Bulimia Nervosa

Bulimia Nervosa is not only complicated, but also distressing. People are prone to developing this eating disorder mainly because they feel pressured to maintain a certain body image. Uncontrolled episodes of overeating are typically associated with women and teens. However, people of all ages, genders and backgrounds are susceptible to developing bulimia. Historical records suggest that bulimia has been a real nuisance, plaguing people since the beginning of time. The first one to describe the illness was a wealthy person, from the Middle Ages. It was named and described in clinical terms by British psychiatrist Gerald Russell. It is believed that about 4% of people will have bulimia during their lifetime.


Bulimia Nervosa Overview & Facts

Bulimia Nervosa, which is commonly referred to as bulimia, is a serious and often fatal sickness, characterized by erratic eating habits. It falls into the eating disorder category. People suffering from this illness consume significant amounts of food in a short period of time. These individuals tend to have an obsession with body shape or weight. As a rule, patients with bulimia nervosa have social phobia and body image distortions. They are exposed all day long to images that reinforce anxiety with regard to their personal appearance. Bulimia is basically a mental illness, although at first glance it seems to be a body image and weight issue. Bulimia sufferers require therapeutic intervention.

Bulimia nervosa is an eating disorder where people overheat regularly. This is what is called binge eating. It involves two important aspects: eating too much in a short period of time and lacking a sense of control. The effects of bulimia on the human body are truly devastating. Binging food can possibly lead to stomach pain, tooth sensitivity, dehydration, hormonal imbalances, hair loss, etc. Bulimia has a negative impact on the person’s physical and emotional health. It is not thus surprising to understand that many patients fall into depression or even develop an obsessive-compulsive disorder.

There are two major subtypes of bulimia nervosa:

  • Purging bulimia: Bulimia sufferers make amends for the binge episodes. What they do is self-induce vomiting so as to control the weight.
  • Non-purging bulimia: Binge eating is generally followed by using medications for weight control. Examples include diet pills and stimulants.

Bulimia behaviors are impulsive and they tend to overlap. It is important to stress that purging and non-purging bulimia is not to be confused with binge eating disorders.

The great majority of those with bulimia are women, but this does not mean that men cannot be affected. Eating disorders are not gender specific, which is the reason why it is not unusual for a man to have bulimia nervosa. They as well struggle with binge eating and the associated side effects. The fact is that male patients are not likely to manifest visible symptoms, not to mention seek professional help.


Bulimia Nervosa Symptoms & Diagnosis

Bulimia nervosa symptoms include:

  • Weight gain anxiety: obesity fear (pocrescophobia), reducing calorie intake by vomiting, development of food rituals
  • Attitudes to food and eating: episodes of binge eating, Impossibility to control eating habits, continuous weight fluctuations, vanishing of large quantities of food, avoiding certain foods, eating when nobody knows
  • Social behavior and personality changes: fatigue, rapid mood swings, feeling guilty about overeating, plunging deep into emotional overeating
  • Physical symptoms: having a round, swollen appearance, going to the bathroom after eating, damaged teeth, damaged gums, poor voice quality, sores in the mouth and the throat

Those who recognize any of the aforementioned symptoms are recommended to address to a medical practitioner.

The process of detection requires becoming aware of symptoms and signs. The treatment provider will look for a combination of symptoms in order to confirm the diagnosis. The fact is that bulimia is hard to identify. The reason for this is that the manifestations listed earlier are common to other eating disorders as well. There is no routine screening for the illness, which makes things more difficult for the doctor. Another reason why the eating disorder is hard to diagnose is that patients usually hide their thoughts and way of action.

The medical practitioner conducts a physical examination for bulimia nervosa. The doctor will look for effects of an eating disorder, making sure to check the mouth, skin, and hair for issues. The trained professional may want to verify the heart, lungs, and blood pressure. A psychological evaluation is equally necessary in the case of bulimia nervosa. This assessment includes talking with the patient about eating habits and changes in food attitudes. The medical practitioner can categorize the illness as being mild or severe.


Bulimia Nervosa Symptoms & Diagnosis


Bulimia Nervosa Treatment & Care

Although it can take a lot of time, bulimia nervosa can be managed. The doctor is an important part of the treatment and recovery process. What the medical practitioner does is discuss things over with the patient, provide additional information and nutritional counseling, and refer them to a trained specialist. The professional that treats the eating disorder is called a therapist. The eating disorder specialist’s role is to identify triggers and, of course, help the individual avoid binging food and vomiting.

Antidepressants are commonly used for treating bulimia, helping challenge dysfunctional thoughts. Examples include fluoxetine. Cognitive behavioral therapy is just as effective. This treatment is based on thoughts, emotions, and, naturally, behaviors. Due to the fact that sufferers of bulimia view themselves and their bodies in a negative way, special focus should be laid on changing ways of acting and the attitude toward eating. CBT addresses the main issues of bulimia nervosa, more precisely on how the symptoms occur at the present moment. Simply speaking, the focus is not on the “why”, but on the “how”.

