Debra Wood, RN
Bulimia nervosa is an eating disorder. People who have bulimia are overly concerned with weight and body image. They eat large amounts of food (called binge eating) and use inappropriate means to rid their bodies of the food (called purging) or excessive calories. Purging may be done through vomiting, laxatives, or water pills. Excessive exercise or fasting may replace or be used along with purging. This cycle of binge eating and purging is used to prevent weight gain.
The exact cause of bulimia is unknown. Factors that may contribute to this condition include:
Bulimia is more young women, especially between 11-20 years old. Other factors that may increase your chance of bulimia include:
Behavioral symptoms include:
Typically have a normal weight. Physical symptoms may include:
Bulimia may lead to other problems, including:
Symptoms of these complications include:
People with bulimia have a high incidence of psychiatric conditions, including:
Bulemia may be suspected after a physical exam and medical history. Questions about your dietary and exercise habits may be asked.
Once bulimia is suspected, other tests may be done to determine if the bulimia has caused an imbalance in the blood or heart. Tests may include:
A mental health professional may also perform a psychiatric exam and/or psychological tests. Drug screening may also be done.
Immediate care may be needed to stabilize chemical imbalances in the body and manage changes to the heart.
Overall goals of treatment are to stop harmful behaviors and thought patterns.
Treatments may include:
A registered dietitian can create a healthy nutrition plan and create reasonable weight and calorie goals. The plan may also help avoid electrolyte imbalances.
Therapy can help reshape behaviors by helping to:
One type of behavior called cognitive behavioral therapy
(CBT) can be very effective, especially when combined with medication.
Therapy may be one on one, group, family, or a combination of therapies.
For children, the school system should also be included. The school can provide special accommodations like snack breaks in class.
Antidepressants medication may help reduce the urge to binge and purge. Medication is most effective when combined with therapy.
Healthy attitudes about food and your body help prevent bulimia nervosa. Suggestions include:
Bulimia Nervosa Resource Guide for Family and Friends
National Association of Anorexia Nervosa and Associated Disorders
Bulimia Anorexia Nervosa Association
Canadian Mental Health Association
Bulimia nervosa. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed. Updated November 19 2015. Accessed May 5, 2016.
Bulimia nervosa fact sheet. Office on Women's Health website. Available at:
http://www.womenshealth.gov/publications/our-publications/fact-sheet/bulimia-nervosa.html. Updated July 16, 2012. Accessed May 5, 2016.
What are eating disorders? National Institute of Mental Health website. Available at:
http://www.nimh.nih.gov/health/topics/eating-disorders/index.shtml. Updated February, 2016 Accessed May 5, 2016.
Last reviewed June 2016 by Michael Woods, MD
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