Bulimia nervosa is an eating disorder characterized by binging episodes followed by compensatory purging behaviors such as self-induced vomiting, diuretic and laxative abuse and excessive exercise. Although not as common as binge eating disorder but more common than anorexia nervosa, bulimia nervosa affects both men and women of all ages and races.

Misconception #1: Bulimia nervosa is the same as anorexia nervosa except it involves purging behaviors

The main difference between bulimia nervosa and anorexia nervosa is weight. The majority of individuals with anorexia nervosa are underweight and the majority of individuals with bulimia nervosa are normal weight or are overweight. Although bulimia nervosa is characterized by binging episodes followed by compensatory purging episodes, there is also a subtype of anorexia nervosa that is characterized by binging and purging as well.

Misconception #2: You can tell an individual has bulimia nervosa just by looking at them

The majority of individuals with bulimia nervosa are normal weight or are overweight. However, just because someone is normal weight or overweight does not mean they have an eating disorder. The same holds true for individuals who are underweight. Weight, itself, does not determine an eating disorder nor is the cause of an eating disorder. Rather, eating disorders are diagnosed based on behaviors. Underlying triggers such as depression, anxiety, abuse, trauma and low-self esteem are usually responsible for the development of bulimia nervosa.

Misconception #3: Bulimia nervosa is about food

Bulimia nervosa and other eating disorders are not about food. Bulimia nervosa is a serious psychological disorder. Individuals with bulimia nervosa report that their enjoyment of the food during a binging episode is momentarily short lived. As they consume abnormally large quantities of food at a time, it’s often with little concern for what kind of foods they’re eating. Any enjoyment is quickly followed by a sense of utter powerlessness and disgust with themselves. Bulimia nervosa and other eating disorders are highly linked to past emotional trauma, depression, anxiety, low-self esteem and loss of control in all other aspects of an individual’s life.

Misconception #4: Bulimia nervosa only affects women

While the majority of those seeking treatment for bulimia are young women, males are susceptible as well. The statistics for men are less reliable, because it’s believed that fewer men are comfortable seeking treatment.

Seeking treatment for eating disorders

Psychotherapy is the mainstay treatment approach for treating anorexia and bulimia nervosa as well as binge-eating disorder and include the following:

  • Cognitive behavioral therapy (CBT)
  • Interpersonal psychotherapy (IPT)
  • Group therapy
  • Family-based therapy (FBT)

Fluoxetine (Prozac) is the only known SSRI approved by the US Food and Drug Administration (FDA) to treat bulimia nervosa and binge-eating disorder. Most eating disorders can be managed with close outpatient monitoring with weekly weight measurements, nutritional counseling, cognitive behavioral therapy and outreach support groups such as Overeaters Anonymous. However in extreme cases of anorexia and bulimia nervosa, inpatient treatment in a hospitalized setting or inpatient residential setting may be required.