For severe cases of bulimia nervosa, inpatient treatment is required. Choosing the most suitable treatment facility is the duty of the family. It is important not to forget that the medical condition can cause serious effects. What happens if the health issues are not addressed is that the damage can be irreversible. For instance, kidney failure is not reversible as is kidney injury. This is the reason why it is of paramount importance to prevent chemical imbalances from occurring or, at least, improving kidney function.

People with bulimia need to look after themselves. Otherwise, it is not possible to have a full recovery. It is advisable to not brush the teeth after purging as this will destroy the enamel. Most importantly, the individual has to make an effort to reach a normal weight. All thoughts negative or not, should be discussed with a therapist. Or with family and friends.


Natural Treatment of Bulimia Nervosa

At present, researchers are looking for new ways to treat bulimia nervosa, alternative medicine being the focal point. The general opinion is that hypnotherapy is a good alternative treatment. Saying that hypnotherapy techniques cure the eating disorder is an exaggeration. It is sure though that entering a calm state of mind helps patients, in the sense that it helps individuals gain control over their actions. The Mayo Clinic warns that hypnotherapy is not to be considered a solution in itself. More precisely, it should accompany other treatment plans and patients should not expect miracles because they are not going to happen.


Importance of Early Intervention for Bulimia Nervosa

Most people do not realize that it is essential to diagnose and treat bulimia early. Early intervention can be life-saving. Surprising or not, bulimia nervosa has one of the highest mortality rates. Patients can die from cardiac arrest, seizure, pancreatitis, electrolyte imbalance, gastric rupture, depression, and so on. What is worse is that the person can go for a long time without realizing that they have serious health problems.

Developing bulimia nervosa is not a conscious choice, which explains why people having this illness do not comprehend its severity or the fact that they need to seek specialized attention. The point is that early detection and treatment can result in favorable outcomes. The future for people with this eating disorder is more positive than the one for people suffering from anorexia. During the course of the treatment, it is normal to expect relapses. This does not mean that the patient cannot be cured. Treatment takes time.

What causes bulimia nervosa?

Bulimia nervosa does not have an exact cause. As a matter of fact, specialists have no idea what causes the onset eating disorders in general. What can be said for sure is that it is not only one cause. The illness can be caused by a number of factors, like emotional, societal, or genetic. Emotional and societal causes refer to the unhappiness with one’s body or body weight. In today’s culture, a great emphasis is laid on image and individuals feel a pressure to look perfect. They typically have low self-esteem and this is not always obvious.

Genes may be responsible for the manifestation of bulimia. Studies have proved that some people have a genetic predisposition for developing an eating disorder. Last but not least, mention was made of trauma. A shocking event, like an accident or an abuse can trigger the apparition of bulimia nervosa. This is not a rule, but individuals who have gone through traumatic experiences are more likely to develop a medical condition. Treating the individual implies treating the trauma first.


Living with Bulimia Nervosa

It is difficult if not impossible to imagine what a person suffering from bulimia nervosa goes through. What is sure is that sick individuals manage to hide their state of affairs. While some of them keep the illness a secret from early school, others have problems at a late age. People with health problems experience strange feelings, such as anxiety, fear, weakness, neglect, etc. What is more, they have no power whatsoever over their medical condition until they get help.

Patients with bulimia end up leading a double life. They try to act normally in order to hide their suffering, as having bulimia is a stigma. The stigma is the reason why they refuse to get treatment. Therefore, when no one is looking they are eating significant quantities of food and purging them. Bulimics manage to go to school, even pursue a job or higher education. The signs of illness are only visible when it is too late.

Those who lead a normal life may find it hard to understand what it is like to live with bulimia nervosa. They can learn about the matter, yet ultimately they are not able to understand their feelings and emotions. The best that family members and close friends can do is providing support. When changes in behavior are evident, they should coax the person to seek attention right away.


Bulimia Nervosa Prevention

Is there any way to prevent bulimia nervosa? There is no knowledge of a sure way to prevent this medical condition. However, measures can be taken in order to reduce the risk. This is how.

  • Developing healthy eating habits
  • Encouraging a healthy view of oneself
  • Boosting self-regard
  • Avoiding punishing or rewarding oneself with food
  • Recognizing the symptoms
  • Minimizing social pressure

The support of the family is very important. Patients need permanent encouragement and support from loved ones. When they feel like they are loved and treasured, individuals do not feel the need to resort to extreme measures. They are happy just the way they are. As mentioned previously, bulimia nervosa is not about food and weight. It is a psychological matter and the underlying causes are anxiety and, in general, uncomfortable feelings.

Changing the way that body image is perceived in today’s society represents a step forward. Prevention is only possible when there is not much accent placed on how individuals look, how much they weigh, or what they eat. For most members of the society, regardless of age, sex, and religion, eating erratically has become commonplace. Many advocate for a paradigm shift. If things will change in future time, there is no way of knowing. What is sure, though, is that eating disorders like bulimia nervosa have come to be accepted and people are no longer shamed for being sick. On the contrary, they are offered means to get better.

Last updated on September 6th, 2018

Editorial Team


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