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Bulimia Nervosa: Causes, Symptoms, Signs & Treatment Help

What is Bulimia?

Bulimia Nervosa is a psychological and severe life-threatening eating disorder described by the ingestion of an abnormally large amount of food in short time period, followed by an attempt to avoid gaining weight by purging what was consumed.  Methods of purging include forced vomiting, excessive use of laxatives or diuretics, and extreme or prolonged periods of exercising.  Often, in these binge/purge episodes, a woman or man suffering with this disorder will experience a loss of control and engage in frantic efforts to undo these feelings.

Jane Fonda discusses her recovery from bulimia. As posted by: Amanda de Cadenet

Since he or she may have bingeing and purging episodes in secret, they are often able to conceal their disorder from others for extended periods of time.  Those suffering with bulimia nervosa often utilize these behaviors in an attempt to prevent weight gain, to establish a sense of control, and/or as a means of coping with difficult circumstances or situations. Described and classified by the British psychiatrist Gerald Russell in 1979, Bulimia Nervosa comes from a Greek word meaning ravenous hunger. If you or a loved one are suffering with bulimia, seek professional treatment for eating disorders.

Major Types of Bulimia

There are two common types of bulimia nervosa, which are as follows:

  • Bulimia Nervosa Purging type -This type of bulimia nervosa accounts for the majority of cases of those suffering from this eating disorder.  In this form, individuals will regularly engage in self-induced vomiting or abuse of laxatives, diuretics, or enemas after a period of bingeing.
  • Bulimia Nervosa Non-purging type -In this form of bulimia nervosa, the individual will use other inappropriate methods of compensation for binge episodes, such as excessive exercising or fasting.  In these cases, the typical forms of purging, such as self-induced vomiting, are not regularly utilized.

Causes of Bulimia

The exact cause of bulimia nervosa is currently unknown; though it is thought that multiple factors contribute to the development of this eating disorder, including genetic, environmental, psychological, and cultural influences.  Some of the main causes for bulimia include:

  • Stressful transitions or life changes
  • History of abuse or trauma
  • Negative body image
  • Poor self-esteem
  • Professions or activities that focus on appearance/performance

Bulimia Signs & Symptoms

An individual suffering from bulimia nervosa may reveal several signs and symptoms, many which are the direct result of self-induced vomiting or other forms of purging, especially if the binge/purge cycle is repeated several times a week and/or day.

Physical signs and symptoms of bulimia nervosa are:

  • Constant weight fluctuations
  • Electrolyte imbalances, which can result in cardiac arrhythmia, cardiac arrest, or ultimately death
  • Broken blood vessels within the eyes
  • Enlarged glands in the neck and under the jaw line
  • Oral trauma, such as lacerations in the lining of the mouth or throat from repetitive vomiting
  • Chronic dehydration
  • Inflammation of the esophagus
  • Chronic gastric reflux after eating  or peptic ulcers
  • Infertility

Signs and symptoms of binge eating and purging are:

  • Disappearance of large amounts of food
  • Eating in secrecy
  • Lack of control when eating
  • Switching between periods of overeating and fasting
  • Frequent use of the bathroom after meals
  • Having the smell of vomit

Bulimia nervosa can also create problematic strains between the sufferer and family and friends, particularly as the individual has abnormal eating behaviors and/or the avoidance of social activities to engage in binge/purge episodes.

Bulimia Treatment

Since negative body image and poor self-esteem are often the underlying factors at the root of bulimia, it is important that therapy is integrated in the recovery process.  Treatment for bulimia nervosa usually includes:

  • Discontinuing the binge-purge cycle:  The initial phase of treatment for bulimia nervosa involves breaking this harmful cycle and restoring normal eating behaviors.
  • Improving negative thoughts:  The next phase of bulimia treatment concentrates on recognizing and changing irrational beliefs about weight, body shape, and dieting.
  • Resolving emotional issues:  The final phase of bulimia treatment focuses on healing from emotional issues that may have caused the eating disorder.  Treatment may address interpersonal relationships and can include cognitive behavior therapy, dialectic behavior therapy, and other related therapies.

Don’t delay and risk serious medical complications. Seek out an eating disorder treatment facility in your area.

