Condition Overview
What is bulimia nervosa?
Bulimia (say "boo-LEE-mee-uh") is a type of eating disorder. People with bulimia will eat a larger amount of food than most people would in a similar situation, in a short period of time (binge). Then, in order to prevent weight gain, 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 judge themselves harshly on their body weight and shape. In order to help them cope with these feelings, they follow a strict diet to try to lose weight. But over time the hunger from the strict diet triggers them to binge eat. After binge eating, they feel out of control, ashamed, guilty, and afraid of gaining weight. This distress causes them to purge, in hopes of "undoing" any possible weight gain from the binge.
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 who has 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 or have an eating disorder.
- You have a job or do a sport that stresses body size, such as ballet, modeling, or gymnastics.
- You are often on a diet or you exercise too much in order to lose weight or change your body shape.
- Have a poor body image, or feel that your body should be slim like many people in the media.
- 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. But boys and men have it too.
While bulimia often starts in the teen years, it usually lasts into adulthood and is a long-term disorder.
What are the symptoms?
People with bulimia:
- Binge eat on a regular basis. They eat larger amounts of food than most people would in a similar situation, in a short period of time (2 hours or less). During a binge, they feel out of control and feel unable to stop eating.
- 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 you 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 he or she:
- Goes to the bathroom right after meals.
- Is secretive about eating, hides food, or will not eat around other people.
- Exercises a lot, even when he or 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 the hands or swollen cheeks or jaws. These are caused by making oneself vomit.
How is it treated?
Bulimia can be treated with psychological 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.
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 you do if you 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 him or her. Tell the person how much you care and why you are worried.
- Urge him or her to talk to someone who can help, like a doctor or counselor. Offer to go along.
- 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.