0:00:11.049,0:00:14.269
Hi there, it’s Kati again, thanks for checking back.

0:00:14.269,0:00:18.949
As always I have some great information[br]for you today and it's pretty educational.

0:00:18.949,0:00:19.523
Today's is

0:00:19.523,0:00:23.055
a little bit more clinical and the clinical[br]side of what I do.

0:00:23.055,0:00:28.259
And I'd like to talk to you about the[br]diagnosis of Bulimia Nervosa.

0:00:28.259,0:00:33.003
Now I know a lot of you say "I already know what[br]that is", "I’ve heard it a ton of times" and

0:00:33.003,0:00:37.061
that's why I just want to clarify, I know[br]that people use eating disorder terms

0:00:37.061,0:00:38.042
loosely.

0:00:38.042,0:00:42.005
In media, in everyday life and I want to[br]make sure that you know

0:00:42.005,0:00:46.043
when I use the term bulimia, what I mean[br]by it.

0:00:46.043,0:00:50.063
So when I diagnose someone with bulimia[br]what am I looking for?

0:00:50.063,0:00:54.018
As always I refer to my DSM.

0:00:54.018,0:00:58.016
Now, the DSM is pretty much the Bible for[br]diagnosis and I know I've referred to

0:00:58.016,0:01:02.004
it before, it gives me a list of criteria[br]that someone needs to meet in order to

0:01:02.004,0:01:06.149
be diagnosed. Because I don't want to give[br]a diagnosis to someone

0:01:06.149,0:01:10.054
if they don't really meet the criteria. Right?

0:01:10.054,0:01:15.055
Now, when I begin, the first thing that I'm[br]looking for, for someone with bulimia

0:01:15.055,0:01:18.019
is that they binge eat.

0:01:18.019,0:01:21.002
I know a lot of you say

0:01:21.002,0:01:24.085
"I binge this", "this is what I binge", how much[br]In this amount of time.

0:01:24.085,0:01:27.079
Everybody has something different that[br]they do.

0:01:27.079,0:01:29.046
It's not competition.

0:01:29.046,0:01:32.009
I have heard videos of people saying "this[br]person said that their binge

0:01:32.009,0:01:37.092
that's not as much, I binge much more than[br]they binge." It doesn't matter.

0:01:37.092,0:01:39.027
What I want to say

0:01:39.027,0:01:42.082
to a client of mine is what feels like a[br]binge to you

0:01:42.082,0:01:47.056
all the diagnosis criteria says that it[br]has to be more than a normal amount of

0:01:47.056,0:01:48.073
food,

0:01:48.073,0:01:50.053
in a short period of time.

0:01:50.053,0:01:53.094
now the time constraint that they give[br]is two hours, but

0:01:53.094,0:01:57.095
I wouldn't even restrict it to that with[br]my clients. I want to know what feels like a binge

0:01:57.095,0:01:59.003
to them.

0:01:59.003,0:02:01.043
I've had people who eat

0:02:01.043,0:02:04.097
twenty-five hamburgers, and I’ve had people[br]who’ve eaten an apple and that can feel like

0:02:04.097,0:02:07.045
a binge to them.

0:02:07.045,0:02:09.049
So,

0:02:09.049,0:02:12.599
you have to binge eat, that's part of the[br]bulimia criteria.

0:02:12.599,0:02:14.409
The second portion of that,

0:02:14.409,0:02:16.659
is that during this binge

0:02:16.659,0:02:19.469
the person feels completely out of[br]control.

0:02:19.469,0:02:22.829
And I know that doesn't always makes[br]sense, especially if you haven't

0:02:22.829,0:02:25.999
suffered from an eating disorder you think "out[br]of control?

0:02:25.999,0:02:28.389
They’re just eating, they’re choosing to eat

0:02:28.389,0:02:29.004
this much."

0:02:29.004,0:02:31.039
That's not the case.

0:02:31.039,0:02:32.609
I had a patient

0:02:32.609,0:02:35.093
who told me she used to drive along this[br]road and get

0:02:35.093,0:02:39.829
these certain fast food restaurants she’d[br]stop and get her certain

0:02:39.829,0:02:44.009
binge foods, it was kind of a ritual that[br]she would do

0:02:44.009,0:02:45.409
and she would tell me that when she[br]reached

0:02:45.409,0:02:48.086
the last fast food restaurant, she had picked[br]up all the food that she was planning to

0:02:48.086,0:02:50.739
eat for her binge

0:02:50.739,0:02:53.048
would almost have a out-of-body[br]experience

0:02:53.048,0:02:55.959
she said it was like she came out of her[br]body,

0:02:55.959,0:02:58.219
didn't even remember eating the food,

0:02:58.219,0:03:00.729
until she kind of awoke from this[br]experience

0:03:00.729,0:03:02.959
to see wrappers all over a car

0:03:02.959,0:03:05.489
and receipts from what she purchased.[br]And that’s

0:03:05.489,0:03:08.239
the only way she would realize what had[br]happened.