Articles on Bulimia Nervosa

  • Trying to getting insurance coverage for bulimia is a confusing and frustrating experience for many patients, families and treatment providers. Several factors play into the difficulties.
  • Interpersonal Therapy is based on a simple idea: how you relate to others impacts your emotional and mental health. This idea grew out of the work of a psychiatrist named Harry Stack Sullivan who believed that an individual’s personality was significantly influenced by his/her interpersonal relationships.
  • Bulimia Nervosa is an eating disorder that is characterized by “a cycle of bingeing and compensatory behaviors such as self-induced vomiting designed to undo or compensate for the effects of binge eating.”
  • Do you believe your child may have bulimia? Let’s define what bulimia nervosa is, and why it can be difficult to detect –– even among a family member.
  • Weight fluctuations can be a common occurrence within a healthy individual. One’s body weight can fluctuate on average 2 to 4 pounds per day. However, individuals who consistently engage in chronic dieting behavior, as well as individuals suffering from bulimia nervosa, experience weight fluctuations beyond the normal day to day variance.
  • Recovery from an eating disorder is difficult and there are many opportunities to backslide into old habits. There are tools available that will help in the continued journey of recovery after the completion of treatment. Dr. Jantz has composed five essentials that will aid in the continued success of recovering from bulimia.
  • Bulimia Nervosa is a psychological disorder resulting in devastating health consequences if left untreated.  New research findings are creating more effective methods and approaches for the treatment of bulimia nervosa, which can improve outcomes for individuals seeking recovery from this eating disorder.  Addressing the underlying issues related to bulimia along with the use of effective psychotherapy methods can dramatically improve the chances for recovery.  Learn more about these new research findings for bulimia treatment in this article.
  • Often times, men and women with eating disorders may not appear as though they are struggling.  Part of this is due to the fact that eating disordered behaviors are hidden and may not be as obvious to concerned family and friends.  This is especially true for Bulimia, where binge and purge cycles are usually done in secret.  This secrecy can allow individuals suffering with Bulimia to do so for several years before seeking help.  If you are concerned that someone you care about may be struggling with Bulimia, read this article to learn more about identifying signs and tips for approaching your loved one with bulimia.
  • Add the chaos and pressure from the transition to college life and the lifestyle changes this involves, and the perfect storm may be created for students struggling with bulimia.
  • Is it possible to be compelled to lose weight for reasons other than aesthetics? Last but not least to ask is, whether there are external forces that reinforce weight loss in order to achieve success in an occupation or avocation?
  • I would like to examine some of those differences to illustrate how an obvious, general similarity can obscure a telling difference. Exercise, body image, and the effects of media among males are prime examples where apparent similarities with females can obscure crucial differences.
  • One behavior that differentiates non-athletes with bulimia from athletes with bulimia is the athlete’s use of exercise as the predominant purging method. Because excessive exercise is a normative behavior in competitive athletes, exercising as a compensatory behavior may go unrecognized, thus putting the athlete at physical and psychological risk.
  • While bulimia has devastating effects on an individual’s mental and physical health, it also affects the entire family. When a loved one is struggling tension is often created within the family unit.
  • Eating disorders are often said to be both compulsive and impulsive. Compulsive means to act repeatedly on an irresistible urge. Impulsive means to act without thought, to act on a whim. So, eating disorders are repeated behavior, often taken without thought. Now, I’m no doctor, but that sounds right to me. What about the link between specific manifestations of an eating disorder and impulsivity, though? How does bulimia intersect with impulsive behavior? Let’s find out.
  • For some in the gay community, gay pride may mask gay shame as more than 15% of gay and bi-sexual men struggle with some form of disordered eating. The pressures to achieve the so-called gay “ideal” physique–a body that is both lean and muscular—are enough to drive some into a dangerous relationship with their bodies, food, and exercise.
  • One of the more detrimental and common side effects of bulimia involves dental damage. The negative ways in which teeth are impacted by bulimia is often overshadowed by other major health consequences, such as cardiovascular complications, electrolyte imbalances, gastrointestinal distress, and bone loss.
  • When a bulimic individual purges their body, they are inadvertently robbing their body of insulin. This is the same with a diabetic who purges, or limits their insulin injections. For this reason, diabetics have a higher chance of becoming bulimic, compared to individuals who are not. Young women with Type One diabetes are shown to be 2.4 times more likely to develop some form of eating disorder.
  • The National Center on Addiction and Substance Abuse has shown that approximately 35 percent of all women who suffer from alcoholism also suffer with an eating disorder. Eating disorder sufferers also have an increased risk of abusing alcohol or illicit drugs, with studies revealing that up to 50 percent of individuals with eating disorders simultaneously struggling with substance abuse.
  • For a mother who is trying to raise a family while also dealing with an eating disorder, the struggles encountered are much more intense and forceful. The effects of a severe psychiatric illness, such as bulimia, are wearisome for any individual who may be suffering with this disorder.
  • Unless we have lived it ourselves, bulimia may seem clouded in mystery. Without the facts, misinformation circulates. If we want to be part of the solution, we do well to become more informed about this troubling psychological disorder. Here are a few common misunderstandings.
  • Weight suppression (WS) is defined as highest ever historical weight minus current weight. It represents a measure of the level of weight lost since being at the highest ever weight achieved over a lifetime. Although the psychological and behavioral symptoms of bulimia nervosa (BN) are undoubtedly the major focus in this eating disorder, it has been argued that the magnitude of weight suppression may play an important role.
  • Researchers have discovered a link between women who suffer with post-traumatic stress disorder (PTSD) and bulimia, finding that the chances of developing bulimia nervosa are increased significantly when an individual is diagnosed with PTSD.
  • Some family members, teachers, coaches, and trusted friends may mistake bulimia for a “fad” that teenagers will “grow out of”, but the reality is that bulimia can result in detrimental physical and emotional consequences, including death.
  • While headway has been made to moderate the impact of the thin-ideal in the sports and dance industries, similar pressure is yet to be applied to the beauty and fashion industries. There is little doubt that the pressure to be thin has seen an increase in eating disorders in recent years and there is much evidence that social norms and ideals can be changed. In a similar way that the public health discourse of smoking has changed radically in the last 100 years, so too, can discourse around thinness transform to occupy a new and better-informed space in the health debate.
  • As you come alongside your loved one (whether it’s your child, your spouse, or a close family member) on their road to recovery from bulimia, you will find things that are in your power and things that are not. You can’t wave a magic wand and “fix” the eating disorder, but you can certainly play a vital role in the recovery process by helping to create the best possible atmosphere for healing. Here are some helpful things you can do.
  • While no single factor can be pinpointed as the cause of bulimia nervosa, the role of genetics in eating disorder development has been increasingly understood. Because the heritability factor is not as readily discussed, it is seems more straightforward to base our insight on these disorders on what we know, namely what is seen in our environment.
  • For those who have struggled with Bulimia, it is easy to identify and recognized the heightened anxiety that often comes hand-in-hand with this mental illness. Whether severe anxiety is a co-occurring condition with Bulimia, if anxiety is induced by the eating disorder, or if bulimia is used to help cope with anxiety, these two conditions are often intertwined.
  • While commonly used to treat major depressive disorders, anxiety disorders, obsessive compulsive disorder, and other chronic conditions, antidepressants have become an effective part of treatment for bulimia.
  • While anorexia nervosa is defined by low body weight, it is divided into two types: restricting and binge-purge based on the mechanism used to achieve low body weight. There are many common physical side effects to both types with a few unique consequences in the binge-purge subtype.
The Effects of Bulimia on the Body
Page Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on November 1, 2016
Published on, Eating Disorders Information & Resources
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{ 6 comments… read them below or add one }

