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.
Because when I post or if I respond to a question or anything like that you’ll
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And continue this journey with me
to a healthy mind, healthy body!