Bulimia nervosa

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at January 22, 2016
StartDiseasesBulimia nervosa

Bulimia nervosa is a very dangerous eating disorder that affects 1-2% of teens and young adults. Those affected with bulimia nervosa binge or overeat and then induce vomiting to rid themselves of the large caloric intake.


Definition & Facts

Bulimia nervosa is characterized by an individual binge eating due to stress, trauma, and then vomiting, using laxatives, or exercise to lose weight. After a purge, ridding the body of the unwanted calories, the bulimic will feel a great sense of guilt and shame, which will, in turn, lead to another binge. This cycling of behavior makes the eating disorders behaviors hard to break.

Those suffering from bulimia nervosa are often of a normal body weight so the disease can be difficult to sort. 80% of those diagnosed with bulimia nervosa are female, most being adolescents and young adults. Anxiety and depression are often contributing factors to bulimia nervosa; therefore, the suicide rate amongst those who suffer from the disease is high.

Symptoms & Complaints


The causes of bulimia nervosa are often hard to trace and can vary from person to person. Having a parent or family member with a history of an eating disorder will increase one's chances of developing bulimia nervosa. People who struggle with low self-esteem and perfectionism are at higher risk as well as those individuals who display impulsive behaviors or have difficulties managing their emotions.

Social media, peer pressure, and pop culture also have a heavy influence on those inflicted with bulimia nervosa as they feel the pressure to obtain and maintain a certain body size or shape. Difficult life changes and transitions also make one more vulnerable to developing bulimia nervosa, such as a divorce, death, move, etc. A person who suffers from an eating disorder usually has a co-occurring affliction such as a history of drug abuse or alcoholism or a history of psychological trauma.

Diagnosis & Tests

If a physician suspects that someone has bulimia nervosa, they will conduct a thorough physical exam, order blood tests and urine tests, and will ask the patient about their current eating and exercise habits, as well as their personal social history. Such questions will include but are not limited to:

  • How long have you been concerned with your weight and body shape?
  • If you exercise, how much do you exercise and how often?
  • Do you have any physical symptoms such as an irregular heartbeat or swelling in the face?
  • Have you stopped having or never had your menstrual cycle?
  • Do you hid food or eat only when alone?
  • Do you make yourself vomit after you eat?
  • Do you use laxatives or diet pills?
  • Do you have a family member who has or had an eating disorder?
  • Do you often think about ways to lose weight or obsess about weight loss?

Diagnosis will be based on the presence of the following symptoms:

  • Repeating episodes of eating large quantities of food within a two hour time frame
  • Vomiting, excessive exercising, or using laxatives to rid the body of unwanted calories
  • Abnormal obsession with body image and weight
  • Binging and purging for at least three months
  • Feeling like eating habits are out of control

Treatment & Therapy

Treatment for bulimia nervosa will often necessitate a treatment team involving a general practitioner, therapist, psychiatrist, and nutritionist. If medically necessary, someone with bulimia nervosa may have to be hospitalized in order to get medically stabilized. There are many inpatient and outpatient programs through out the country and world that offer long term care when deemed necessary.

There are several psychotherapy modules that have been proven useful in the treatment of bulimia nervosa. Talk therapy is often used to help those suffering from the eating disorder find alternate problem solving skills so as to decrease, and ultimately eliminate all eating disorder behavior.

A psychiatrist will often prescribe an antidepressant to help stabilize anxiety and depression, which are catalysts to bulimia nervosa. Consultations with a nutritionist will be needed to teach and show the client what healthy eating habits look like. Parents' participation in therapy will be necessary for those living at home so they know what warning signs and behaviors to look for.

Prevention & Prophylaxis

There is no known or proven way to prevent bulimia nervosa from developing; however, one can look for the warning signs and changes in behavior, and thus, offer the sufferer the needed support. Early intervention is key to decreasing the symptoms and allowing one to recover from the eating disorder more rapidly.

Promoting healthy eating habits and promoting positive body image will help foster good eating practices and positive self-worth and self-esteem. The following self-care steps can be taken to decrease symptoms of bulimia nervosa:

  • Resist all temptations to binge and purge by using distracting techniques
  • Avoid media publications and websites that promote thinness or dieting fads
  • Identify situations or topics that are triggering to eating disorder behaviors
  • Have an emergency plan in place in case of distress or crisis
  • Develop a support circle through family members, friends, the church, or support groups
  • Find ways to bolster or boost self-esteem and self-worth