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In the world For Tips and Tricks to Weight loss...
This site also has the largest selection in the world of diet, exercise, celebrity and
Supermodel weight loss tips... With a thinspiration gallery...
To keep you motivated visually and Special Tips and Tricks to weight loss
From Jodee the Queen of this scene...
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INDEX.
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advice. If you suffer from, or think you may suffer from, a medical condition you should consult your doctor before starting a weight
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consult your doctor if you experience any discomfort, distress or any other symptoms. If you feel any discomfort or pain when you
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TOP STORIES BELOW...
Pro-Ana Acronyms, ect.
Ana:   Anorexia Nervosa

Mia:   Bulimia Nervosa

Coe:   Compulsive Over-eating disorder

Ednos:   Eating disorder not otherwise specified

BED:   Binge eating disorder.

ED:   Eating disorder

SI:   Self injury

MiAna:   Having both anorexia and bulimia (this term is what I came up with for my first website, and since
has been used on the net a lot ... I have never seen the term used before until my first site went on the net.)

Pro-ana:   This term infers being pro-active in the ED community, usually online. It does not mean promote
ED's in any way, shape or form.

Thinspiration:   Collection of thin looking peoples pictures, used to inspire those with ana/mia.

Anorectic:   One who has anorexia.

CW:   Current weight.

HW:   Highest weight.

LW:   Lowest weight.

GW:   Goal Weight.

STGW:   Short term goal weight.

LTGW:   Long term goal weight.

FGW:   Final goal weight.

IP:   In patient.

BMI:   Body Mass Index.
Compulsive Over Exercising

What is compulsive exercising?
Compulsive exercising, also called over-exercising or obligatory exercising, is when an individual engages
in strenuous physical activity with to the point that is unsafe and unhealthy.

How much exercise is considered too much?
To maintain cardiovascular health, 2,000-3,500 calories should be burned each week through aerobic
exercises, such as running, dancing, cycling and the like. Thirty to forty-five minutes a day, five or six days a
week is sufficient to acquire these health benefits. Exercise beyond 3,500 calories per week, however,
leads to decreased physical benefits and increased risk of injury. This can also lead to something called
muscle dysmorphia, a condition in which a sufferer engages in compulsive weight-bearing exercises.

What motivates sufferers to exercise too much?
Those who compulsively exercise often work out to attain a temporary sense of power and self-control.
Some over-exercisers are also anorexic or bulimic, and cope with their emotions and anxiety through
excessive exercise in addition to their eating disorder. Participation in athletics or dance can also play a
role, as coaches, parents, and other participants stress that being thin is necessary to succeed with the
activity. Those involved in sports or dance may also receive a great deal of praise for being so “fit and trim”
which can fuel the destructive behavior.

What are the signs and symptoms of compulsive exercising?
Over-exercisers typically work out beyond the limits of safe. They will find ways to work out even if it means
cutting school, taking time off from work, getting too little sleep, or missing social events. Sufferers
typically feel severe guilt when they cannot exercise, and rarely consider their workouts fun or enjoyable.

What are some consequences of compulsive exercise?
The risks with this disorder are both physical and emotional. All too often, a sufferer may see deterioration
of their personal relationships or failure at work or school. Many who exercise compulsively become
socially withdrawn.

The physical risks are numerous. A very real risk with this disorder is dehydration if the sufferer is not
drinking enough fluids. Over-exercise can also lead to insomnia, depression, and fatigue. Additional
physical side effects include muscular and skeletal injuries, like shin splits, bone fractures, arthritis, or
damage to cartilage and ligaments. Too much exercise can lead to the release of excessive free radicals,
which have been linked to cellular mutations and cancer. Females may no longer menstruate, a condition
called amenorrhea.

Can a person who compulsively over-exercises become cured?
About 80% of persons with body image disorders who seek professional help recover completely or make
significant progress. All in all, these disorders are behavior patterns that display very complex emotional
conflicts, which need to be resolved for the person to have a healthy relationship with food and exercise.
Is Pro Ana your religion? Well, it seems that if it is your religion people should not
judge you based on it. Fellow Prothinspoer's I know how you feel when people judge
you. I just wanted to say, belief what you want to belief and follow your dreams.. On
this planet, you can be whatever religion you want to be! I surfed the web and found
some more info I thought you would like to read.
Pro-Ana prays to anorexia.

