Healthy Living

Bulimia Nervosa: Get the Facts

 Bulimia Nervosa: Get the Facts

Bulimia nervosa, commonly called as bulimia, is a serious eating disorder that can have potentially harmful effects. People with bulimia nervosa secretly eat and then purge through an unhealthy way, so they won't put on extra weight.

This condition is characterized by repeated episodes of binge eating and is followed by compensatory actions. People with bulimia put too much emphasis on their weight and body shape. This self-evaluation often results in an individual’s sense of self-worth and confidence being defined by the way they look.

Categories of Bulimia

  • Purging bulimia - People with purging bulimia do self-induced vomiting as well as the improper use of diuretics, enemas, and laxatives after bingeing on a regular basis.
  • Non-purging bulimia - People with non-purging bulimia use other techniques to prevent weight gain. Some techniques include excessive exercise, fasting, and strict dieting.

The cause of bulimia nervosa varies from person-to-person. Some of the known causes of bulimia nervosa are genetic predisposition, social and cultural pressure, environmental factors, or a combination of the three.

Bulimia is often kept secret. Thus, most of the time, this type of eating disorder goes undetected for a prolonged period. Most people with bulimia nervosa experience fluctuations in weight, but do not lose weight. They could have a normal weight, maybe slightly underweight, or may gain weight.

Warning Signs of Bulimia Nervosa

The warning signs of bulimia nervosa can be physical, behavioral, or psychological. It could also be a combination of these signs. Being aware of the signs and symptoms of bulimia nervosa can make a huge difference.

Physical Signs

  • Signs of damage as a result of vomiting (bad breath, swelling of the jaw or around the cheeks, damaged teeth, and calluses on knuckles)
  • Abnormal menstrual periods
  • Feeling tired
  • Frequent changes in weight 
  • Constipation
  • Feeling bloated
  • Fainting
  • Not sleeping well
  • Food intolerance

Behavioral Signs

  • Hoarding of food
  • Eating in private
  • Avoiding meals with other people
  • Obsessive behavior regarding weight and body shape
  • Excessive or compulsive exercising
  • Frequent trips to the bathroom immediately after meals
  • Vomiting
  • Uses laxatives, diuretics, or appetite suppressants
  • Say they have eaten, but in reality, they haven’t
  • Spending too much money on food
  • Becomes antisocial
  • Spends more time alone
  • Self-harm or suicidal tendencies
  • Substance abuse

Psychological Signs

  • Sensitive to comments about food, body shape, weight, or exercise
  • Have a distorted body image
  • Depression
  • Irritability
  • Anxiety
  • Preoccupation with eating, weight, and body shape
  • Low self-esteem
  • Feeling of guilt or self-loathing after eating
  • Food obsessions
  • Severe body dissatisfaction

If you or someone you love is experiencing these signs, it is very important to seek immediate medical help and support. It is also vital to seek help at the first warning sign rather than wait for the illness to become severe.

When to See a Doctor

If one has bulimia nervosa symptoms, seek medical attention as soon as possible. If left untreated, it can have a severe impact on the health of the person. If one is nervous, then confide in friends, family or relatives, so they can help take the first step.

How to help someone cope with bulimia?

If one of your close family, friends, or relative is suffering from bulimia, then it is always best to take the first step and have an open and honest discussion. Do not force your advice on the individual, but rather understand the concern of the person, and offer words of encouragement and support. Individuals suffering from bulimia won’t look obese. They look like normal individuals with normal weight or slightly overweight.

Keep an eye on the following red flags as warning signs:

  • Individuals get obsessed with exercising and exerting themselves.
  • They are always worrying and complaining about being fat.
  • Eating unusually large quantities of food in one sitting, especially foods, which the individual should avoid.
  • Avoiding to eat in public or in front of other people.
  • Damaged teeth and gums
  • Presence of sores and scars on knuckles and hands

The following are various factors that can increase the risk of bulimia:

  • Females are more prone to develop bulimia than males.
  • The disorder begins in the late teens or early adulthood.
  • Individuals suffering from emotional and psychological problems are at greater risk of bulimia. They may start bingeing due to stress, poor body self-image, boredom, and low self-esteem. At times, traumatic incidents or environmental stress may also add as contributing factors.
  • A deficiency in the brain chemical called serotonin could also increase the risk of bulimia.