0:03:08.239,0:03:10.069
So when I say out of control,

0:03:10.069,0:03:15.269
I mean they feel completely out of[br]control.

0:03:15.269,0:03:19.519
The next criteria that needs to be met

0:03:19.519,0:03:23.139
is following that binge and that out of[br]control sensation,

0:03:23.139,0:03:26.299
they do something to “make up” for the[br]binge.

0:03:26.299,0:03:27.001
Now,

0:03:27.001,0:03:31.009
everybody does something different.[br]That's the same like a binge, everybody's

0:03:31.009,0:03:32.269
different.

0:03:32.269,0:03:37.169
The most common, and the one I hear the most[br]is self-induced vomiting.

0:03:37.169,0:03:40.919
Now that's the one that people throw around[br]a lot, “Oh, she went to the bathroom after eating

0:03:40.919,0:03:42.519
she must be bulimic.”

0:03:42.519,0:03:43.619
That's not

0:03:43.619,0:03:47.179
quite going to work, that's not really[br]the criteria. That's,

0:03:47.179,0:03:52.139
that's an uneducated guess to[br]somebody.

0:03:52.139,0:03:56.049
Now, the criteria that that I'm meeting in [br]My DSM says that

0:03:56.049,0:04:00.069
Their, they could do self-induced vomiting,[br]they can use laxatives, they can use

0:04:00.069,0:04:02.007
enemas, they can use diuretics.

0:04:02.007,0:04:05.489
some people don't even purge at all.[br]They actually

0:04:05.489,0:04:10.259
will purge through excessive exercise or[br]some people even will force themselves

0:04:10.259,0:04:13.809
to starve for x amount of days or[br]time,

0:04:13.809,0:04:16.269
following a binge to make up for it.

0:04:16.269,0:04:18.329
I even had a patient once, that would use the term

0:04:18.329,0:04:20.016
it set me back to base line.

0:04:20.016,0:04:21.539
it would put me to zero.

0:04:21.539,0:04:25.033
because she had these equations that[br]would, you know, binge equals this much

0:04:25.033,0:04:27.033
minus this is back to zero.

0:04:27.033,0:04:31.000
And that was her goal with her eating[br]disorder.

0:04:31.000,0:04:34.219
So once these criterias have been met,

0:04:34.219,0:04:35.053
what else?

0:04:35.053,0:04:39.086
Well obviously like any eating disorder,[br]the person's going to have

0:04:39.086,0:04:42.389
a lot of focus on their shape and weight.

0:04:42.389,0:04:46.028
And that drives the behaviors.

0:04:46.028,0:04:48.229
That's what bulimia is:

0:04:48.229,0:04:49.065
someone will binge eat,

0:04:49.065,0:04:51.094
they will feel out of control when they binge eat,

0:04:51.094,0:04:55.439
they'll do something to make up for it[br]afterwards, and they’ll be

0:04:55.439,0:04:59.066
horribly, horribly focused on their shape[br]and weight at all times.

0:04:59.066,0:05:03.019
And I hope that helps clarify a little[br]bit about what bulimia really is.

0:05:03.019,0:05:07.074
Especially if you have a loved one suffering from[br]it and you want to just understand a little more,

0:05:07.074,0:05:10.018
that's kind of the world that they live[br]in.

0:05:10.018,0:05:14.043
Now I hope that is clear and don't forget[br]to comment if it's not. Ask questions,

0:05:14.043,0:05:17.086
tell me your feedback, things that you'd[br]like to hear from me and don't forget to

0:05:17.086,0:05:20.068
subscribe as well to my videos.

0:05:20.068,0:05:24.019
Because when I post or if I respond to a[br]question or anything like that you’ll

0:05:24.019,0:05:26.008
know about it right away.

0:05:26.008,0:05:27.989
And continue this journey with me

0:05:27.989,0:05:33.125
to a healthy mind, healthy body!