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Sunday, 1 December 2013

Eating Disorders: Bulimia nervosa - Treatments In Traditional Chinese Medicine Perspective

Bulimia nervosa is defined as a medical condition of  consuming a large amount of food in a short amount of time or one setting (binge eating), followed by self induced vomiting, taking a laxative or diuretic and/or excessive exercise, etc. to compensate for the binge. Bulimia nervosa also effects almost 90% of female. Unlike anorexia nervosa, people suffering from bulimia nervosa are usually normal or slightly over weight.
Treatments
In Traditional Chinese medicine perspective
According to Perspectives on Eating Disorders (bulimia nervosa and anorexia nervosa) and Traditional Chinese Medicine Norman Kraft, LST, DCH, MTOM, Dipl.Ac., L.Ac(51) 
1. Kidney deficiency 
a. Kidney deficiency (primarily of Yin and Essence) leads to Empty Fire (pathological Will) and poor control of the Heart’s Fire.
b. Chinese herbal formula: Liu Wei Di Huang Wan, ingredients include
b.1. Sheng Di Huang (Rhemannia) 15-20 gm
b.2. Shan Zhu Yu (Cornus) 12-15 gm
b.3. Shan Yao (Dioscorea) 10-15 gm
b.4. Ze Xie (Alisma) 9-12 gm
b.5. Mu Dan Pi (Moutan) 6-9 gm
b.6. Fu Ling/Fu Shen (Poria/Poria Spirit) 9-12 gm
Fu Shen is preferred over Fu Ling in this formula

2.   Kidney Yang Deficiency 
a. But One must be careful in using Yang tonics and warming herbs with bulimia in particular, for while the overall picture may be Yang Deficiency the constant abuse of the stomach tends to quickly lead to Stomach Yin Deficiency with Heat.
b. Chinese herbal formula: Jin Gui Shen Qi Wan, ingredients include
b.1. Fu Zi (Aconite) 6 gm
b.2. Rou Gui (Cinnamomum)  6 gm
b.3. Shu Di Huang (Rehmannia) 20-30 gm
b.4. Shan Zhu Yu (Cornus)  10-15 gm
b.4. Mu Dan Pi (Moutan) 10-12 gm
b.4. Fu Ling/Fu Shen (Poria/Poria Spirit) 10-15 gm
b.5. Shan Yao (Dioscorea) 10-15 gm
b.6. Ze Xie (Alisma) 10-15 gm

3. Fire/Heart deficiencies
a. Fire/Heart deficiencies than Water/Kidney issues,
b. Chinese Modification of Gui Pi Tang, ingredients
b.1. Ren Shen (Ginseng) 6-9gm
b.2. Huang Qi (Astragalus) 9-12gm
b.3. Bai Zhu (Atractylodes)  9-12gm
b.4. Dang Gui (Angelica) 6-9gm
b.5. Fu Shen (Poria) 6-9gm
b.6. Suan Zao Ren (Zizyphus) 9-12gm
b.7. Long Yan Rou (Euphoria) 9-12gm
b.8. Yuan Zhi (Polygala) 3-6gm
b.8. Mu Xiang (Saussurea) 3-6gm
b.9. Zhi Gan Cao (Glycyrrhiza)  3-6gm
b.10. Hong Zao (Jujuba) 3-5 pc
b.11. Bai Zi Ren (Biota) 6-9gm
b.12. He Huan Pi (Albizzia) 6-9gm
b.13. Shi Chang Pu (Acori) 6-9gm
b.14. Bai He (Lilii) 6-9gm

4. The author also notes that with care in formulation taking into account the cold temperature of the herb, Bai He could be added to the other two formulas above as well. In Liu Wei Di Huang Wan I usually combine Bai He with Zhi Mu (Anemarrhena) as these two herbs work very well together to calm Shen disturbed by interior Heat due to Deficiency of Yin.

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Sources
(51) http://www.myacudoc.com/images/ED.article.pdf