Bulimia Nervosa




Bulimia Nervosa is a type of eating disorder that is characterized by a cycle of binge eating followed by purging to try and rid the body of unwanted calories. Bulimia is more prevalent than anorexia and data shows that it affects 1-3% of teens in the USA. The term Bulimia comes from the Greek word for ‘ravenous hunger’, and many sufferers report feeling that they have little control over their hunger when they binge. Most binges are precipitated by a period of restriction or relative restriction, where the sufferer tries to limit what they are eating. This then at some point gives way to an uncontrolled intake of food.


The Diagnostic and Statistical Manual of Medical Disorders (DSM) lists repetitive episodes of binge eating among the classification criteria for bulimia which is compensated for by excessive or inappropriate behaviors in order to avoid gaining weight. The binging episodes are most often done discreetly in secret when there are no other people present. Afterwards sufferers report intense feelings of guilt and regret about what they have eaten. Many sufferers also report that purging gives them feelings of well being, comfort and sometimes even euphoria or intense happiness.

You might notice that the subcategories of anorexia nervosa binge purge type and bulimia nervosa overlap. This is because eating disorders present differently in different individuals and do not follow a neat path. Often, people with anorexia develop symptoms of bulimia, and often a person may have symptoms that place them in between the two categories.

Unlike people with anorexia, most people with bulimia are not underweight; this can make it difficult to detect as it is not as physically obvious. However, like anorexia, bulimia has a strong genetic component to it.

Often what constitutes a binge will differ depending on the individual, but generally binges involve sweet carbohydrates, cakes, biscuits, cookies and processed/baked goods. Purging methods usually involve vomiting and laxative abuse. Other forms of purging can involve excessive exercise, fasting, use of diuretics, diet pills and enemas.

Signs and Symptoms

Bulimia Nervosa

  • Binge eating
  • Secretive eating (food missing)
  • Bathroom visits after eating (in order to purge)
  • Vomiting/purging
  • Laxative, diet pill or diuretic abuse
  • Weight fluctuations (usually with 10-15 lb range)
  • Swollen glands
  • Broken blood vessels
  • Harsh exercise regimes if the sufferer uses exercise to purge
  • Fasting or avoiding eating after a purge
  • Mood swings
  • Depression
  • Severe self-criticism
  • Self-worth determined by weight
  • Fear of not being able to stop eating voluntarily
  • Self-deprecating thoughts following eating
  • Fatigue
  • Muscle weakness
  • Tooth decay
  • Irregular heartbeats
  • Avoidance of restaurants, planned meals or social events
  • Complains of sore throat
  • Need for approval from others
  • Substance abuse
  • Ipecac abuse – this can be particularly dangerous. Ipecac is a medicine used to induce vomiting; long-term misuse of ipecac can actually be deadly as it can lead to cardiac arrest.

Physical/Medical Complications

  • Fatigue and lack of energy
  • Amenorrhea (loss of menstruation) and irregular menstruation
  • Dizziness
  • Headaches
  • Dehydration
  • Constipation and diarrhea
  • Shortness of breath
  • Irregular heartbeats
  • Depression
  • Tears of esophagus
  • Hair loss
  • Stomach pain and bloating
  • Erosion of teeth enamel
  • Chronic sore throat
  • Kidney and liver damage
  • Parotid gland enlargement
  • Electrolyte imbalances
  • Cathartic colon (caused from laxative abuse)
  • Edema (swelling of hands and feet)
  • Low blood pressure
  • Chest pains
  • Development of peptic ulcers and pancreatitis (inflammation of the pancreas)
  • Gastric dilation and rupture
  • Abrasions on back of hands and knuckles
  • Anemias
  • Cardiac arrest and death

Bulimia is a very serious disorder and if you suspect that you may be suffering from bulimia it is important that you seek professional medical treatment. Treatment usually entails nutritional therapy in order to get your body the nutrients that it needs, and behavioral therapy which will help you break the binge purge cycle.

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A very successful program that specializes in eating disorder treatment is the Milestones In Recovery Program. Their comprehensive program addresses all of the needs of both the affected individual and their family. You can follow this link to the Milestones In Recovery Website to learn more, and see how they can help you.

Additional Reading:

Bulimia Signs and Symptoms and Dental Issues.

Family-Based Treatment For Adolescent Bulimia Nervosa – How it works, effectiveness, resources.

Treatment For Eating Disorders – Information about treatment, what to expect, resources.

Prozac Bulimia Treatment – Information on the effectiveness of using prozac to treat bulimia and other eating disorders.

Teenage Bulimia – How bulimia affects teens. Symptoms, physical effects, getting help.


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Updated by Tabitha Farrar –  2014
Written by: Colleen Thompson – 2001


Help Your Teenager Beat an Eating Disorder – By James Lock

Bulimia: A Guide to Recovery – By Lindsey Hall

Surviving an Eating Disorder: Perspectives and Strategies for Family and Friends by Michelle Siegel, Ph.D., Judith Brisman, Ph.D., and Margot Weinshel, Ph.D. – Harper & Row Publishers, NY, 1988

Walking A Thin Line by Pam Vredevelt and Joyce Whitman – Mullnomah Press, Oregon 1985

Eating Disorders Handout – Sudbury General Hospital Eating Disorders Clinic (information for handout obtained from NEDIC)