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Hi there, it’s Kati again, thanks for checking back.

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As always I have some great information
for you today and it's pretty educational.

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Today's is

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a little bit more clinical and the clinical
side of what I do.

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And I'd like to talk to you about the
diagnosis of Bulimia Nervosa.

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Now I know a lot of you say "I already know what
that is", "I’ve heard it a ton of times" and

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that's why I just want to clarify, I know
that people use eating disorder terms

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loosely.

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In media, in everyday life and I want to
make sure that you know

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when I use the term bulimia, what I mean
by it.

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So when I diagnose someone with bulimia
what am I looking for?

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As always I refer to my DSM.

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Now, the DSM is pretty much the Bible for
diagnosis and I know I've referred to

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it before, it gives me a list of criteria
that someone needs to meet in order to

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be diagnosed. Because I don't want to give
a diagnosis to someone

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if they don't really meet the criteria. Right?

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Now, when I begin, the first thing that I'm
looking for, for someone with bulimia

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is that they binge eat.

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I know a lot of you say

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"I binge this", "this is what I binge", how much
In this amount of time.

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Everybody has something different that
they do.

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It's not competition.

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I have heard videos of people saying "this
person said that their binge

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that's not as much, I binge much more than
they binge." It doesn't matter.

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What I want to say

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to a client of mine is what feels like a
binge to you

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all the diagnosis criteria says that it
has to be more than a normal amount of

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food,

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in a short period of time.

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now the time constraint that they give
is two hours, but

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I wouldn't even restrict it to that with
my clients. I want to know what feels like a binge

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to them.

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I've had people who eat

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twenty-five hamburgers, and I’ve had people
who’ve eaten an apple and that can feel like

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a binge to them.

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So,

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you have to binge eat, that's part of the
bulimia criteria.

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The second portion of that,

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is that during this binge

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the person feels completely out of
control.

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And I know that doesn't always makes
sense, especially if you haven't

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suffered from an eating disorder you think "out
of control?

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They’re just eating, they’re choosing to eat

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this much."

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That's not the case.

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I had a patient

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who told me she used to drive along this
road and get

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these certain fast food restaurants she’d
stop and get her certain

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binge foods, it was kind of a ritual that
she would do

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and she would tell me that when she
reached

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the last fast food restaurant, she had picked
up all the food that she was planning to

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eat for her binge

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would almost have a out-of-body
experience

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she said it was like she came out of her
body,

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didn't even remember eating the food,

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until she kind of awoke from this
experience

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to see wrappers all over a car

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and receipts from what she purchased.
And that’s

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the only way she would realize what had
happened.

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So when I say out of control,

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I mean they feel completely out of
control.

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The next criteria that needs to be met

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is following that binge and that out of
control sensation,

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they do something to “make up” for the
binge.

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Now,

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everybody does something different.
That's the same like a binge, everybody's

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different.

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The most common, and the one I hear the most
is self-induced vomiting.

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Now that's the one that people throw around
a lot, “Oh, she went to the bathroom after eating

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she must be bulimic.”

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That's not

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quite going to work, that's not really
the criteria. That's,

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that's an uneducated guess to
somebody.

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Now, the criteria that that I'm meeting in 
My DSM says that

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Their, they could do self-induced vomiting,
they can use laxatives, they can use

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enemas, they can use diuretics.

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some people don't even purge at all.
They actually

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will purge through excessive exercise or
some people even will force themselves

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to starve for x amount of days or
time,

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following a binge to make up for it.

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I even had a patient once, that would use the term

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it set me back to base line.

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it would put me to zero.

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because she had these equations that
would, you know, binge equals this much

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minus this is back to zero.

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And that was her goal with her eating
disorder.

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So once these criterias have been met,

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what else?

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Well obviously like any eating disorder,
the person's going to have

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a lot of focus on their shape and weight.

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And that drives the behaviors.

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That's what bulimia is:

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someone will binge eat,

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they will feel out of control when they binge eat,

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they'll do something to make up for it
afterwards, and they’ll be

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horribly, horribly focused on their shape
and weight at all times.

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And I hope that helps clarify a little
bit about what bulimia really is.

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Especially if you have a loved one suffering from
it and you want to just understand a little more,

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that's kind of the world that they live
in.

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Now I hope that is clear and don't forget
to comment if it's not. Ask questions,

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tell me your feedback, things that you'd
like to hear from me and don't forget to

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subscribe as well to my videos.

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Because when I post or if I respond to a
question or anything like that you’ll

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know about it right away.

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And continue this journey with me

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to a healthy mind, healthy body!