Bulimia nervosa, commonly known as bulimia, is a serious and potentially life-threatening eating disorder. Individuals with bulimia engage in secretive binge-eating episodes, consuming large amounts of food and feeling a loss of control over their eating. Following the binge, they resort to unhealthy methods to get rid of the extra calories and prevent weight gain.
Methods used to purge calories include self-induced vomiting, misuse of laxatives, diuretics, or enemas, excessive exercise, fasting, and strict dieting. Bulimia is not solely about food; it is closely linked to self-image, making it difficult to overcome. However, with effective treatment, individuals can improve their self-esteem, develop healthier eating patterns, and address serious complications.
Signs and symptoms of bulimia include:
The severity of bulimia is assessed based on the frequency of purging, usually occurring at least once a week for three months or more.
If you or someone you know is exhibiting bulimia symptoms, seek medical help as soon as possible. Untreated bulimia can have severe health consequences. Reach out to a primary care provider or a mental health professional to discuss the symptoms and feelings associated with bulimia. If seeking treatment is difficult, confide in someone you trust, who can offer support and help you take the first steps towards successful treatment.
If you suspect a loved one has bulimia symptoms, have an open and honest discussion about your concerns. Although you cannot force someone to seek professional care, you can offer encouragement and support. Help find a qualified doctor or mental health professional, make an appointment, and offer to accompany them if needed.
Red flags that family and friends may notice include constant worries about weight, distorted and excessively negative body image, repeated episodes of binge eating, secretive eating behaviors, and excessive exercise.
The exact cause of bulimia is not known. It may be influenced by genetics, biology, emotional health, societal expectations, and other factors.
Girls and women are more likely to have bulimia than boys and men. Risk factors for bulimia include:
Bulimia can lead to several serious and life-threatening complications, including heart problems, dehydration, digestive issues, and mental health disorders such as anxiety and depression.
Although preventing bulimia is not guaranteed, you can promote healthier behaviors or seek professional treatment early on. Foster a healthy body image in children, have regular family meals, avoid discussions about weight at home, discourage unhealthy dieting, and talk to a primary care provider about early signs of eating disorders.
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If your primary care provider suspects you have bulimia, they will typically:
Additional tests may be requested to rule out medical causes for weight changes and check for related complications.
When dealing with bulimia, several types of treatment may be necessary, with the combination of psychotherapy and antidepressants often proving most effective in overcoming the disorder.
Treatment typically involves a team approach with the involvement of you, your family, your primary care provider, a mental health professional, and a dietitian experienced in eating disorder treatment. A case manager may be assigned to coordinate your care.
Psychotherapy, also known as talk therapy or psychological counseling, can be beneficial for bulimia treatment. Types of psychotherapy that may help improve symptoms include:
Discuss with your mental health professional which psychotherapy approach will be used and the evidence supporting its effectiveness in treating bulimia.
Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs) like fluoxetine (Prozac), may be used to reduce bulimia symptoms when combined with psychotherapy, even if you are not depressed.
Dietitians can design an eating plan to promote healthy eating habits and ensure adequate nutrition. Regular eating and avoiding food restriction are essential in overcoming bulimia.
While most cases of bulimia can be treated outside of the hospital, severe symptoms with serious complications may require hospitalization. Some eating disorder programs may offer day treatment as an alternative to inpatient hospitalization.
Although most individuals with bulimia recover, some may experience periodic cycles of bingeing and purging, especially during times of high stress. In such cases, follow-up sessions with your healthcare team can help prevent a relapse and provide coping strategies.
In addition to professional treatment, consider the following self-care tips:
Dealing with bulimia can be challenging due to mixed messages from the media, culture, and social circles. Consider the following coping strategies:
Support groups can be helpful for individuals and families dealing with bulimia, providing encouragement, hope, and coping advice.
Before your appointment, prepare by:
During your appointment, expect your healthcare provider to ask questions about your eating habits, exercise, symptoms, and family history.
