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What is bulimia?

Bulimia is an eating disorder defined by a cycle of bingeing and purging that occurs at least once a week for three months. A person with bulimia:

  • Eats large amounts of high-calorie food quickly and in secret, to a point of feeling out of control. A binge may be followed by feelings of depression and shame.
  • Purges after the binge through self-induced vomiting, abusing laxatives or diuretics, fasting, or excessive exercising.
  • Is extremely concerned with body weight or shape.

What causes bulimia?

Bulimia may develop as a result of life changes or stressful events, such as a new job, giving birth, divorce or the death of a loved one, according to the American Psychological Association. Bulimia may have several contributing factors.

Biological factors. Bulimia runs in families, according to the National Institute of Mental Health (NIMH). Researchers are studying genetic factors that may be linked to an increased risk of developing bulimia. Brain chemical imbalances also are being investigated as a possible contributing factor.  

Psychological factors. The binge-purge cycle of bulimia may be an outlet for frustration, disappointment, anger, loneliness or boredom. People with bulimia may experience anxiety, depression and problems with impulse control, according to the National Association of Anorexia Nervosa and Associated Disorders. They may shoplift, engage in casual sex, or abuse alcohol or drugs.

Relationship factors. People with bulimia may be dependent on their families and lack satisfying friendships or romantic attachments.

What bulimia does to the body

Repetitive bingeing and purging can affect the whole digestive system and result in electrolyte and chemical imbalances that affect organ function, says the National Eating Disorders Association. This can cause serious medical consequences, such as:

  • Irregular heartbeat and possible cardiac arrest or heart failure.
  • Kidney damage.
  • Dehydration.
  • Stomach rupture during binges, and inflammation and rupture of the esophagus from frequent vomiting.
  • Tooth decay and staining from stomach acid brought up during vomiting.
  • Irregular bowel movements and constipation from laxative abuse.
  • Peptic ulcers and pancreatitis.

Treating bulimia

Recovery from bulimia is a difficult process that can take months or years, and it succeeds more often when it starts early in the disease's progression. Treatment should involve health professionals who can address both medical and psychological issues.

The primary goal, according to the NIMH, is to decrease or end bingeing and purging. Nutritional and psychological counseling and medication can address the two things that make a binge likely—hunger and negative feelings. The aims are to establish a pattern of regular meals, improve attitudes toward food, relieve anxiety and depression, and encourage appropriate exercise.

Individual, group and family counseling and support groups and medication all may play a role in successful treatment, notes the NIMH.

reviewed 1/14/2019

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