Reality: There is reference to a religion of sorts that exists on pro-ana websites,
with several referrals of the name "Ana" mentioned. But people, mainly the media
and anti's get confused and spread the misinformation that Ana refers to anorexia.
The name Ana in the religious connotation actually is the full name Anamadim, and
not some goddess named anorexia. The origin of Anamadim was the creation of a
site by the name of Underground Grotto, where there is even a summoning spell to
invoke Anamadim. However there is an extremely slim (no pun intended) minority of
those on pro-ana sites that partake in this religious style activity. This also has
nothing to do with the letters, creeds, commandments, etc. Either (see below for that
information). It has nothing to do with the huge majority of pro-ana.

The entire pro-ana religion.

Reality: The pro-ana religion seen on many pro-ana sites was never created by any
pro-ana site at all. All the creeds, letters, commandments are all made by professional
psychologists in an attempt to make the mindset of the anorexic views be seen
through their eyes. This was seen as a powerful message, and to those who are
anorexic and wanting to go further into it, seen these messages as motivation
instead of the reverse that it was intended to be. It's funny how those that hate
pro-ana unwittingly gave it a religion isn't it? Not too many want that be known, and
no wonder. Big oops eh? Just so you know, that is their writings if you ever see
and/or use it.


Myth: Pro-Ana is Pro Death

Reality: If you ever been on a pro-ana forum before, you will notice that allot of the
long term members are of a normal to ever so slightly below normal weight range.
There is very few long termer's that are in the medical anorexic weight range. So true
they are thin, but in reality terms, they are in fact normal. In fact many of the extreme
thin don't frequent pro-ed forums at all, they are on support forums instead. Of those
that get to an extreme level who post pics and weights, are replied back with
messages of concern and pleas for them to take care of themselves and to not loose
any more weight. Now you have to actually be ON the forums to know this, but those
who cry out the evils do not do very good research into what they are talking about.
You could say that pro-ana is allot more pro-support leaning than it lets on too.

Myth: Pro-Ana is teaching others to become anorexic

Reality: You cannot "become" anorexic, it is not something you choose like a diet,
anorexia chooses you and in the lottery of anorexia winning is loosing more than you
know. It's outside factors in your own environment that make one eating disordered,
not text and pictures on a website. To those that think you can become "Ana" ... It
won't happen. You may skip a few meals, fast for a few days but that does not make
you anorexic at all. Much like a drag queen, you can look act talk walk and sing
every bit like Cher ... But you are not Cher. It's simple as that.

Myth: Pro-Ana encourages you to stay anorexic

Reality: This is the touchy one. We don't encourage you to stay anorexic, but this is
the biggest way in which we differ from the professional and pro-recovery sites.
Instead of treating a disorder itself, pro-ana treats the person. We get to know the
individual, what makes them laugh, smile, cry and scared to see what their world is
like through their eyes. See, like I said before, eating disorders are a deep rooted
problem and there is no point trying to get rid of something that will just come back
again instantly. To get rid of this, one must get to the main root and work from there.
Once the root is gone, the consequence of eating disorders are that much easier to
recover from ... And the process will be a lasting one. This is why the most important
part of any ed forum is the journal area.

Ana Creed
I believe in Control, the only force mighty enough to bring order to the chaos that is
my world.
I believe that I am the most vile, worthless and useless person ever to have existed
on this planet, and that I am totally unworthy of anyone's time and attention.
I believe that other people who tell me differently must be idiots. If they could see
how I really am, then they would hate me almost as much as I do.
I believe in oughts, musts and shoulds as unbreakable laws to determine my daily
behavior.
I believe in perfection and strive to attain it.
I believe in salvation through trying just a bit harder than I did yesterday.
I believe in calorie counters as the inspired word of god, and memorize them
accordingly.
I believe in bathroom scales as an indicator of my daily successes and failures
I believe in hell, because I sometimes think that I'm living in it.
I believe in a wholly black and white world, the losing of weight, recrimination for sins,
the abnegation of the body and a life ever fasting.

