Bulimia Nervosa

What is bulimia nervosa?

Bulimia (say “boo-LEE-mee-uh”) is a type of eating disorder. People with bulimia will eat a large amount of food in a short time (binge). Then they will do something to get rid of the food (purge). They may vomit, exercise too much, or use medicines like laxatives.

People who have bulimia may binge because food gives them a feeling of comfort. But eating too much makes them feel out of control. After they binge, they feel ashamed, guilty, and afraid of gaining weight. This causes them to purge.

Without treatment, this “binge and purge” cycle can lead to serious, long-term health problems. Acid in the mouth from vomiting can cause tooth decay, gum disease, and loss of tooth enamel. Any type of purging can lead to bone thinning (osteoporosis), kidney damage, heart problems, or even death.

If you or someone you know has bulimia or another eating disorder, get help. Eating disorders can be dangerous, and willpower alone is not enough to overcome them. Treatment can help a person with an eating disorder feel better and be healthier.

What causes bulimia?

All eating disorders are complex problems, and experts do not really know what causes them. But they may be caused by a mix of family history, social factors, and personality traits. You may be more likely to have bulimia if:

Other people in your family are obese, have an eating disorder, or have a mood disorder such as depression or anxiety.

You have a job or do a sport that stresses body size, such as ballet, modeling, or gymnastics.

You are the type of person who tries to be perfect all the time, never feels good enough, or worries a lot.

You are dealing with stressful life events, such as divorce, moving to a new town or school, or losing a loved one.

Bulimia is most common in:

Teens. Like other eating disorders, bulimia usually starts in the teen years. But it can start even earlier or in adulthood.

Women. About 10 out of 11 people with bulimia are female. But some boys and men have it too.

Many people who have bulimia are white and come from wealthy families. But it can happen to anyone.

What are the symptoms?

People with bulimia:

Binge on a regular basis. They eat large amounts of food in a short period of time, often over a couple of hours or less.

Purge to get rid of the food and avoid weight gain. They may make themselves vomit, exercise very hard or for a long time, or misuse laxatives, enemas, water pills (diuretics), or other medicines.

Base how they feel about themselves on how much they weigh and how they look.

Any one of these can be a sign of an eating disorder that needs treatment.

How can I know if someone has bulimia?

Bulimia is different from anorexia nervosa, another eating disorder. People who have anorexia eat so little that they become extremely thin. People who have bulimia may not be thin. They may be a normal size. They may binge in secret and deny that they are purging. This makes it hard for others to know that a person with bulimia has a serious problem.

If you are concerned about someone, look for the following signs. A person may have bulimia if she:

Goes to the bathroom right after meals.

Overeats but does not gain weight.

Is secretive about eating, hides food, or will not eat around other people.

Exercises a lot, even when she does not feel well.

Often talks about dieting, weight, and body shape.

Uses laxatives or diuretics often.

Has teeth marks or calluses on the back of her hands or swollen cheeks or jaws. These are caused by making herself vomit.

How is it treated?

Bulimia can be treated with counseling and sometimes medicines, such as antidepressants. The sooner treatment is started, the better. Getting treatment early can make recovery easier and prevent serious health problems.

By working with a counselor, a person with bulimia can learn to feel better about herself. She can learn to eat normally again and stop purging. A nutritionist or dietitian can help her learn to make healthy food choices.

Other mental health problems such as depression often happen with bulimia. If a person has another condition along with bulimia, more treatment may be needed, and it may take longer to get better.

Eating disorders can take a long time to overcome, and it is common to fall back into unhealthy ways of eating. If you are having problems, don’t try to handle them on your own. Get help.

What should I do if I think someone has bulimia?

It can be very scary to realize that someone you care about has an eating disorder. If you think a friend or loved one has bulimia, you can help.

Talk to her. Tell her why you are worried.

Urge her to talk to someone who can help, like a doctor or counselor. Offer to go with her.

Tell someone who can make a difference—like a parent, teacher, counselor, or doctor. The sooner your friend or loved one gets help, the sooner she will be healthy again.