Bulimarexia is a term used to refer to an eating disorder that mixes characteristics of bulimia nervosa and anorexia nervosa. This is not a formal diagnostic term; patients with bulimarexia are typically diagnosed with an eating disorder not otherwise specified (ED-NOS), a term used to describe people who clearly have disordered eating but do not fall into the diagnostic criteria for anorexia or bulimia. Treatment of an ED-NOS can be complicated and may require extensive therapy, nutritional counseling, and hospitalization in some cases.
Patients with bulimarexia usually have poor self esteem and a distorted body image. Women are more likely to develop this condition. The patient engages in an aggressive campaign designed to generate weight loss and falls into a cyclical pattern of disordered eating. This can include prolonged fasting accompanied with the use of medications like diuretics to try and lose weight, followed by a binging and purging cycle where the patient eats large amounts of food and vomits.
Health risks with bulimarexia are considerable. Patients can develop organ damage as a result of the extreme stress on the body along with issues like damage to the enamel on the teeth and reduction in bone mass leading to an increased susceptibility to fractures. Comorbidities like depression can be observed and patients may overexercise, putting additional strain on the body. Patients with bulimarexia can lose weight precipitously and will still report dissatisfaction with their appearance.
Treating an ED-NOS is often difficult due to the lack of a clear guideline for patient care as there are with anorexia and bulimia. Patients with bulimarexia require a customized treatment plan to address their disordered eating and body image issues while also working on reaching and maintaining a healthy weight. This can include counseling with a mental health professional along with nutritional therapy. Nutrition for such patients may be complicated as patients try to avoid certain foods.
In some cases, a bulimarexia patient will need to receive care in an inpatient facility. This may be recommended when a patient is at serious risk of medical complications, including death, as a result of the disordered eating, or when patients do not respond to outpatient treatment. At an eating disorder clinic, patients receive highly attentive care from doctors and nurses with the goal of getting them healthy enough to return to outpatient treatment. Many patients with eating disorders report lifelong struggles with food even after treatment, and it is important to pursue continuing care after the dangerous phase of the disease is over.
