What is bulimia nervosa?
Bulimia nervosa, also called bulimia, is a psychological eating disorder that is characterized by episodes of binge eating followed by inappropriate methods of weight control (purging). Inappropriate methods of weight control include vomiting, fasting, enemas, excessive use of laxatives and diuretics, and compulsive exercising. A binge is an episode where an individual eats a much larger amount of food than most people would in a similar situation.
Bulimia tends to develop late in childhood or in early adulthood. It affects females more often than males. People with bulimia often perform the behaviors in secret, feeling disgusted and ashamed when they binge, yet relieved once they purge. People with bulimia usually weigh within the normal range for their age and height. However, they may fear gaining weight, have desire to lose weight, and may feel intensely dissatisfied with their bodies.
What causes bulimia nervosa?
The exact cause of bulimia is not known, but research suggests that a combination of certain personality traits, emotions and thinking patterns, as well as biological and environmental factors might be responsible. Researchers also believe that bulimia may begin with a dissatisfaction of the person's body and extreme concern with body size and shape. Usually individuals suffering from bulimia have low self-esteem and fear becoming overweight. The fact that bulimia tends to run in families also suggests that a susceptibility to the disorder might be inherited.
What are the symptoms of bulimia nervosa?
The symptoms of bulimia nervosa include:
- Eating uncontrollably followed by purging
- Vomiting or abusing laxatives or diuretics in an attempt to lose weight
- Using the bathroom frequently after meals
- Excessive exercising
- Preoccupation with body weight
- Dental problems
- Sore throat
- Depression or mood swings
- Feeling out of control
- Swollen glands in neck and face
- Heartburn, indigestion, bloating
- Irregular periods
- Weakness, exhaustion, bloodshot eyes
What complications are associated with bulimia?
- Erosion of tooth enamel because of repeated exposure to acidic gastric contents
- Dental cavities
- Tooth sensitivity to hot or cold food
- Swelling and soreness in the salivary glands (from repeated vomiting)
- Stomach ulcers
- Ruptures of the stomach and esophagus
- Disruption in the normal bowel release function
- Electrolyte imbalance
- Irregular heartbeat
- Heart attack (in severe cases)
- Higher risk for suicidal behavior
How is bulimia treated?
Bulimia treatment requires the consideration of the physical as well as the psychological needs of the person. Treatment may include psychological counseling and medications such as antidepressants. In many cases, treatment is undertaken by a team of medical, nutritional, and mental health professionals to evaluate the severity and meaning of the symptoms and to both prescribe and provide care. The ideal outcome of treatment is to restore physical health and normal eating patterns.
What is the outlook for people with bulimia?
Bulimia is a condition that is difficult to cure “once and for all.” Many people improve, but bad spells (relapses) may recur from time to time in some cases. In addition, some people who are considered “cured” continue with less-than-normal eating patterns throughout their lives. In general, however, the outlook for people with bulimia is more positive than the outlook for people with anorexia.
Can bulimia be prevented?
Because the true reason for the development of bulimia is not known, it is difficult to say how bulimia can be prevented. However, we live in a society where the "ideal" woman portrayed by the media is far from realistic. Educators and parents can help young people to put that "ideal" picture into perspective. Adolescents should be encouraged to understand that appropriate body weight does not equal extreme thinness.
When should I seek help?
If you or any member of your family develops an unhealthy preoccupation with weight and size and/or appears unduly interested in food, you should consult a health care professional. Eating disorders can have negative outcomes if treatment is postponed.
- American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013.
- Guarda AS, Redgrave G. Chapter 228. Eating Disorders. In: McKean SC, Ross JJ, Dressler DD, Brotman DJ, Ginsberg JS. eds. Principles and Practice of Hospital Medicine. New York: McGraw-Hill; 2012. library.ccf.org Accessed 3/3/2014.
- Gwirtsman HE, Mitchell JE, Ebert MH. Chapter 26. Eating Disorders. In: Ebert MH, Loosen PT, Nurcombe B, Leckman JF. eds. CURRENT Diagnosis & Treatment: Psychiatry, 2e. New York: McGraw-Hill; 2008. library.ccf.org Accessed 3/3/2014.
- Mehler PS. Medical complications of bulimia nervosa and their treatments. Int J Eat Disord. 2011 Mar; 44(2):95–104.
- NAMI. Bulimia Nervosa Accessed 3/3/2014.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 3/4/2014…#9795