Ana Psalm
Strict is my diet. I must not want. It maketh me to lie down at night hungry. It leadeth
me past the confectioners. It trieth my willpower. It leadeth me in the paths of
alteration for my figure's sake. Yea, though I walk through the aisles of the pastry
department, I will buy no sweet rolls for they are fattening. The cakes and the pies,
they tempt me. Before me is a table set with green beans and lettuce. I filleth my
stomach with liquids, My day's quota runneth over. Surely calorie and weight charts
will follow me all the days of my life, And I will dwell in the fear of the scales forever.


Ana Commandments
1. If you aren't thin you aren't attractive.
2. Being thin is more important than being healthy.
3. You must buy clothes, style your hair, take laxatives, starve yourself, do anything
to make yourself look thinner.
4. Thou shall not eat without feeling guilty.
5. Thou shall not eat fattening food without punishing oneself afterwards.
6. Thou shall count calories and restrict intake accordingly.
7. What the scale says is the most important thing.
8. Losing weight is good/gaining weight is bad.
9. You can never be too thin.
10. Being thin and not eating are signs of true will power and success.


Letter From Ana:

Allow me to introduce myself. My name, or as I am called by so called "doctors", is
Anorexia. Anorexia Nervosa is my full name, but you may call me Ana. Hopefully we
can become great partners. In the coming time, I will invest a lot of time in you, and I
expect the same from you. In the past you have heard all of your teachers and
parents talk about you. You are "so mature", "intelligent", "14 going on 45", and you
possess "so much potential". Where has that gotten you, may I ask? Absolutely no
where! You are not perfect, you do not try hard enough, further more you waste your
time on thinking and talking with friends and drawing! Such acts of indulgence shall
not be allowed in the future.

Your friends do not understand you. They are not truthful. In the past, when the
insecurity has quietly gnawed away at your mind, and you asked them, "Do I
look....fat?" and they answered "Oh no, of course not" you knew they were lying!
Only I tell the truth. Your parents, let's not even go there! You know that they love
you, and care for you, but part of that is just that they are your parents and are
obligated to do so. I shall tell you a secret now: deep down inside themselves, they
are disappointed with you. Their daughter, the one with so much potential, has
turned into a fat, lazy, and undeserving girl.

But I am about to change all that. I will expect you to drop your calorie intake and up
your exercise. I will push you to the limit. You must take it because you cannot defy
me! I am beginning to embed myself into you. Pretty soon, I am with you always. I am
there when you wake up in the morning and run to the scale. The numbers become
both friend and enemy, and the frenzied thoughts pray for them to be lower than
yesterday, last night, etc. You look into the mirror with dismay. You prod and poke at
the fat that is there, and smile when you come across bone. I am there when you
figure out the plan for the day: 400 calories, 2 hours exercise. I am the one figuring
this out, because by now my thoughts and your thoughts are blurred together as
one. I follow you throughout the day. In school, when your mind wanders I give you
something to think about. Recount the calories for the day. It's too much. I fill your
mind with thoughts of food, weight, calories, and things that are safe to think about.
Because now, I am already inside of you. I am in your head, your heart, and your
soul. The hunger pains you pretend not to feel is me, inside of you.

Pretty soon I am telling you not only what to do with food, but what to do ALL of the
time. Smile and nod. Present yourself well. Suck in that fat stomach, dammit! God,
you are such a fat cow!!!! When mealtimes come around I tell you what to do. I make
a plate of lettuce seem like a feast fit for a king. Push the food around. Make it look
like you've eaten something. No piece of anything...if you eat, all the control will be
broken...do you WANT that?? To revert back to the fat COW you once were?? I
force you to stare at magazine models. Those perfect skinned, white teethed, waifish
models of perfection staring out at you from those glossy pages. I make you realize
that you could never be them. You will always be fat and never will you be as
beautiful as they are. When you look in the mirror, I will distort the image. I will show
you obesity and hideousness. I will show you a sumo wrestler where in reality there is
a starving child. But you must not know this, because if you knew the truth, you might
start to eat again and our relationship would come crashing down.

