Bulimia

What Is Bulimia?

Bulimia is a psychological eating disorder in which you have episodes of binge eating (consuming a large quantity of food in one sitting). During these binges, you have no sense of control over your eating. Afterward, you try inappropriate ways to lose weight such as:

Bulimia, also called bulimia nervosa, tends to start in late childhood or early adulthood. You usually binge and purge in secret. You feel disgusted and ashamed when you binge, and relieved once you purge.

People with bulimia usually weigh within the normal range for their age and height. But they may fear gaining weight, want to lose weight, and feel very dissatisfied with their bodies.

Bulimia Causes and Risk Factors

We don't know the exact cause of bulimia. But research suggests that a mixture of certain personality traits, emotions, and thinking patterns, as well as biological and environmental factors, might be responsible.

Researchers believe this eating disorder may begin with dissatisfaction with your body and extreme concern with your size and shape. Usually, you have low self-esteem and fear becoming overweight. The fact that bulimia tends to run in families also suggests that you might inherit a risk for the disorder.

Other risk factors include:

Bulimia Symptoms

Different people may have different symptoms of bulimia. You may notice changes in both your body and your behavior.

Physical symptoms of bulimia can include:

Behavioral symptoms of bulimia may include:

  • Eating uncontrollably, followed by purging
  • Hoarding or stealing food
  • Food rituals, like eating only a certain food, chewing more than necessary, or not allowing foods to touch
  • Skipping meals or eating only small portions during meals
  • Feeling out of control
  • Vomiting or abusing laxatives or diuretics to try to lose weight
  • Using the bathroom frequently after meals
  • Excessive exercising
  • Preoccupation with body weight
  • Depression or mood swings
  • Drinking large amounts of water or calorie-free beverages
  • Often using mints, gum, or mouthwash
  • Avoiding friends and activities you used to enjoy

If you or any member of your family has an unhealthy focus on weight and size and/or appears overly interested in food, call a doctor. The sooner you're treated, the better your chances for a successful outcome.

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Bulimia Complications

Another reason to get prompt treatment is to avoid the serious problems bulimia can cause. They include:

Bulimia Diagnosis

If your doctor thinks you might have bulimia, they'll probably ask you about your eating habits, if you've lost or gained weight, and whether you have any physical symptoms. They may also:

  • Give you a complete physical
  • Do blood and pee tests
  • Give you an EKG to see if you have heart problems resulting from bulimia
  • Do a psychological exam that includes questions about your body image

You may also have other tests to rule out medical causes for weight loss or gain.

Bulimia Treatment and Home Remedies

To treat bulimia, your doctor will consider your physical and psychological needs. Your treatment may include counseling and medications. Often, it involves a team of medical, nutritional, and mental health professionals. They'll try to help you restore your health and healthy eating patterns.

Medical treatments

  • Medications. The antidepressant fluoxetine (Prozac) is FDA-approved for the treatment of bulimia. Doctors sometimes recommend other antidepressants or types of medicines.
  • Hospitalization. This doesn't happen often. But with serious cases of bulimia, you might be treated in a hospital for a short time. Most eating-disorder programs offer outpatient treatment.

Psychotherapy

  • Cognitive behavioral therapy (CBT). In this type of therapy, you learn normal eating habits and watch out for things that lead you to binge or purge. You challenge irrational thoughts and unhealthy behaviors as they arise.
  • Family-based treatment (FBT). Often used in children and teens with bulimia, it helps the family deal with the illness and the issues it can cause.
  • Interpersonal psychotherapy (IPT). This focuses on problems in your relationships with other people in your life. The way you interact with others can affect your emotional state and mental health.

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Nutritional therapy

The goal is to teach you good eating habits. You work with a dietitian to learn to recognize your body's signals of hunger and fullness. They help you stabilize your weight and gain a healthier attitude toward food.

Self-care for bulimia

Along with following your treatment and therapy plan, you can take steps to care for yourself:

  • Look after your body. Include healthy foods in your diet to make sure you're getting the nutrients you need. Ask your doctor whether supplements are right for you. And check with your doctor about how much exercise is healthy for you.
  • Connect with others. Support from friends and family can help you overcome unhealthy habits and feel better about yourself. A support group might help, too. The National Association of Anorexia Nervosa and Associated Disorders lists several. The National Eating Disorders Association also offers help via chat, text, or phone.
  • Avoid your triggers. Don't linger over social media images of people with bodies that are unrealistic for you. Stay away from the scale and your mirror. If stress or boredom triggers binges, practice using healthier ways to deal with them.

Bulimia Outlook

Bulimia is difficult to cure. Many people improve, but some may relapse from time to time. In addition, some people who are considered "cured" continue with less-than-normal eating patterns throughout their lives.

But in general, the outlook for people with bulimia is more positive than the outlook for people with anorexia, another eating disorder.

Bulimia Prevention

Because we don't know exactly why people get bulimia, it's hard to know how to prevent it. But there are ways to teach children and teens healthy attitudes and behaviors about food and body image. They include:

  • Have regular family mealtimes as often as possible.
  • Don't talk about weight with your children. Instead, focus on healthy habits.
  • Try to promote a healthy, realistic body image in your kids.
  • Discourage fad dieting.
WebMD Medical Reference Reviewed by Smitha Bhandari, MD on September 18, 2020

Sources

SOURCES:

American Psychiatric Association: "Eating Disorders."

National Institute of Mental Health: "Eating Disorders."

womenshealth.gov: "Bulimia nervosa fact sheet."

National Eating Disorders Association: "Bulimia Nervosa," "Introduction to Nutrition Therapy," "Contact the Helpline."

Mayo Clinic: "Bulimia nervosa."

Cedars-Sinai: "Gastroparesis."

Johns Hopkins Medicine: "Frequently Asked Questions About Eating Disorders."

National Association of Anorexia and Related Disorders: "Online Support Groups."

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