and followed by feelings of guilt, depression, and self-condemnation (Lewingsohn et al., 2002). Bulimia is seen as a major concern not only in females, but now more than ever, for males as well. More and more males are being diagnosed with bulimia each year, which is leading more health professionals to take a greater interest in the male segment of this eating disorder. Bulimia in males can be divided into two specific types: a purging type and a non-purging type. The purging type occurs during episodes of Bulimia, the person will engage in self-induced vomiting or the misuse of laxatives, diuretics, and enemas (Muise, Stein, & Arbess, 2003). The second type, non-purging is more commonly seen in males. It involves compulsive methods of weight loss like fast or excessive exercise in attempt to burn off calories eaten while bingeing. This method does not include any form of self-inducted vomiting or the use of laxatives (Lewinsohn et al., 2002). This paper will focus on three aspects of bulimia, the signs and symptoms of bulimia, and how psychotherapy, medication, and self-help programs are being used to treat bulimia.

Bulimia was not a well-recognized disorder in females or in males. After first being acknowledged as an eating disorder in the 1980's bulimia nervosa was given a more concrete definition. Bulimia nervosa was defined as a psychological eating disorder characterized by episodes of binge eating followed by unconventional methods of weight control (Mangweth et al., 2004). Some methods of weight control include: vomiting, fasting, enemas, excessive use of laxatives and diuretics, compulsive exercising and obsession with weight and body shape. Bingeing is defined as an episode where an individual eats a larger amount of food than the average person in a short period of time (Schneider & Agras, 1987). Binge eating is generally a response to depression, self-esteem, or stress. When a male resorts to bingeing, they generally loose a sense of control. This is immediately followed by a short lived period of calmness, and a period of self-loath.(Ref.) This quickly becomes a reoccurring pattern that is difficult to break away from.

Bingeing and purging are often done secretively which makes it difficult to determine whether a person is bulimic. In males eating disorders are seen as a weakness. Only ten percent of males with bulimia admit to their disorder while over sixty percent of females admit to their eating disorder. (Ref.) This demonstrates that gender has a role in how an individual feels society will treat someone with an eating disorder. Those individuals affected by bulimia whether male or female, consume high quantities of food in a small amount of time. Sometimes individuals that are bulimic can consume up to twenty thousand calories in one sitting (Lewinsohn et al., 2002). This is equivalent to eating over seventy-eight boxes of

'Smarties' in one sitting. Binge eaters usually eat foods that are classified as 'comfort

foods.' They are items that are typically high in calories, and are smooth and soft when you eat them. These can be items like ice cream, cake, or chocolate bars. A recent study done by Name: at Some University, retrieved the eating habits of forty-two Bulimic Males and using this information they revealed that men were typically eating the same 'comfort foods' as women. They would eat these items as an escape from their troubles (Rosen, 2003). Bingeing quickly becomes an obsession, which can occur anywhere from twice to several times a day.

Bulimia can be divided into three categories: bulimia nervosa, anorexic bulimia nervosa, and multi-impulsive bulimia nervosa. Bulimia nervosa in males commonly begins at around the age of eighteen. Bulimia occurs in individuals that are generally under confident and unassertive. (Ref.) Bulimia usually originates in an unpleasant situation between a family member or significant other caused by a sudden period of unhappiness. Emotions tend to flare and relationships quickly fall apart. These destructive relationships cause a male to focus on other problems in their lives. The first aspect drawn to his attention is generally his appearance; feelings of obesity and low self-esteem enable actions such as bulimia and dieting to seem beneficial (Vincent, McCabe, & Ricciardelli, 1999). Anorexic bulimia nervosa is a combination between both anorexia and bulimia. It begins with an individual who suffers from anorexia and is attempting to recover without professional treatment. The individual begins to stabilize their weight generally below a hundred and one pounds. Although it is a long and slow recovery process, a slip in the treatment of anorexia leads to bingeing. Once bingeing begins it is difficult for the individual to stop and they develop bulimia (Mangweth et al., 2004). Multi-impulsive bulimia nervosa begins in much of the same ways as bulimia began. It starts with a strange range of abnormal behaviours which indicate emotional and impulsive problems. Multi-impulsive bulimia nervosa does not just include problems involving eating disorders, but it also involves a mixture of other problems including drug abuse, alcohol abuse, deliberate self-harm (usually cutting of the forearms), stealing and promiscuity (Vincent, McCabe, & Ricciardelli, 1999). In these situations it is quite common to see a high level of tension within the family and their living arrangements.

It is extremely difficult for family, friends, and physicians to detect bulimia in a male. Males who are bulimic usually remain the same weight, or above, due to their dependency on bingeing and purging. Usually, fifty percent of males who suffer from anorexia do not seek treatment, thus developing bulimia (Rosen, 2003). Many males who are bulimic are ashamed of their habits and do not seek treatment until they are in their early thirties or late forties. At this point problems have occurred beyond repair.

There are many evident signs in a male that is suffering from bulimia. These symptoms can be developed using three different groups: behavioral characteristics, emotional and mental characteristics, and physical characteristics (Muise, Stein, & Arbess, 2003). Behavioural characteristics are characteristics that are fairly evident in most males. Some examples are hoarding, hiding, and eating secretly, weighing themselves on a daily basis, and a preoccupation with food. Emotional and mental characteristics can be classified as behaviours that are kept hidden inside and cause a male with bulimia to slowly breakdown. Some examples are depression, social isolation, feelings of worthlessness, difficulty expressing