Sometimes you will rebel. Hopefully not often though. You will recognize the small
rebellious fiber left in your body and will venture down to the dark kitchen. The
cupboard door will slowly open, creaking softly. Your eyes will move over the food
that I have kept at a safe distance from you. You will find your hands reaching out,
lethargically, like a nightmare, through the darkness to the box of crackers. You
shove them in, mechanically, not really tasting but simply relishing in the fact that you
are going against me. You reach for another box, then another, then another. Your
stomach will become bloated and grotesque, but you will not stop yet. And all the
time I am screaming at you to stop, you fat cow, you really have no self control, you
are going to get fat.

When it is over you will cling to me again, ask me for advice because you really do
not want to get fat. You broke a cardinal rule and ate, and now you want me back. I'll
force you into the bathroom, onto your knees, staring into the void of the toilet bowl.
Your fingers will be inserted into your throat, and, not without a great deal of pain,
your food binge will come up. Over and over this is to be repeated, until you spit up
blood and water and you know it is all gone. When you stand up, you will feel dizzy.
Don't pass out. Stand up right now. You fat cow you deserve to be in pain! Maybe
the choice of getting rid of the guilt is different. Maybe I chose to make you take
laxatives, where you sit on the toilet until the wee hours of the morning, feeling your
insides cringe. Or perhaps I just make you hurt yourself, bang your head into the wall
until you receive a throbbing headache. Cutting is also effective. I want you to see
your blood, to see it fall down your arm, and in that split second you will realize you
deserve whatever pain I give you. You are depressed, obsessed, in pain, hurting,
reaching out but no one will listen? Who cares!! You are deserving; you brought this
upon yourself.

Oh, is this harsh? Do you not want this to happen to you? Am I unfair? I do do things
that will help you. I make it possible for you to stop thinking of emotions that cause
you stress. Thoughts of anger, sadness, desperation, and loneliness can cease
because I take them away and fill your head with the methodical calorie counting. I
take away your struggle to fit in with kids your age, the struggle of trying to please
everyone as well. Because now, I am your only friend, and I am the only one you
need to please. I have a weak spot. But we must not tell anyone. If you decide to
fight back, to reach out to someone and tell them about how I make you live, all hell
will break lose. No one must find out, no one can crack this shell that I have covered
you with. I have created you, this thin, perfect, achieving child. You are mine and
mine alone. Without me, you are nothing. So do not fight back. When others
comment, ignore them. Take it into stride, forget about them, forget about everyone
that tries to take me away. I am your greatest asset, and I intend to keep it that way.

Sincerely,

Ana

Dear Ana:

I offer you my soul, my heart and my bodily functions. I give you all my earthly
possessions.

I seek your wisdom, your faith and your feather weight. I pledge to obtain the ability
to float, to lower my weight to the single digits, I pledge to stare into space, to fear
food, and to see obese images in the mirror. I will worship you and pledge to be a
faithful servant until death does us part.

If I cheat on you and procreate with Ronald MacDonald, Dave Thomas, the colonel or
that cute little dog. I will kneel over my toilet and thrust my fingers deep in my throat
and pray for your forgiveness.

Please Ana, don't give up on me. I'm so weak, I know, but only you with your strength
inside me will I become a woman worthy of love and respect. I'm begging for you not
to give up, I'm pleading with my shallow breathes and my pale skin. I bleed for you,
suffer leg pains, headaches and fainting spells. My love for you makes me dizzy and
confused I don't know whether I'm coming or going. Men run when they see the love I
have for you and never return. But they aren't important to me all that's important is
that you love me.

