Bulimia

(Bulimia Nervosa)

Definition

Bulimia is an eating disorder. People with bulimia are overly worried about their weight and body image. They binge and purge their food. Bingeing is eating large amounts of food. Purging is using vomiting, laxatives, or diuretics to get it out of the body. Exercise may be used to replace purging, or it may be used with it. The cycle is done to stop weight gain.

Causes

The cause of bulimia is unknown. It appears to be a mix of your genes, way of life, and environment.

Risk Factors

Bulimia is more common in young women. Your risk is also higher for:

Low self-esteem
Feelings of helplessness
Wanting to be perfect
Fear of gaining weight
Not being happy with weight and size
Pressure to be thin
Other people in your family have the same problems
Emotional stress
Prior obesity or anorexia
Other mental health problems such as depression or anxiety
Substance misuse
Way of life that highlights being thin as ideal

Symptoms

People with bulimia have a normal weight. But, their habits are not healthy.

Bulimia may cause:

Eating of large amounts of food at one time
Feeling like eating is not in your control
Forced vomiting
Taking of laxatives, enemas, diuretics, or diet pills
Too much exercise
Mood swings
Problems with impulse control
Misuse of alcohol or other substances

Physical problems with bulimia:

Belly pain
Heartburn
Menstrual problems
Swollen cheeks and jaw
Sore throat
Swollen glands in the mouth and throat
Bloating
Stained or chipped teeth—because of contact with stomach acid
Cuts or scars on back of hands—from scraping skin on teeth during forced vomiting

Bulimia may lead to:

Dental and throat problems from stomach acid
Changes in body chemistry and fluids

Diagnosis

The doctor will ask about your symptoms and health history. Your answers and a physical exam may point to bulimia. You may also have:

Blood tests—which can also detect drug use
ECG —to check how the heart is working
A psychological exam

ECG

Bulimia can lead to severe heart problems.

Treatment

The goal is to keep weight in a normal range in a healthy way. This is done by stopping harmful behaviors and thought patterns. For serious bulimia, care may start in a hospital.

This can be done with:

Nutritional Support

You will learn how to eat a healthful diet. You will also learn what your healthy weight and calorie goals are.

Counseling

Cognitive behavioral therapy (CBT) helps you learn to handle stress. You will change how you think. This will help you gain control of your feelings. You will also find out the cause of the problems you’re having.. Therapy may be alone or with a group.

Medicines

Medicines will depend on other problems you may have. The most common are:

Antidepressants—To balance brain chemicals. They may not be as useful without counseling.
Vitamins and minerals to keep up adequate nutrition.

Prevention

Healthy attitudes about food and your body help prevent bulimia.

RESOURCES

Bulimia Nervosa Resource Guide for Family and Friends
https://bulimiaguide.org

NEDA—National Eating Disorders Association
https://www.nationaleatingdisorders.org

CANADIAN RESOURCES

Canadian Mental Health Association
https://cmha.ca

National Eating Disorder Information Center
http://www.nedic.ca

References

Bulimia nervosa. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114924/Bulimia-nervosa . Updated July 16, 2018. Accessed August 31, 2018.

Bulimia nervosa. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/psychiatric-disorders/eating-disorders/bulimia-nervosa. Updated March 2018. Accessed August 31, 2018.

Bulimia nervosa. Office on Women's Health website. Available at: https://www.womenshealth.gov/mental-health/mental-health-conditions/eating-disorders/bulimia-nervosa. Updated August 28, 2018. Accessed August 31, 2018.

Eating disorders. National Institute of Mental Health website. Available at: https://www.nimh.nih.gov/health/topics/eating-disorders/index.shtml. Updated February, 2016 Accessed August 31, 2018.

Revision Information

Reviewer: EBSCO Medical Review Board Adrian Preda, MD
Review Date: 05/2018
Update Date: 08/31/2018

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This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.