Specific exercising. According to the 1990 book,

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Specific purpose: I want my audience to understand what bulimia is.

Organizational pattern: Cause-effect
I. Attention statement: Nearly half of Americans personally know someone with an
eating disorder such as bulimia, according to a recent survey of 1,264 adults, in the New
York Times, by Zogby, published Friday July seventh. In addition the poll states that
college graduates are more likely to know someone with an eating disorder (Zogby).

II. Orientation phase point: I am going to tell you what is bulimia, signs/side affects and
Adaptation: Bulimia is an eating disorder in which a person eats an abnormally large
amount of food (which is a binge), and then tries to prevent the weight gain by purging.
Some examples of purging are: vomiting (most common), waterpills, laxatives, fasting or
even excessive exercising. According to the 1990 book, titled Eating Habits and
Disorders, written by Rachel Epstein.
Credibility : Bulimia is difficult to detect in someone you know. This is because many of
the bulimics remain at normal body weight or even above normal weight. This is due to
their frequent binges on food. Binges can range from one or two times a week to many
times a day.
Enumerated preview: My object today is for you to understand bulimia and to be able for
you to receive information that could maybe help you out some day. First I will tell you
the causes, then the signs/side affects, and treatments.

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Transitions: To begin with I would like to tell you that there are many factors that
contribute to bulimia but the exact cause is unknown.

III. Suffers of bulimia binge and purge for a variety of reasons.

A. Bulimia usually starts in the teen or early adult years and is far more common
in females than in males. The illness may be constant or it may get better and
worse over a period of many years. Usually bingeing alternates with periods of
normal eating and /or fasting. In severe cases there may be periods of bingeing
and fasting with no periods of normal eating. Web page, Fact Sheet: Bulimia
Nervosa, Yahoo.com, 1996
B. The onset of bulimia may be associated with stressful life events, which are not
related to the persons concern about body image or weight. For example a
domestic argument, illness or death in the family, the stress of examinations,
exchange in job, break down of a relationship, divorce, or even pregnancy may
precipitate the first eating-binge, from Eating Disorders: The Facts, by Suzanne
Abraham and Derek Llwewllyn-Jones, 1992, page 104.
C. Many of the bulimics binge only to be able to purge themselves afterward-it is
the purge, in fact, that offers these people the most relief for their emotional
distress (Epstein 66).
Transition: Now you know what some of the causes of bulimia are, I will discuss some of
the behavioral and physiological signs and side affects
A. Behavioral signs and side affects:
Bingeing. Secretive eating, evidenced by missing food. Preoccupation with and
constant talk about food and/or weight. The avoidance of restaurants, planned
meals, or social events if food is present. Self-disarrangement when too much has
been eaten. Bathroom visits after meals. Purging at least twice a week for a
minimum of 3 months. Laxative, enema, diuretics abuse, or fasting. Rigid and
harsh exercise regimes. Notice of feeling out of control.

B. Physiological signs and affects:
Swollen glands, puffiness in the cheeks, or broken blood vessels under the eyes.
Complaints of sore throats. Complaints of fatigue and muscle ache. Unexplained
tooth decay. Frequent weight fluctuations, often within a ten to fifteen pound
range. Dehydration. Electrolyte imbalances. Low sodium and potassium levels.
Liver and Kidney damage. Constipation. Salivary-gland inflammation and
swelling(a chimpmunk face). Severe bowel abnormalities. Distorted skin on
index and middle fingers. Internal bleeding from vomiting. Ulcers of the stomach
and/or esophagus from vomiting . Lacerations of the esophagus. Hearth
palpitations. Heart attack. Death.
Signs and side affects from Bulimia nervosa emailprotected, Complete Guide to
Symptoms, Illness & Surgery, H. Winter Griffith, 1995.

Transition: Now you have learned what bulimia is, the causes and the signs/side affects. I
will explain some treatments for bulimia.

V. Getting help for the bulimic. It is best if bulimia is treated early. If not long
term treatment may be necessary. Family and friends need to always give full support, to
the bulimic.

A. Admission to hospital, just a short stay so that the health professional can
assess the patients psychological or medical problems further and devise a
program of treatment which is appropriate. The health professional will be there
to provide on going support. He will provide an environment in which the patient
can learn normal eating habits and can cease to use the potentially dangerous
methods of weight control (Abraham & Llwellyn-Jones,120). The health
professioinal would give one on one treatment or group meetings.

B. Another way to cure bulimia is with medications. The medications are
antidepressant medicines. However in a one-year study, the use of antidepressant
medicines, the success rate was only 18%. Once medication is discontinued the
patient usually has a relapse. Nidus Information Services, Lycos.com,
C. A recovering bulimic should not take vacations or attend large social events.
Because of the unfamiliar environment, it is common for their routine to start up
again. Friends and family should remember to always be supportive.

VI. Summary
Once the behavioral symptoms of bulimia have been stopped or reduced, the goals
are for the sufferer to become independent and more confident with their weight
and eating intake. It is very important for the bulimic to keep in mind that a cure is
possible, even through it may take a lot of time and hard work. Recovery is made
when the bulimic can identify the cause of the behavior and can stop the behavior.
Concluding Device
Now you have a better understanding of bulimia the causes, signs/side affects and
treatment. Therefore if you or someone else has bulimia you now know how to better
understand the disorder. Also may even be able to help someone with bulimia stop their

The New York Times, by Zogby, published Friday July 7, 2000.

Eating Habits and Disorders, by Rachel Epstein, New York, Philadelphia,
Copyright 1990, pages 109.
Web page, Yahoo.com, Fact Sheet: Bulimia Nervosa, New York Presbyterian
Hospital, Copyright 1996.

Eating Disorders the Facts, by Suzanne Abraham and Derek Llwewllyn-Jones,
United States, Copyright 1992.
Web page, Yahoo.com, Bulimia Nervosa Thrive @ Health, Complete Guide to
Symptoms, Illness and Surgery, By H. Winter Griffith, MD, United States, Copyright

Web page, Lycos.com., Nidus Information Services, New York, New York,
Copyright 1996-2000.

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