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2001óLoretta F. Kasper, Ph.D.

Directions: Today you will be doing a different kind of reading practice.You will read the following text on Bulimia, an eating disorder. This text contains glosses, which, when you move your mouse under the blue link, provide you with an on-screen definition of new words. After you finish reading this text, you will search the Internet to find THREE additional texts on Bulimia.Then after you read BOTH this text and the ones you find on the Internet, you will answer a series of comprehension questions.

Read the following essay. Find three additional texts on Bulimia and Read them. Then CLICK HERE to answer the comprehension questions. You will type the answers to the questions directly into the computer screen. When you are finished, click the button that says "Submit your answers." This will take you to a page that has the correct answers. To keep a copy of your answers, you will need to print them out.

Bulimia Nervosa

††††††††††† Bulimia is a cycle of uncontrolled binge eating following by purging. People with bulimia nervosa consume large amounts of food and then rid their bodies of the excess calories by vomiting, abusing laxatives or diuretics, taking enemas, or exercising obsessively.Some use a combination of all these forms of purging.Because many individuals with bulimia "binge and purge" in secret and maintain normal or above normal body weight, they can often successfully hide their problem from others for years.

††††††††††† Bulimia can range from a mild and relatively infrequent response to stress to an extremely debilitating pattern that absorbs nearly all of a person's time, energy, and money.In its most severe forms, binge eating and purging may occur ten or more times a day.

††††††††††† Bulimia usually begins innocuously as an attempt to control weight.Purging may seem to be a convenient means for a person to overeat without gaining weight.It can quickly become a destructive process that cannot be controlled.Persons with bulimia are often aware that their eating patterns are abnormal and out of control and that their lives are dominated by their eating habits.They may feel quilty and depressed after a binge.Over time, the cycle becomes more and more dominant in the person's thoughts and behavior.It may impair personal relationships and interfere with other activities, leading to depression, isolation, and lowered self-esteem.Once caught in this pattern, the resulting shame and sense of helplessness may make it difficult for the person to seek the help that is needed.

††††††††††† Physical effects can also be serious.Frequent vomiting can cause permanent tooth damage from erosion of tooth enamel as well as damage to the tissues of the throat and esophagus.Kidney problems and seizures are also possible. Electrolyte imbalance with consequent risk of serious cardiac problems is also a significant danger.

††††††††††† Consider the case of Lisa, a young woman suffering from bulimia.

†††††††††† --Lisa developed bulimia nervosa at 18.Her strange eating behavior began when she started to diet.She too dieted and exercised to lose weight, she regularly ate huge amounts of food and maintained her normal weight by forcing herself to vomit.Lisa often felt like an emotional powder keg--angry, frightened, and depressed.

††††††††††† --Unable to understand her own behavior, she thought no one else would either.She felt isolated and lonely.Typically, when things were not going well, she would be overcome with an uncontrollable desire for sweets.She would eat pounds of candy and cake at a time, and often not stop until she was exhausted or in severe pain.Then, overwhelmed with guilt and disgust, she would make herself vomit.

††††††††††† --Her eating habits so embarrassed her that she kept them secret until, depressed by her mounting problems, she attempted suicide.Fortunately, she didn't succeed.While recuperating in the hospital, she was referred to an eating disorders clinic where she became involved in group therapy. There she received medications to treat the illness and the understanding and help she so desperately needed from others who had the same problem.

††††††††††† Family, friends, and physicians may have difficulty detecting bulimia in someone they know.Many individuals with the disorder remain at normal body weight or above because of their frequent binges and purges, which can range from once or twice a week to several times a day.Dieting heavily between episodes of binging and purging is also common.Eventually, half of those with anorexia will develop bulimia.

††††††††††† As with anorexia, bulimia typically begins during adolescence.The condition occurs most often in women but is also found in men.Many individuals with bulimia, ashamed of their strange habits, do not seek help until they reach their thirties or forties.By this time, their eating behavior is deeply ingrained and more difficult to change.

††††††††††† Bulimia nervosa patients--even those of normal weight--can severely damage their bodies by frequent binge eating and purging.In rare instances, binge eating causes the stomach to rupture; purging may result in heart failure due to loss of vital minerals, such as potassium.Vomiting causes other less deadly, but serious, problems--the acid in vomit wears down the outer layer of the teeth and can cause scarring on the backs of hands when fingers are pushed down the throat to induce vomiting.Further, the esophagus becomes inflamed and glands near the cheeks become swollen.As in anorexia, bulimia may lead to irregular menstrual periods.Interest in sex may also diminish.

††††††††††† Some individuals with bulimia struggle with addictions, including abuse of drugs and alcohol, and compulsive stealing.Like individuals with anorexia, many people with bulimia suffer from clinical depression, anxiety, OCD, and other psychiatric illnesses.These problems, combined with their impulsive tendencies, place them at increased risk for suicidal behavior.

Causes of Eating Disorders

††††††††††† Anorexia nervosa has been known for over a century but it is only since the early 1970's that bulimia, not associated with anorexia, has been known to professionals.One out of every one hundred women may become anorexic. Estimates of the frequency of bulimia vary from five out of a hundred to twenty out of a hundred in college age women.Men also develop anorexia nervosa and bulimia but in far smaller numbers.Both disorders appear to be on the increase.Experts do not know the causes of these disorders nor why they are increasing, but most agree that biological, psychological, and social factors all play a part.

††††††††††† Least is known about biological factors.Some evidence suggests that eating disorders may develop as a response to inherited predispositions to mood swings and depression.Other evidence reveals an increased incidence of major depression and alcoholism in blood relatives of persons with bulimia or bulimic variations of anorexia nervosa.Antidepressant medication under the supervision of a physician has been found helpful to some individuals in controlling the binge-purge cycle.

††††††††††† More attention has been paid to the psychological development of persons with eating disorders.It is speculated that anorexia may function as an attempt to gain control over life or life circumstances when a person has felt little control in the past.It may also serve as an avoidance of the bewildering complexities of physical and emotional maturation.Individuals with anorexia are often compliant "model children" who tend to be intelligent, perfectionist, and have high personal standards.They often want to please others but have low self-esteem and problems with assertion. They will also frequently be depressed.High expectations within their families may be another contributing factor.

††††††††††† Persons with bulimia also suffer from low self-esteem but tend to be less passive than persons with anorexia nervosa.Individuals with bulimia tend to be more socially active, are more likely to date, and may use alcohol and drugs.Research suggests that persons with bulimia have a higher general level of anxiety than others.Thus the binge-purge cycle may function as a mechanism for relieving anxiety and emotional stress.

††††††††††† Social factors also seem to contribute to eating disorders.Excessive emphasis within our culture on slim, boyish figures for women makes it increasingly hard for the adolescent girl, already worried about herself and her body, to feel acceptable.Increasing numbers of teenage girls resort to extreme diets or purging in attempts to make their maturing bodies conform to the expectations of society.Some of these individuals will be trapped in the destructive pattern of eating disorders.Females have traditionally felt more pressure than males to conform to physical stereotypes of what is acceptable.This may explain why so many more females than males develop eating disorders.

BEFORE you answer the comprehension questions, search the Internet for additional information on Bulimia. Find and read THREE additional texts on Bulimia. Use the information in this text AND in the additional texts you find to answer the comprehension questions.Go to to search.

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