Nowadays, media has also been the greatest contributor. Television, magazines, internet, and social media have created a different image of the perfect body by showing skinny models and actors. These images often signify popularity and success.

Risks Associated with Bulimia Nervosa

People with bulimia may experience the following risks, which could be severe:


If the doctor suspects the individual is suffering from bulimia nervosa, then he or she will perform a complete physical examination of the body. The doctor would also conduct blood and urine tests. Apart from physical and laboratory exams, the doctor would also check the eating patterns and attitude of the person regarding food. The doctor would also suggest additional tests (if required) to rule out any other causes of weight gain or complications.


Below are psychological treatment methods that can help people with bulimia nervosa:

  • Cognitive behavioral therapy
  • Stress management
  • Interpersonal psychotherapy
  • Dialectical behavior therapy
  • Crisis intervention
  • Guided imagery

Few of the treatments are mentioned in detail below:

  • Cognitive behavioral therapy - This therapy helps to identify unhealthy negative beliefs or behaviors of the person and replace these thoughts with positive healthy thoughts and behaviors.
  • Stress management - One of the things that often trigger bulimia is stress. It can be emotional stress, physical stress, or psychological stress. Usually, an eating disorder is often seen as a recourse when a person is going through difficult times. In such cases, instead of bingeing, it is best to stay calm and understand that stress is normal. Gather yourself and distract your mind with other activities, which would keep you happy.
  • Interpersonal psychotherapy - This therapy addresses the difficulty one is facing with close relationships. By conducting this therapy, interpersonal relationships are improved along with providing open communication and problem-solving techniques.
  • Family-based therapy - This helps parents to intervene and stop their teenagers from practicing unhealthy eating habits, after which it would help the teens gain control over their eating patterns and have a normal healthy diet.
  • Dialectical behavior therapy - This is a cognitive treatment originally developed to treat patients with chronic suicidal tendencies. This therapy is recognized as the gold standard in psychological treatment. This therapy is focused on enhancing patient motivation and helps the patients to apply the skills to specific events in their lives. This therapy teaches the patients to be very mindful of any activity they are conducting, to tolerate pain in any given situation, and how to increase self-esteem without feeling low.

Apart from these therapies, there are also medications or antidepressants that can help reduce the signs and symptoms of bulimia. Fluoxetine is a type of antidepressant, which would help the patient even if he or she is not depressed.

Check with a nutritionist or dietitian who can design a suitable plan for eating, which can help you with the cravings while maintaining a normal healthy weight. It is advisable to follow a medically supervised weight loss program if you are suffering from bulimia.

If one ignores the warning signs of bulimia and does not go in for timely treatment, then it could severely impact your health leading to complications. In such cases, hospitalization would be required.

Effects of Bulimia

People with bulimia are at risk of substance abuse and suicidal tendencies. Constant monitoring of weight or food becomes an obsession. They binge in private and hide any evidence of food. They have mood changes and always feel irritated. At times, such people also have feelings of embarrassment and shame.

Bulimia not only mentally affects a person since it also has physical side effects. Stomach problems and sore throat are probably the first signs of physical side effects. Excessive vomiting also can cause sore or swollen throat. Usually, people with bulimia induce vomiting by putting their finger down their throat. If this is done over and over again, it can cause scars on the fingers and hands.

Bulimia also causes low blood pressure and anemia. Violently throwing up every time can cause the blood vessels in the eyes to rupture. Moreover, due to constant vomiting, the person would have low levels of potassium, magnesium, and sodium.

In females, bulimia can interfere with the reproductive system. It can change the menstrual cycle pattern or completely stop it. Moreover, hormonal imbalance and fatigue can kill one's sex drive. Pregnant women who engage in continuous eating and purging behaviors face complications, such as the higher risk of cesarean section, babies born with low weight, miscarriage, premature babies, or stillbirth.