Randy October 28, 2014 at 8:02 pm

My 15 yr old has an issue with bulimia. Can you help?

Bea Galono February 25, 2015 at 12:56 am

Thanks for this detailed and well written article about bulimia. I’ve been through the condition for quite a while now. I can’t say that my treatment is not effective, but I’m not totally back to normal. However, I’m seeing some big positive changes. I still believe I’ll be able to fully recover.

Crystal Karges MS, RDN, IBCLC February 25, 2015 at 2:33 pm

Thank you Bea for sharing and for your feedback. Glad to see that you are seeing positive changes! We believe in you and your recovery also. Thank you for being part of this community!

May April 22, 2015 at 3:59 pm

Thank you for this detailed and well crafted article about bulimia. I have experienced the problem for a long time now. I can not state that my treatment isn’t effective, but I am not totally normal again. However, I am seeing some large positive changes. I still believe I’ll have the ability to be fully cured.

N May 13, 2015 at 8:37 am

Great article! It would be great if there were a printable version available to be able to easily share… Thank you!

Kathy Welter March 6, 2017 at 12:18 pm

These past weeks on the show, I’ve had some great guests and families that have lost loved ones to eating disorders. All the shows are listed on my page, and you can replay them. We need to talk about this, we need to share, we need to illuminate what’s possible and what can be achieved together. Thanks for choosing to take your life back from an Eating Disorder. Join me Tuesdays on Voice America, 11am PST for more information on Eating Disorders, bulimia and family issues that can help you support your own recovery and family members. Call in, share, help others with your story of recovery.

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