Bulimia nervosa is an eating disorder that impacts an individual’s mental and physical health. Though we often visualize someone suffering with bulimia to be a young white woman, anyone of any gender, race, ethnicity, or background can struggle with the disorder. Those battling this disorder most often experience intense bingeing episodes, followed by compensatory behaviors such as purging or over-exercising. Though the causes of bulimia are extremely complex, they can be broken down into four categories: biological factors, including traits we inherit via our genes; developmental factors, including our personalities and childhood trauma; psychological factors, including undiagnosed mutually-occurring mental illness; and sociocultural factors, such as diet culture and the thin ideal.

Biological factors associated with bulimia nervosa

Bulimia can be ingrained in your brain or genes; meaning that developing this disorder is not your fault. Genes are heritable traits that we pass down to our offspring and include hair color, eye color, personality traits and an increased prevalence for developing medical and mental health disorders. Although there is no specific gene associated with bulimia nervosa, a familial component appears to be present in the development of eating disorders. First-degree relatives (parents, siblings, and children) of individuals with an eating disorder are more likely to develop an eating disorder than the general public.  Neurotransmitters are chemicals in the brain responsible for brain cell communication and mood regulation and serotonin, norepinephrine and dopamine are neurotransmitters that are associated with bulimia nervosa and other eating disorders. Additionally, these specific neurotransmitters are associated with depression, which can lead to the development of bulimia nervosa.  Hormones are natural biological chemicals in the body that regulate every physiological process including digestion and studies have shown that hormonal levels can be abnormal in untreated bulimia nervosa and can return back to baseline once the individual undergoes successful treatment.

Developmental factors associated with bulimia nervosa

Our personalities, habits, thought patterns and behaviors become ingrained during childhood and therefore both positive and negative experiences during our developing years can have an everlasting impact on us through adulthood. Childhood abuse and trauma are strongly associated with the development of bulimia nervosa later on in life. Divorce, the loss of parents, emotional, physical, mental, sexual and verbal abuse, bullying and neglect are all strongly linked with the development of a mental health disorder or low-self-esteem resulting in harmful eating disorders such as bulimia.

Psychological factors associated with bulimia

Studies have shown that approximately 30% of individuals who partake in binge and purge behaviors also practice self-harm behaviors such as cutting; thereby a direct link has been associated with bulimia nervosa and self-harm. Depression, anxiety and borderline personality disorder are also closely linked with bulimia nervosa. Treating these underlying psychological disorders is necessary in order to treat bulimia nervosa.

Sociocultural factors associated with bulimia

Peer pressure, media influences and trending diet fads are all associated with the development of bulimia. We live in a society where our image is measured by our body shape and physical appearance. Emotional stress, substance abuse, and the influence of social media are sociocultural factors known to contribute to the development of bulimia nervosa.

Recognizing the causes and understanding that this disorder is not related to one individual cause is necessary to develop the proper treatment plan where all underlying triggers can be addressed. These causes and triggers associated with bulimia nervosa can vary among each individual. For example, some individual may just have the biological components whereas other individuals may have deep-rooted emotional trauma or mental health disorders resulting in their bulimia nervosa.