Bulimia (boo-LEE-me-uh) nervosa, commonly called bulimia, is a serious, potentially life-threatening eating disorder. People with bulimia may secretly binge — eating large amounts of food with a loss of control over the eating — and then purge, trying to get rid of the extra calories in an unhealthy way.
To get rid of calories and prevent weight gain, people with bulimia may use different methods. For example, you may regularly self-induce vomiting or misuse laxatives, weight-loss supplements, diuretics or enemas after bingeing. Or you may use other ways to rid yourself of calories and prevent weight gain, such as fasting, strict dieting or excessive exercise.
If you have bulimia, you're probably preoccupied with your weight and body shape. You may judge yourself severely and harshly for your self-perceived flaws. Because it's related to self-image — and not just about food — bulimia can be hard to overcome. But effective treatment can help you feel better about yourself, adopt healthier eating patterns and reverse serious complications.
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Bulimia signs and symptoms may include:
- Being preoccupied with your body shape and weight
- Living in fear of gaining weight
- Repeated episodes of eating abnormally large amounts of food in one sitting
- Feeling a loss of control during bingeing — like you can't stop eating or can't control what you eat
- Forcing yourself to vomit or exercising too much to keep from gaining weight after bingeing
- Using laxatives, diuretics or enemas after eating when they're not needed
- Fasting, restricting calories or avoiding certain foods between binges
- Using dietary supplements or herbal products excessively for weight loss
The severity of bulimia is determined by the number of times a week that you purge, usually at least once a week for at least three months.
When to see a doctor
If you have any bulimia symptoms, seek medical help as soon as possible. If left untreated, bulimia can severely impact your health.
Talk to your primary care provider or a mental health professional about your bulimia symptoms and feelings. If you're reluctant to seek treatment, confide in someone about what you're going through, whether it's a friend or loved one, a teacher, a faith leader, or someone else you trust. He or she can help you take the first steps to get successful bulimia treatment.
Helping a loved one with bulimia symptoms
If you think a loved one may have symptoms of bulimia, have an open and honest discussion about your concerns. You can't force someone to seek professional care, but you can offer encouragement and support. You can also help find a qualified doctor or mental health professional, make an appointment, and even offer to go along.
Because most people with bulimia are usually normal weight or slightly overweight, it may not be apparent to others that something is wrong. Red flags that family and friends may notice include:
- Constantly worrying or complaining about being fat
- Having a distorted, excessively negative body image
- Repeatedly eating unusually large quantities of food in one sitting, especially foods the person would normally avoid
- Strict dieting or fasting after binge eating
- Not wanting to eat in public or in front of others
- Going to the bathroom right after eating, during meals or for long periods of time
- Exercising too much
- Having sores, scars or calluses on the knuckles or hands
- Having damaged teeth and gums
- Changing weight
- Swelling in the hands and feet
- Facial and cheek swelling from enlarged glands
The exact cause of bulimia is unknown. Many factors could play a role in the development of eating disorders, including genetics, biology, emotional health, societal expectations and other issues.
Girls and women are more likely to have bulimia than boys and men are. Bulimia often begins in the late teens or early adulthood.
Factors that increase your risk of bulimia may include:
- Biology. People with first-degree relatives (siblings, parents or children) with an eating disorder may be more likely to develop an eating disorder, suggesting a possible genetic link. Being overweight as a child or teen may increase the risk.
- Psychological and emotional issues. Psychological and emotional problems, such as depression, anxiety disorders or substance use disorders are closely linked with eating disorders. People with bulimia may feel negatively about themselves. In some cases, traumatic events and environmental stress may be contributing factors.
- Dieting. People who diet are at higher risk of developing eating disorders. Many people with bulimia severely restrict calories between binge episodes, which may trigger an urge to again binge eat and then purge. Other triggers for bingeing can include stress, poor body self-image, food and boredom.
Bulimia may cause numerous serious and even life-threatening complications. Possible complications include:
- Negative self-esteem and problems with relationships and social functioning
- Dehydration, which can lead to major medical problems, such as kidney failure
- Heart problems, such as an irregular heartbeat or heart failure
- Severe tooth decay and gum disease
- Absent or irregular periods in females
- Digestive problems
- Anxiety, depression, personality disorders or bipolar disorder
- Misuse of alcohol or drugs
- Self-injury, suicidal thoughts or suicide
Although there's no sure way to prevent bulimia, you can steer someone toward healthier behavior or professional treatment before the situation worsens. Here's how you can help:
- Foster and reinforce a healthy body image in your children, no matter what their size or shape. Help them build confidence in ways other than their appearance.
- Have regular, enjoyable family meals.
- Avoid talking about weight at home. Focus instead on having a healthy lifestyle.
- Discourage dieting, especially when it involves unhealthy weight-control behaviors, such as fasting, using weight-loss supplements or laxatives, or self-induced vomiting.
- Talk with your primary care provider. He or she may be in a good position to identify early indicators of an eating disorder and help prevent its development.
- If you notice a relative or friend who seems to have food issues that could lead to or indicate an eating disorder, consider supportively talking to the person about these issues and ask how you can help.