What compensatory behaviors present in bulimia nervosa?
Compensatory behaviors are a range of behaviors utilized by people struggling with eating disorders to avoid weight gain or to alleviate the guilt associated with eating.12
These behaviors can take many forms, including purging behaviors and non-purging behaviors. Someone with BN may use purging and non-purging methods simultaneously or purging or non-purging behaviors exclusively.12
Purging behaviors involve the physical expulsion of food from the body. This includes many of the behaviors more commonly associated with BN, such as self-induced vomiting and the misuse of laxatives and enemas.
But there are also several non-purging compensatory behaviors people with BN may turn to after a binging episode.
Non-purging compensatory behaviors
Non-purging compensatory behavior spans a wide range of actions and practices that may counteract the effects of eating or alleviate the negative emotions one may associate with eating.
These types of behaviors have not only been found to be prevalent in adolescents with eating disorders but also associated with greater eating disorder symptomology and presentations of depression.12
Some people living with BN may follow a binging episode with a period of fasting to compensate for the extra calories.
Such rigid food restrictions can lead to feelings of deprivation and cravings for “forbidden” foods.13 This, in turn, can lead to another binge episode, continuing the cycle of binging and fasting.
The idea of excessive exercise is to burn off calories that may have come from eating or binging.
Over time, the urge to exercise can become compulsive, whereby a person will still exercise while injured, feel anxious when unable to exercise, and neglect commitments in favor of exercising.14
Caffeine-based diet pills, certain prescription medications, and some recreational drugs work to increase energy and suppress appetite.
Someone with bulimia nervosa may use these stimulants or similar drugs to help them curb hunger and control their weight.
For many people with non-purging bulimia nervosa, skipping meals, reducing portion sizes, and practicing other dieting behaviors are common. Studies show these behaviors may, in many cases, precede actual compensatory behaviors associated with BN.11
These dieting behaviors can leave a person feeling hungry and deprived, which leads to a binging episode, and the cycle continues.
Signs and symptoms of non-purging bulimia
In many ways, non-purging type bulimia nervosa resembles purging-type BN. While favored compensatory behaviors differ between the two groups, there are many similar signs and symptoms, including:1,2
- A preoccupation with body weight, shape, or size
- A preoccupation with overall appearance
- Regularly comparing one’s body to others
- Low self-esteem or self-worth
- Rigid rituals surrounding food and eating habits
- Eliminating or only eating certain foods or food groups
- Eating in secret
- Hiding or hoarding food
- Disappearance of large amounts of food
- Hiding empty food containers and packaging
- Fluctuating weight
- Mood swings
- Gastrointestinal complaints
- Dizziness, fatigue, weakness
- Feeling cold
- Problems sleeping
- Dry skin, brittle nails, thinning hair
- Swelling
Additionally, someone with non-purging bulimia nervosa may:
- Exercise excessively (longer than intended, despite illness, injury, etc.)
- Be preoccupied with dieting, focus on nutritional information, or regularly diet
- Skip meals, avoid eating with others, or avoid situations that involve food
- Showcase bursts of energy that stimulants could cause
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Treatment for bulimia nervosa non-purging type
Like other eating disorders and mental health conditions, non-purging BN is very complex, often developing alongside a number of co-occurring conditions, such as childhood trauma, dysfunctional personal relationships, anxiety, and depression.
As such, a comprehensive treatment plan with a multidisciplinary approach is often thought of as the best way to help someone with non-purging bulimia nervosa. This can include a combination of psychotherapy, medical care, nutrition therapy, movement therapy, and experiential therapies.
Therapy for non-purging bulimia nervosa
Cognitive behavioral therapy (CBT) is the leading psychotherapy approach for treating bulimia nervosa of all types.3 However, other therapies have had positive outcomes in treating eating disorders, including:4,5,6,7,8,9,10
Experiential treatments for bulimia nervosa can help a person heal by getting them out of their mind and into their body. They include:
- Art therapy
- Dance therapy
- Music therapy
- Psychodrama
- Wilderness therapy
- Recreational therapy
- Yoga therapy
- Adventure therapy
Finding help for bulimia nervosa
An individualized treatment plan can help you learn how to love your body, feel good about yourself, and have a healthy relationship with food, eating, movement, yourself, and others.
Remote treatment that works
At Within Health, we strive to help clients in just this way. Our multidisciplinary team of experts can help create a treatment plan catered to your specific needs and history to help ensure you have just the right kind of help and support needed to overcome these hurtful thoughts and behaviors.
Get help today
Always remember it’s not your fault. An eating disorder can be a way to cope with difficult feelings or situations and society’s sometimes unrealistic expectations about appearance. But there are healthier ways to deal with hard things. And finding the right kind of treatment can be the first step toward a healthier and happier future.
