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

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

Today's is

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

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

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

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

loosely.

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

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

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

As always I refer to my DSM.

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

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

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

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

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

is that they binge eat.

I know a lot of you say

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

Everybody has something different that
they do.

It's not competition.

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

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

What I want to say

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

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

food,

in a short period of time.

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

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

to them.

I've had people who eat

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

a binge to them.

So,

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

The second portion of that,

is that during this binge

the person feels completely out of
control.

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

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

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

this much."

That's not the case.

I had a patient

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

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

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

and she would tell me that when she
reached

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

eat for her binge

would almost have a out-of-body
experience

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

didn't even remember eating the food,

until she kind of awoke from this
experience

to see wrappers all over a car

and receipts from what she purchased.
And that’s

the only way she would realize what had
happened.

So when I say out of control,

I mean they feel completely out of
control.

The next criteria that needs to be met

is following that binge and that out of
control sensation,

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

Now,

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

different.

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

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

she must be bulimic.”

That's not

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

that's an uneducated guess to
somebody.

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

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

enemas, they can use diuretics.

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

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

to starve for x amount of days or
time,

following a binge to make up for it.

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

it set me back to base line.

it would put me to zero.

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

minus this is back to zero.

And that was her goal with her eating
disorder.

So once these criterias have been met,

what else?

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

a lot of focus on their shape and weight.

And that drives the behaviors.

That's what bulimia is:

someone will binge eat,

they will feel out of control when they binge eat,

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

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

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

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

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

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

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

subscribe as well to my videos.

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And continue this journey with me

to a healthy mind, healthy body!