Understanding Bulimia. Signs, Symptoms And The Human Experience - Research Reviews - Brief Article

AORN Journal,  Feb, 2002  by Michelle Byrne

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UNDERSTANDING BULIMIA. SIGNS, SYMPTOMS AND THE HUMAN EXPERIENCE S Orbanic American Journal of Nursing Vol 101 (March 2001) 35-42

Bulimia nervosa is a widely publicized psychiatric disorder. Many nurses, however, may not be able to address the needs of this patient population effectively. As perioperative nurses, we may care for bulimic patients, and this disorder may affect our coworkers, significant others, or even ourselves. This article presents a comprehensive overview of this disorder and the results of a phenomenological study that provide readers with knowledge of what it is like to live with bulimia. This article is a combination of a literature review, research report, and continuing education module, and it effectively disseminates current, comprehensive knowledge about bulimia.

Literature review. The author provides an overview of bulimia and describes the hallmarks of binging and purging. Highlighted sidebars provide readers with the diagnostic criteria for bulimia from the Diagnostic and Statistical Manual of Mental Disorders. The author, however, believes these stringent criteria miss many people who have behavioral patterns similar to patients diagnosed with bulimia. Another sidebar identifies the signs and symptoms of the disorder. This information is helpful when screening patients. The article also includes resources for clinicians and patients with eating disorders.

Phenomenological study. Included are the findings of a phenomenological study that explored the human experience of being bulimic. The researcher used Colaizzi's method for data analysis, which is a common phenomenological method. The sample included six women ages 22 to 54 who were interviewed about what it is like to live with bulimia. The researcher did not identify race, ethnicity, or social class of the participants. She did, however, identify herself as a person living with and recovering from bulimia. The findings are presented as themes, and participant descriptions were used to document these themes.

Five themes reflect the findings of this study. The first theme is described as "a living hell." Four of six participants used this terminology to describe living with bulimia. The second theme is "the perpetual cycle." This describes how binging, purging, and restricting food are a self-perpetuating cycle. The third theme is titled "the right to exist." This theme describes feelings of self-criticism. "Food as an anesthetic" is the fourth theme, and it describes how restricting food, binging, and purging are used to detach from strong feelings. One participant stated, "It was easier to eat and throw up than it was to be sad." The final theme is "it's like living a facade," which captures how these participants avoid detection and scrutiny by others.

Summary. To strengthen support of the themes, the researcher could have used credibility strategies, such as prolonged engagement or confirmation of the themes by experts or participants. This article is recommended for perioperative nurses who have little knowledge about this complex eating disorder. It provides strategies for nurses to assess patients and recognize bulimic behaviors. It is imperative that perioperative nurses provide patients who suffer from this disease--an illness cloaked in shame and secrecy--a timely referral to treat it.

MICHELLE BYRNE
RN, MS, PHD, CNOR
NURSING RESEARCH COMMITTEE

COPYRIGHT 2002 Association of Operating Room Nurses, Inc.
COPYRIGHT 2002 Gale Group