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Bulimia: Symptoms, diagnosis, treatment and prevention

What is bulimia?

Bulimia, also called bulimia nervosa, is a mental health condition and eating disorder.

A person with bulimia may control their weight by restricting the food they eat, then binge eating, then making themselves sick or using laxatives, called purging.

Bulimia mainly affects women, and although it can develop at any age, it usually begins in the late teens. Up to 8% of women may experience bulimia at some stage in their life.

A person with bulimia may also be at risk of being depressed, have low self-esteem, abuse alcohol or self-harm.

What causes bulimia?

The precise cause of bulimia is unknown. Pressures and conflicts within the family and amongst peers, stressful life events, low self-esteem, and mental health problems are thought to make someone more likely to develop bulimia. Many with bulimia are over-achievers and perfectionists and often feel they can't live up to the expectations of their parents, family or peers.

They may have problems with:

  • Self-esteem
  • Suffer from depression
  • Have been physically or sexually abused as a child; about half of all bulimics report a history of abuse.


What are the symptoms of bulimia?

According to health experts, you are suffering from the eating disorder bulimia if you experience these binge-purge symptoms at least twice a week for three months:

  • You eat much more food than usual, in just a short time - especially snacks or other foods high in calories. This episode is called a binge, and while it lasts, you feel like your eating is out of control.
  • After a binge, you use aggressive purging tactics to try to prevent gaining weight from all the food you just ate. You might make yourself vomit or take laxatives, diuretics, enemas or other medications. You also might use fasting or excessive exercise as part of this harmful strategy.
  • Your thoughts about your bodyweight and shape dominate how you feel about yourself overall.
  • If you have bulimia, you probably share some common feelings that people with anorexia may have. For example, you may fear gaining weight, and you always want to lose weight. However, bulimics are not as concerned about their weight as anorexics are.

Unlike anorexia, you might be able to keep your body weight in the normal range, which helps to keep your bingeing and purging a secret. But to you, bingeing can make you feel ashamed, while purging brings a sense of relief.

Other symptoms include:

  • Recurrent episodes of binge eating and purging
  • Weight fluctuation (although people with bulimia may have a relatively normal weight)
  • Food cravings
  • An obsessive attitude towards food and eating
  • Overuse of laxatives
  • Depression and anxiety
  • Tooth enamel erosion, gum infections, cavities, and tooth discoloration (caused by stomach acids from frequent vomiting)
  • Gastrointestinal upset
  • Disappearing soon after eating (usually visiting the toilet to vomit)
  • Scarred knuckles (from forcing fingers down the throat to induce vomiting)
  • Distorted opinions about body weight and shape
  • Isolation

WebMD Medical Reference

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