Bulimia Nervosa

imagesBulimia nervosa is an eating disorder characterized by frequent binge eating followed by efforts to prevent gaining weight. People with bulimia secretly eat large amounts of food and then try to get rid of the calories by purging. People with bulimia are preoccupied with their weight and judge themselves for what they perceive to be considered as flaws. Bulimia is characterized by:

Purging: you self induce vomiting or use laxatives after bingeing

Nonpurging: You use other ways to lose weight such as fasting, exercising, or strict dieting.

A person does not want to binge but they give in and eat anywhere from 3,000 to 5,000 calories in an hour. To undo the binge and the feeling of lack of control over the eating, people feel panic and usually purge, take laxatives or engage in excessive exercising. Bulimia however does not necessarily involve purging or using laxative. You can make up for the binges by exercising, fasting, or severe dieting. Individuals suffering from bulimia often keep unhealthy thoughts and behaviors a secret. They may deny they have a problem and often seek treatment when someone else notices the problems and encourages them to get help.

What are the symptoms:

  • Secretive about eating
  • sneaks or hides food
  • drastic changes in weight
  • often talks about weight and body image
  • tooth decay
  • overuses laxatives
  • lack of energy
  • feels depressed
  • irregular menstrual cycle
  • eating a large amount of food in a single episode
  • heart problems
  • dehydration
  • kidney failure

Bulimia tends to be co-morbid with body dysmorphic disorder which involves having a false sense that their is something wrong with their appearance.


The exact cause is unknown however genetics, societal expectations (such as peer pressure to be thin), and psychological and emotional health (such as low self esteem or traumatic events) can play a role. It can also be common among athletes where coaches and parents may not be aware they are contributing to an eating disorder by encouraging them to lose weight for better performance.


Psychotherapy and antidepressants may be the most effective treatment. Treatment involves a team approach involving your primary care physician, mental health provider, family, and dietitian experienced in treating eating disorders. Cognitive behavior therapy, interpersonal psychotherapy, dialectical behavior therapy, and family therapy can also be a form of treatment. People with bulimia do recover however some find that their symptoms do not go away. Binging and purging may come and go throughout the years especially during high level of stress. If this occurs, booster sessions with a health care provider is recommended before the eating disorder gets worse. It is important to learn to cope during high levels of stress and create healthy relationships.



Image taken from
Bulimia Nervosa

Helen Nieves

Helen Nieves is a Licensed Mental Health Counselor and Certified Attention Deficit Consultant Specialist. She teaches ADHD on line and is on the Advisory Board at The American Institute of Health Care Professionals. She also received advanced training in Rational Emotive Behavior Therapy and in Grief Counseling.

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APA Reference
Nieves, H. (2015). Bulimia Nervosa. Psych Central. Retrieved on October 23, 2020, from


Last updated: 16 Apr 2015
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