If you stay with me, I will worship you daily, I will run miles a day, come rain, snow,
bitter cold or searing heat I will run from the pain and in fright. I will do 1,000 sit ups a
day and lie to my family about what I eat and how I feel. I will stop weeping when I feel
your warm arms embrace my shivering body. I will numb the hunger pains with razor
blades and your strength.

Today, I renew our friendship and resolve to be faithful to you year long, life long. I
begin each year with a 3 day fast in honor of you. If you give me the strength to fade
away I will love you and worship you forever.

When I'm finally faded to nothing, when you've given me the gift of ending this
torturous life. I will float on to the next world and be thin and beautiful payment for my
undying love for you in this world.

I ask only one more thing you, please Ana, remove me from this hell, from this world
ASAP. Please take away this hatred for my pain and allow me to be free and light.

Love Always,
(Insert Name Here)

Sources.. 1, 2
Pro-Ana Acronyms, etc.

Ana:   Anorexia Nervosa

Mia:   Bulimia Nervosa

Coe:   Compulsive Over-eating disorder

Ednos:   Eating disorder not otherwise specified

BED:   Binge eating disorder.

ED:   Eating disorder

SI:   Self injury

MiAna:   Having both anorexia and bulimia (this term is what I came up with for my
first website, and since has been used on the net a lot ... I have never seen the term
used before until my first site went on the net.)

Pro-ana:   This term infers being pro-active in the ED community, usually online. It
does not mean promote ED's in any way, shape or form.

Thinspiration:   Collection of thin looking peoples pictures, used to inspire those with
ana/mia.

Anorectic:   One who has anorexia.

Ana Buddy:   An online friendship between pro-ana individuals. Ana buddies guide
one another toward recovery or are penpals, sometimes becoming real life friends.

Fasting Buddy:   An online friend (or friends) who compete in weight loss
competitions and attempt to keep one another motivated to lose more weight.

Wannarexic:   Someone who wants to develop an eating disorder, usually under
some confusion about the consequences. Wannarexics are USUALLY unwanted at
most websites aimed at sufferers, including pro-ana websites.

Wannarexia:   The act of wanting to develop an eating disorder. Wannarexia is
USUALLY discouraged at most websites aimed at sufferers, including pro-ana
websites.

CW:   Current weight.

HW:   Highest weight.

LW:   Lowest weight.

GW:   Goal Weight.

STGW:   Short term goal weight.

LTGW:   Long term goal weight.

FGW:   Final goal weight.

IP:   In patient.

BMI:   Body Mass Index.


What is anorexia Nervosa?

Anorexia Nervosa is a serious, often chronic, and life-threatening eating disorder
defined by a refusal to maintain minimal body weight within 15 percent of an
individual's normal weight. Other essential features of this disorder include an
intense fear of gaining weight, a distorted body image, and amenorrhea (absence of
at least three consecutive menstrual cycles when they are otherwise expected to
occur). In addition to the classic pattern of restrictive eating, some people will also
engage in recurrent binge eating and purging episodes. Starvation, weight loss, and
related medical complications are quite serious and can result in death. People who
have an ongoing preoccupation with food and weight even when they are thin would
benefit from exploring their thoughts and relationships with a therapist. The term
anorexia literally means loss of appetite, but this is a misnomer. In fact, people with
anorexia Nervosa ignore hunger and thus control their desire to eat. This desire is
frequently sublimated through cooking for others or hiding food that they will not eat
in their personal space. Obsessive exercise may accompany the starving behavior
and cause others to assume the person must be healthy.

Who develops anorexia Nervosa?

Like all eating disorders, anorexia Nervosa tends to occur in pre- or post-puberty, but
can develop at any major life change. Anorexia Nervosa predominately affects
adolescent girls and young adult women, although it also occurs in men and older
women. One reason younger women are particularly vulnerable to eating disorders is
their tendency to go on strict diets to achieve an "ideal" figure. This obsessive dieting
behavior reflects today's societal pressure to be thin, which is seen in advertising
and the media. Others especially at risk for eating disorders include athletes, actors,
dancers, models, and TV personalities for whom thinness has become a professional
requirement. For the person with anorexia Nervosa, the satisfaction of control
achieved over weight and food becomes very important if the rest of their life is
chaotic and emotionally painful.

