It’s likely that you’ve heard of bulimia before, and that a certain image comes to mind when this disorder is discussed, one that illustrates the binge-purge cycle, and one that most likely exists within a thin, white, female body. The truth, however, is more complex. 

We’ve all seen the Lifetime movies: a thin-to-maybe-chubby young, white girl walks into the bathroom stall after eating lunch in the school cafeteria. We hear retching, followed by the girl coming out of the stall to clean out her mouth with some water from the sink. In just a few minutes, we’ve been shown the classic perception of what someone with bulimia looks like. But is this picture really all the disorder is about?

Bulimia nervosa is a mental disorder that is extremely dangerous, both physically and mentally. If we wish to prevent and treat bulimia in order to reduce the harm that people are experiencing, it is important that we recognize not only the classic signs of bulimia—as seen in the Lifetime movie vignette—but also the behaviors and circumstances that do not receive as much attention. One way to ensure that we are pushing past our own biases and creating a space where affirming care can occur for people of all ways, shapes, and forms, is to dispel common rumors around this disorder.

MYTH: Bulimia nervosa only impacts women.

FACT: Bulimia nervosa affects people of all genders. In fact, studies show us that the population most at risk for eating disorders in general are those who belong to the transgender community (2). Cisgender men are also increasingly at risk for eating disorders, and gay men are also disproportionately impacted by these illnesses (3).

MYTH: Self-induced vomiting is the only compensatory behavior that clinicians and family members should be on the lookout for when diagnosing someone with bulimia nervosa.

FACT: Those struggling with bulimia may engage in compensatory behaviors of many kinds, including excessive exercise, or using laxatives, diet pills, and more (7).

MYTH: Someone struggling with bulimia nervosa is likely to be in a small body.

FACT: People with bulimia come in all shapes and sizes, and it is important that we remember that ALL eating disorders are mental illnesses that cannot be detected by looking at someone’s body size. Eating disorders do not have a body type! MYTH: Bulimia is not as dangerous as anorexia.

FACT: Bulimia is extremely physically and mentally dangerous. Those who are engaging in repeated purging behaviors can impact their electrolyte levels to the point that the body can actually give out and have a heart attack.

As explained by NEDA, “Purging by vomiting or laxatives depletes your body of important chemicals called electrolytes. The electrolyte potassium plays an important role in helping the heart beat and muscles contract, but is often depleted by purging. Other electrolytes, such as sodium and chloride, can also become imbalanced by purging or by drinking excessive amounts of water. Electrolyte imbalances can lead to irregular heartbeats and possibly heart failure and death.” (4)

Less extreme—though still serious!—physical consequences include damage to the esophagus, IBS, eroded tooth enamel, and more (4).

MYTH: Bulimia is untreatable.

FACT: As with all eating disorders, bulimia nervosa is treatable with the right team and the right treatment approach. Research shows us that cognitive-behavioral-therapy (CBT), alongside working with a competent and compassionate recovery team, offers someone the best chance for recovery (6).

There are many myths about bulimia out there. Though we have only covered a handful, it is clear that these misconceptions have real-life consequences. These misconceptions, when unchecked, can determine who gains access to treatment, who is considered deserving of treatment, and more. If we hope to treat and prevent eating disorders in the long-term, it is important that we recognize and interrogate these myths. Ultimately, it is important that we eradicate these myths, not only from the popular-culture narrative of eating disorders, but from our treatment centers as well.

If you’re interested in learning more about bulimia, check out these relevant articles:

Overcoming Bulimia

Impulsivity and Bulimia Nervosa

How to Talk to Someone With an Eating Disorder

About the Author
Ashley M. Seruya is a social work student, virtual assistant, and content creator specializing in eating disorder recovery, Health at Every Size, and weight stigma. Learn more about her work at ashleymseruya.com or on her Instagram at @cozibae.
Sources
  1. Fast Facts on Eating Disorders, Academy for Eating Disorders (AED)
  2. Shining a Light on Gender Identity and Eating Disorders by Allegra R. Gordon
  3. Eating Disorders in LGBTQ+ Populations, NEDA
  4. Health Consequences, NEDA
  5. Bulimia Nervosa, NEDA
  6. Cognitive Behavioral Therapy for Eating Disorders
  7. What Are Compensatory Behaviors in People with Eating Disorders? by  Susan Cowden