
CMScript 12 of 2024: Focus on Bulimia Nervosa
Has the “new year, new you” mindset motivated you to set health goals?
While self-improvement can be empowering, focusing too much on weight loss can have a negative impact on our relationship with food, our bodies, and our mental health.
In this issue of CMScript, we continue our campaign to raise awareness about eating disorders by focusing on Bulimia Nervosa, which is a serious mental health illness that involves unhealthy eating habits and an intense preoccupation with body weight or shape.
By understanding the signs, risks, and available support, you can make informed health choices that prioritise holistic well-being.
What is Bulimia Nervosa?
Bulimia nervosa is an eating disorder where a person eats large amounts of food in a short time (binge eating) and then tries to avoid weight gain by making themselves vomit, using laxatives, or exercising excessively.
The long-term effects of bulimic behaviours include digestive issues, dental problems, heart complications, kidney damage, and weakened bones. These effects can also impact reproductive health, immune function, and mental well-being, with risks of organ failure and increased suicidal ideation.
Types of Bulimia Nervosa
- Purging Type: Involves binge eating followed by self-induced vomiting or the misuse of laxatives, diuretics, or enemas to purge food from the body.
- Non-Purging Type: Instead of vomiting or using laxatives, this type involves compensating for binge eating through fasting or excessive exercise.
Signs and Symptoms of Bulimia Nervosa
People with bulimia nervosa often maintain a normal weight rather than aiming to be extremely thin, which can make the disorder more challenging to recognise. However, there are some signs that may help identify it, such as:
Behavioural Signs:
- Constant obsession with weight and body image, stressing about overeating, mood swings, and avoiding social situations.
- Frequent binge eating, hiding or sneaking food between meals, and choosing meals based on calorie content.
- Frequent weight fluctuations, excessive exercise, restrictive dieting, or repeated fasting.
- Engaging in purging behaviours such as self-induced vomiting or the misuse of laxatives, diuretics, or diet pills.
Physical Symptoms:
- Fatigue and muscle cramps, trouble focusing, dizziness and fainting.
- Nutritional deficiencies, dehydration, electrolyte imbalances and weakened immune system.
- Appearing bloated from fluid retention, nausea, vomiting, and acid reflux, causing sore throat and tooth sensitivity.
- Bright red eyes, bursting of blood vessels in eyes due to vomiting or straining in vomiting, intestinal blockages and infections.
What is Covered as PMB level of care?
Prescribed Minimum Benefit (PMB) regulations prescribe that your medical scheme is required to cover the diagnosis, treatment, and care of eating disorders, such as bulimia, in full. This includes:
- Hospital-based care for up to 3 weeks per year or 15 outpatient consultations annually.
- Coverage for medications and consultations with specialists such as psychiatrists and psychologists.
Important Tips for Maximising Your Benefits:
- Medical schemes often appoint designated service providers (DSPs) like doctors, pharmacists, or hospitals to treat PMB conditions. Using a DSP ensures full coverage, while choosing a non-DSP may lead to co-payments (extra costs).
- Schemes also have formularies, which are lists of approved medications. Check with your scheme and doctor to ensure your medication is covered.
If you or someone you know is struggling with an eating disorder like bulimia, early intervention can make all the difference. To learn more about this condition and support from your medical scheme through PMBs, download the full CMScript here.