Understanding Bulimia: The Basics

What Is Bulimia?

Bulimia nervosa (also called bulimia), like anorexia nervosa, is an eating disorder. Both begin as a psychological problem that over time may lead to serious physical problems -- and even death.

While there are some similarities between these two eating disorders, they are distinct problems. If you have anorexia, it's likely you will slowly starve yourself to lose weight, and you may even use other unhealthy methods to try to help you lose even more. But if you have bulimia, you do eat -- and sometimes much more than usual in a short time, often past the point of feeling full, which is called a binge. Then you purge -- make yourself vomit or use diet pills, laxatives, or diuretics to keep all that food from making you gain weight.

These binge-and-purge episodes, typically happening at least twice a week for three months, is what distinguishes bulimia from other eating disorders. The purging may serve two purposes: to prevent weight gain and to temporarily relieve emotional discomfort or other negative feelings.

Like anorexia, bulimia mostly afflicts young women. Because binge eating and purging often occur in secret, the incidence of the disorder is uncertain, but researchers estimate that as many as one in five of all U.S. women in high school and college display at least temporary bulimic symptoms. The average age of onset is late adolescence to early adulthood. While 90%-95% of bulimic patients are female, boys and men also can suffer from eating disorders.

At a meeting hosted by the National Institutes of Health, experts determined they still have a lot to learn about how many people have bulimia and other eating disorders.

Bulimia can occur on its own or intermittently with anorexia. In the intermittent pattern -- which occurs in about one case out of five -- a young woman will not eat for some time, setting herself up for a binge; she may use appetite suppressants during the time she is not eating.

Remember that anorexia and bulimia may have some similar characteristics, but they are two different eating disorders. They may affect personality in different ways. Anorexia usually causes you to suppress all urges, including sexual ones. But if you have bulimia, you tend to indulge your cravings and act on impulse. This could lead to drug use, engaging in sex with many partners, shoplifting, or shopping binges.


A bulimic's overall health depends on how often she binges and purges. She may vomit occasionally (once a month) or very frequently (many times a day). The health consequences generally relate to the purging and not the binge eating. Physical repercussions include menstrual abnormalities, inflammation of the stomach, pancreas, or esophagus, enlarged salivary glands, vomiting blood, and tooth decay and gum disease from vomiting stomach acids. Frequent self-induced vomiting also depletes the water and potassium in bodily tissues, causing abnormal heart rhythms, seizures, muscle spasms, and even paralysis. In severe cases, some of these physical problems can lead to death. Another danger is suicidal depression.

Bulimia is a real illness. Once it develops, you probably cannot control it without help. And although family or friends may think they are trying to help by warning you about your habits, such criticism usually isn't helpful on its own and may even contribute to unhappiness or being more secretive. Support from your family and friends can help, but you need professional treatment to get better.

What Causes Bulimia?

Pressures and conflicts within the family are thought to be the primary cause of this eating disorder. If you have bulimia, it's likely you're an overachiever and perfectionist and feel you can't live up to the expectations of your parents, family, or peers.

You may have problems with:

  • Self-esteem
  • Depression
  • Having been physically or sexually abused as a child

About half of all bulimics report a history of abuse.

WebMD Medical Reference Reviewed by Joseph Goldberg, MD on February 11, 2017



Halmi, K. Eating Disorders: Anorexia, Bulimia, and Obesity.; Yudofsky, Textbook of Clinical Psychiatry ,4th edition American Psychiatric Publishing, 2003. 

Brewerton, T., Clinical Handbook of Eating Disorders: An Integrated Approach- Edition 1, Marcel Dekker, Inc, 2004.

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