How many people suffer from anorexia Nervosa?

Conservative estimates suggest that one-half to one percent of females in the U.S.
Develop anorexia Nervosa. Because more than 90 percent of all those who are
affected are adolescent and young women, the disorder has been been
characterized as primarily a woman's illness. It should be noted, however, that males
and children as young as seven years old have been diagnosed; and women 50, 60,
70, and even 80 years of age have fit the diagnosis.

How is the weight lost?

People with anorexia Nervosa usually lose weight by reducing their total food intake
and exercising excessively. Many persons with this disorder restrict their intake to
fewer than 1,000 calories per day. Most avoid fattening, high-calorie foods and
eliminate meats. The diet of persons with anorexia Nervosa may consist almost
completely of low-calorie vegetables like lettuce and carrots, or popcorn.

What are the common signs of anorexia Nervosa?

The hallmark of anorexia Nervosa is a preoccupation with food and a refusal to
maintain minimally normal body weight. One of the most frightening aspects of the
disorder is that people with anorexia Nervosa continue to think they look fat even
when they are bone-thin. Their nails and hair become brittle, and their skin may
become dry and yellow. Depression is common in patients suffering from this
disorder. People with anorexia Nervosa often complain of feeling cold (hypothermia)
because their body temperature drops. They may develop lanugo (a term used to
describe the fine hair on a new born) on their body.

Persons with anorexia Nervosa develop strange eating habits such as cutting their
food into tiny pieces, refusing to eat in front of others, or fixing elaborate meals for
others that they themselves don't eat. Food and weight become obsessions as
people with this disorder constantly think about their next encounter with food.
Generally, if a person fears he or she has anorexia Nervosa, a doctor knowledgeable
about eating disorders should make a diagnosis and rule out other physical
disorders. Other psychiatric disorders can occur together with anorexia Nervosa,
such as depression and obsessive-compulsive disorder.

What are the causes of anorexia Nervosa?

Knowledge about the causes of anorexia Nervosa is inconclusive, and the causes
may be varied. In an attempt to understand and uncover the origins of eating
disorders, scientists have studied the personalities, genetics, environments, and
biochemistry of people with these illnesses. Certain personality traits common in
persons with anorexia Nervosa are low self-esteem, social isolation (which usually
occurs after the behavior associated with anorexia Nervosa begins), and
perfectionism. These people tend to be good students and excellent athletes. It does
seem clear (although this may not be recognized by the patient), that focusing on
weight loss and food allows the person to ignore problems that are too painful or
seem irresolvable.

Eating disorders also tend to run in families, with female relatives most often
affected. A girl has a 10 to 20 times higher risk of developing anorexia Nervosa, for
instance, if she has a sibling with the disease. This finding suggests that genetic
factors may predispose some people to eating disorders. Behavioral and
environmental influences may also play a role. Stressful events are likely to increase
the risk of eating disorders as well. In studies of the biochemical functions of people
with eating disorders, scientists have found that the neurotransmitters serotonin and
nor epinephrine are decreased in those with anorexia, which links them with patients
suffering from depression. People with anorexia Nervosa also tend to have higher
than normal levels of cortisol (a brain hormone released in response to stress) and
vasopressin (a brain chemical found to be abnormal in patients with
obsessive-compulsive disorder).

Are there medical complications?

The starvation experienced by persons with anorexia Nervosa can cause damage to
vital organs such as the heart and brain. Pulse rate and blood pressure drop, and
people suffering from this illness may experience irregular heart rhythms or heart
failure. Nutritional deprivation causes calcium loss from bones, which can become
brittle and prone to breakage. In the worst-case scenario, people with anorexia can
starve themselves to death. Anorexia Nervosa is among the psychiatric conditions
having the highest mortality rates, killing up to six percent of its victims.

Is treatment available?

