Bulimia nervosa is an eating disorder marked by uncontrollable binge-eating and subsequent purging by vomiting or using laxatives or diuretics. Other compensatory behaviors after binging include fasting and overexercising. People with bulimia tend to struggle with body dissatisfaction and low self-esteem . Anxiety , depression , and substance use can overlap with the disorder as well.
Bulimia tends to emerge in adolescence , although it can go undetected for years. It occurs far more frequently in women than in men.
It can take time for people with bulimia to accept or seek help, but treatment can address underlying challenges and allow them to make a successful recovery.
For more on causes, symptoms, and treatments, see our Clinical Terms .
Key Takeaways
- Bulimia Nervosa affects mental, emotional, and physical wellbeing
- Understanding bulimia nervosa is the first step toward managing it
- Evidence-based approaches can significantly improve outcomes
- Building daily habits is more effective than one-time interventions
Signs and Symptoms of Bulimia
There is no way to tell by looks alone whether a person is bulimic, and both bingeing and purging are done secretly. People with bulimia often describe the experience as out of control, and intense shame can prevent them from seeking help.
Bulimia involves recurrent episodes of binge eating, in which someone consumes an abnormally large amount of food in a short time, as well as subsequent compensatory behaviors to prevent weight gain such as vomiting, laxatives, diuretics, or overexercise. If this pattern occurs at least once a week for three months, and if the person is concerned about their body image , they may be diagnosed with bulimia .
Many people with bulimia are normal or slightly overweight and they tend to hide their binging and purging, which has led some to call bulimia “the secretive syndrome.” But learning to identify the signs of the disorder can help understand and support someone who is struggling.
Signs of bulimia can include:
• Going to the bathroom after meals
• Exercising excessively
Treatment and Recovery
The road to recovery is long and difficult; it often involves setbacks and relapses . But those who commit to treatment can overcome their past patterns and make a successful recovery.
Therapy can help people with bulimia work through underlying challenges that lead to disordered eating. The primary therapies for bulimia are cognitive-behavioral therapy, which shifts beliefs about oneself and one’s eating patterns, and family therapy, in which a patient’s parents help change eating patterns at home. Medications such as antidepressants may help diminish binging and purging episodes as well; fluoxetine (Prozac) is approved by the FDA to treat bulimia. The therapist will work together with the primary care physician to monitor the patient’s medical status and a nutritionist to create a healthy eating plan.
Bulimia can be treated in an outpatient setting, meaning that the patient lives at home and attends medical and mental health appointments as needed, or an inpatient setting, meaning that the patient stays at the hospital or an eating disorder treatment facility for a sustained period of time. Cases of bulimia with severe medical or psychological risk, such as dangerous weight loss or suicidal thoughts, require hospitalization to stabilize the patient’s condition.
Many people overcome bulimia, but it can be difficult to banish the behavior altogether; people often encounter recurrences at various points in their life. But a few practices can help ensure that these are small bumps rather than overwhelming setbacks. People in recovery can recognize what specifically triggers a relapse, develop and implement healthy coping mechanisms, and continue working with a therapist to maintain a strong relationship.
In eating disorder recovery, learning to trust your body is everything. Are fitness trackers and constant self-monitoring really helping us?
In eating disorder recovery, learning to trust your body is everything. Are fitness trackers and constant self-monitoring really helping us?
Frequently Asked Questions
What exactly is bulimia nervosa?
Bulimia nervosa is an eating disorder marked by uncontrollable binge-eating and subsequent purging by vomiting or using laxatives or diuretics. Other compensatory behaviors after binging include fasting and overexercising. People with bulimia tend to struggle with body dissatisfaction and low self-esteem . Anxiety , depression , and substance use can overlap with the disorder as well.
What are the signs of bulimia nervosa?
There is no way to tell by looks alone whether a person is bulimic, and both bingeing and purging are done secretly. People with bulimia often describe the experience as out of control, and intense shame can prevent them from seeking help. Bulimia involves recurrent episodes of binge eating, in which someone consumes an abnormally large amount of food in a short time, as well as subsequent compens
How can bulimia nervosa be treated?
The road to recovery is long and difficult; it often involves setbacks and relapses . But those who commit to treatment can overcome their past patterns and make a successful recovery. Therapy can help people with bulimia work through underlying challenges that lead to disordered eating. The primary therapies for bulimia are cognitive-behavioral therapy, which shifts beliefs about oneself and one’
Is bulimia nervosa a serious condition?
Bulimia Nervosa exists on a spectrum. While mild forms are a normal part of life, persistent or severe bulimia nervosa can significantly impact daily functioning and quality of life. It's important to seek professional support if bulimia nervosa is interfering with work, relationships, or wellbeing.
Learn More
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