Luckily, most of the complications experienced by persons with anorexia Nervosa are
reversible when they restore weight. People with this disorder should be diagnosed
and treated as soon as possible because eating disorders are most successfully
treated when diagnosed early. Some patients can be treated as outpatients, but
some may need hospitalization to stabilize their dangerously low weight. Weight gain
of one to three pounds per week is considered safe and desirable. The most
effective strategies for treating a patient have been weight restoration within ten
percent of normal, and individual, family, and group therapies.

To help people with anorexia Nervosa overcome their disorder, a variety of
approaches are used. Some form of psychotherapy is needed to deal with underlying
emotional issues. Cognitive-behavioral therapy is sometimes used to change
abnormal thoughts and behaviors. Group therapy is often advised so people can
share their experiences with others. Family therapy is important particularly if the
individual is living at home and is a young adolescent. A physician or
advanced-practice nurse is needed to prescribe medications that may be useful in
treating the disorder. Finally, a nutritionist may be necessary to advise the patient
about proper diet and eating regimens. Where support groups are available, they
can be beneficial to both patients and families.

What about prevention?

New research findings are showing that some of the "traits" in individuals who
develop anorexia Nervosa are actual "risk factors" that might be treated early on. For
example, low self esteem, body dissatisfaction, and dieting may be identified and
interventions instituted before an eating disorder develops.  Advocacy groups have
also been effective in reducing dangerous media stories, such as teen magazine
articles on "being thin" that may glamorize such risk factors as dieting.
What is bulimia Nervosa?

Bulimia Nervosa is a serious eating disorder marked by a destructive pattern of binge-
eating and recurrent inappropriate behavior to control one's weight. It can occur together
with other psychiatric disorders such as depression, obsessive-compulsive disorder,
substance dependence, or self-injurious behavior. Binge eating is defined as the
consumption of excessively large amounts of food within a short period of time. The food is
often sweet, high in calories, and has a texture that makes it easy to eat fast. "Inappropriate
compensatory behavior" to control one's weight may include purging behaviors (such as
self-induced vomiting, abuse of laxatives, diuretics, or enemas) or non-purging behaviors
(such as fasting or excessive exercise). For those who binge eat, sometimes any amount of
food, even a salad or half an apple, is perceived as a binge and is vomited.

People with bulimia Nervosa often feel a lack of control during their eating binges. Their
food is usually eaten secretly and gobbled down rapidly with little chewing. A binge is
usually ended by abdominal discomfort. When the binge is over, the person with bulimia
feels guilty and purges to rid his or her body of the excess calories. To be diagnosed with
bulimia, a person must have had, on average, a minimum of two binge-eating episodes a
week for at least three months. The first problem with any eating disorder is constant
concern with food and weight to the exclusion of almost all other personal concerns.

Who develops bulimia?

Bulimia Nervosa typically begins in adolescence or early adulthood. Like anorexia Nervosa,
bulimia mainly affects females. Only ten percent to 15 percent of affected individuals are
male. An estimated two percent to three percent of young women develop bulimia,
compared with the one-half to one percent that is estimated to suffer from anorexia. Studies
indicate that about 50 percent of those who begin an eating disorder with anorexia Nervosa
later become bulimic.

It is believed that more than five million individuals experience an eating disorder (bulimia
Nervosa or anorexia Nervosa) in this country alone. It is ten times more common in women
than men, with greatest prevalence occurring in adolescents and college-age young adults.
This indicates a need for concern and preventive measures on college campuses across
the country, especially for female students.

How do people with bulimia control their weight?

People with bulimia are overly concerned with body shape and weight. They make repeated
attempts to control their weight by fasting and dieting, vomiting, using drugs to stimulate
bowel movements and urination, and exercising excessively. Weight fluctuations are
common because of alternating binges and fasts. Unlike people with anorexia, people with
bulimia are usually within a normal weight range. However, many heavy people who lose
weight begin vomiting to maintain the weight loss.

What are the common signs of bulimia?

Constant concern about food and weight is a primary sign of bulimia. Common indicators
that suggest the self-induced vomiting that persons with bulimia experience are the erosion
of dental enamel (due to the acid in the vomit) and scarring on the backs of the hands (due
to repeatedly pushing fingers down the throat to induce vomiting).

A small percentage of people with bulimia show swelling of the glands near the cheeks
called parotid glands. People with bulimia may also experience irregular menstrual periods
and a decrease in sexual interest. A depressed mood is also commonly observed as are
frequent complaints of sore throats and abdominal pain. Despite these telltale signs, bulimia
Nervosa is difficult to catch early. Binge eating and purging are often done in secret and
can be easily concealed by a normal-weight person who is ashamed of his or her behavior,
but compelled to continue it because he or she believes it controls weight.
Characteristically, these individuals have many rules about food -- e.g. Good foods, bad
foods -- and can be entrenched in these rules and particular thinking patterns. This
preoccupation and these behaviors allow the person to shift their focus from painful feelings
and reduce tension and anxiety perpetuating the need for these behaviors.

Are there any serious medical complications?

Persons with bulimia -- even those of normal weight -- can severely damage their bodies by
frequent binging and purging. Electrolyte imbalance and dehydration can occur and may
cause cardiac complications and, occasionally, sudden death. In rare instances, binge
eating can cause the stomach to rupture, and purging can result in heart failure due to the
loss of vital minerals like potassium.

Do we know what causes bulimia?

The current obsession with thinness in our culture certainly has a large influence. There is
some evidence that obesity in adolescence or familial tendency toward obesity predisposes
an individual to the development of the disorder. Parents’ anxiety over a chubby child can
perhaps also be a contributor. Some individuals with bulimia report feeling a "kind of high"
when they vomit. People with bulimia are often compulsive and may also abuse alcohol and
drugs. Eating disorders like anorexia and bulimia tend to run in families, and girls are most
susceptible. Recently, scientists have found certain neurotransmitters (serotonin and
norepinephrine) to be decreased in some persons with bulimia. Most likely, it is a
combination of environmental and biological factors that contribute to the development and
expression of this disorder. During the early 1970s, before the prevalence of bulimia was
more widely recognized, almost all persons with an eating disorder believed they had
invented the behaviors and that no one else had such a problem. As in anorexia Nervosa,
the behaviors associated with bulimia provide temporary relief from tension and allow ill
persons to focus less on problems perceived as irresolvable and to instead focus on body
weight and food.

Is treatment available for persons with bulimia?

Most people with bulimia can be treated through individual outpatient therapy because they
aren't in danger of starving themselves as are persons with anorexia. However, if the
bulimia is out of control, admission to an eating disorders treatment program may help the
individual let go of their behaviors so they can concentrate on treatment.

Group therapy is especially effective for college-aged and young adult women because of
the understanding of the group members. In group therapy they can talk with peers who
have similar experiences. Additionally, support groups can be helpful as they can be
attended for as long as necessary, have flexible schedules, and generally have no charge.
Support groups, however, do not take the place of treatment. Sometimes a person with an
eating disorder is unable to benefit from group therapy or support groups without the
encouragement of a personal therapist.

Cognitive-behavioral therapy, either in a group setting or individual therapy session, has
been shown to benefit many persons with bulimia. It focuses on self-monitoring of eating
and purging behaviors as well as changing the distorted thinking patterns associated with
the disorder. Cognitive-behavioral therapy is often combined with nutritional counseling
and/or antidepressant medications such as fluoxetine (Prozac).

Treatment plans should be adjusted to meet the needs of the individual concerned, but
usually a comprehensive treatment plan involving a variety of experts and approaches is
best. It is important to take an approach that involves developing support for the person
with an eating disorder from the family environment or within the patient’s community
environment (support groups or other socially supportive environments).

What about prevention?

Prevention research is increasing as scientists study the known "risk factors" to these
disorders. Given that bulimia and other eating disorders are multi-determined and affect
young women, there is preliminary information on the role and extent such factors as self
esteem, resilience, family interactions, peer pressure, the media and dieting might play in its
development. Advocacy groups are also engaged in prevention through efforts such as
removing damaging articles from teen magazines on "dieting" and the importance of "being
thin."
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