Bulimia Nervosa: Signs, Symptoms, & Treatment

Bulimia nervosa is a serious eating disorder that involves two potentially life-threatening behaviors: bingeing and purging.

A person with bulimia will eat large amounts of food in a short amount of time, often feeling like they’re completely out of control. This behavior is often followed by purging, in which the person will vomit, use laxatives, exercise intensely, and engage in other behaviors to get rid of the food eaten during the bingeing session.

This vicious circle is why bulimia is often dangerous – bingeing and purging can cause serious damage to the body. In some cases, this damage can result in life-threatening complications.

However, bulimia has something in common with other eating disorders: it’s treatable. Through a combination of talk therapy and other proven methods, it’s possible to break the cycle of bulimia and live the life you truly deserve.

If you’re struggling with bulimia or other eating disorders, reach out to Center for Discovery  and learn more about our evidence-based eating disorder treatment programs.

How is Bulimia Nervosa Diagnosed?

Diagnosing bulimia involves both physical and mental health assessments. Only a medical professional can accurately diagnose bulimia and other eating disorders.

Typically, your healthcare provider will ask you questions about how you eat, any diet plans you may be on, and any physical symptoms related to bulimia. They’ll also likely give you a physical exam, which can include an EEG and blood and urine tests.

Finally, your doctor may conduct a mental health screening to make sure there’s not another reason for weight fluctuations and the other physical side effects of bulimia. According to the Mayo Clinic, a diagnosis of bulimia involves bingeing and purging behavior at least once a week over a three-month period. However, they also warn that bingeing and purging can be dangerous even when done less often.

Ultimately, if you’re concerned about your behavior, it’s wise to reach out for help.

What Causes Bulimia Nervosa?

The exact cause of eating disorders like bulimia isn’t known, and there may not be one. Instead, multiple factors seem to contribute to how bulimia develops, including:

Genes

There seems to be a genetic link involved with eating disorders. If you have a close relative with bulimia or it’s in your family history, you may be more likely to develop it.

Trauma

Research has shown that trauma and eating disorders share a relationship.

Environment

Environmental pressures may play a role in how eating disorders develop. Issues about body image and beliefs that a person needs to be a certain weight can contribute to eating disorders like bulimia.

Co-Occurring Conditions

Eating disorders rarely happen by themselves. They’re often accompanied by co-occurring disorders like:

• Anxiety disorders
• Bipolar disorder
• Depression
• Obsessive-compulsive disorder (OCD)
• Self-harming behaviors

How Common is Bulimia Nervosa?

According to the National Institute of Mental Health (NIMH), this eating disorder tends to develop during the adolescent years, and occurs three times as often among women as it does among men.

That’s not to say bulimia can’t affect men – it can. Often tied into ideas about self-image, men can experience the same risks of bulimia as women do. Also, given the stigma that often surrounds eating disorders, it’s possible that there is a fair amount of underreporting on statistics about bulimia.

How is Bulimia Nervosa Treated?

Eating disorders like bulimia are complex, but they’re also treatable. Center for Discovery takes a team approach to our eating disorder treatment programs. Bulimia can be extremely isolating, leaving you feeling like you’re alone and misunderstood. By bringing in both experts and loved ones, we’re able to help heal you in mind and body.

Although everybody’s journey through treatment is different, we typically involve:

• Your loved ones
• Your primary physician
• A mental health professional
• In some cases, a dietitian

We also make use of additional forms of treatment:

Psychotherapy for Bulimia Nervosa

Psychotherapy, or talk therapy, is extremely useful for treating bulimia. During a talk therapy session, you’ll sit down with a mental health professional who will help you safely explore your feelings, thoughts, past trauma, and more.

Talk therapy helps you change your mindset and relationship with food by examining the root causes of your behaviors. You’ll gain valuable insights into where your behaviors come from, what drives your existing behaviors, and how to change them for the better.

At Center for Discovery, we make use of several forms of talk therapy, which include:

• Cognitive behavioral therapy (CBT): Cognitive behavioral therapy, or CBT, is a form of talk therapy that helps people identify and change damaging thought patterns. CBT is based on the principle that many mental issues are driven by harmful behaviors and unhealthy ways of thinking. Role-playing and guided meditation are common in CBT. Some therapists use a form of CBT to treat bulimia called CBT-E, enhanced cognitive behavioral therapy, to help people change their beliefs and behaviors.
• Dialectical behavior therapy (DBT): Dialectical behavior therapy, or DBT, is based on CBT. However, DBT is aimed more at people who struggle with intense emotions. This form of talk therapy helps people achieve greater emotional balance, improve their relationships, and live in the moment. DBT plays a role in treating bulimia, as researchers believe unpleasant and intense emotions drive eating disorders.
• Exposure & response prevention (ERP) therapy: ERP is an evidence-based treatment modality that has proven to be effective in the treatment of anxiety disorders. ERP therapy was designed to desensitize individuals to their fears and distresses. Because anxiety and eating disorders commonly co-occur, ERP has proven to be a useful tool in treating both together.

Inclusive Programming

For a long time, it was assumed that eating disorders only affected a certain kind of person. That’s untrue – eating disorders don’t discriminate. Anyone can develop a condition like bulimia.

Gender Affirmative Care

Unfortunately, sexual minorities tend to experience eating disorders at a higher rate than other groups.  Gender affirmative care recognizes these struggles, ensuring that eating disorder treatment programs are as inclusive (and effective) as possible.

Medication for Bulimia

Antidepressants often play a role in treating bulimia. Currently, Prozac (fluoxetine) is the only antidepressant approved by the U.S. Food & Drug Administration (FDA) used to treat bulimia.

CARE-CFD Dietary Program

At Center for Discovery, we take a real-life approach to eating disorder recovery and handle it with CARE – a dietary model that stands for “consistent attuned relational eating.” This means you have the steadiness of a dietary plan that is adaptable to what’s happening in your life.

How Can I Help a Loved One with Bulimia Nervosa?

Everyone struggles when a loved one is dealing with an eating disorder like bulimia.  Watching someone you care deeply about struggle with bulimia is incredibly hard as you watch them struggle with the cycle of bingeing and purging.

However, you’re not hopeless. There are ways you can help your loved one and even encourage them to seek treatment.

Learn About Bulimia

Learning about bulimia is helpful in multiple ways. It’ll help you understand what your loved one is going through. Also, understanding bulimia will help you feel less anxious and scared.

Seek Help

You’re likely not alone. Don’t forget to lean on your friends or other family members for help during this difficult time. You can also reach out to professionals like Center for Discovery. We’ll help you plan out your course of action, direct you to resources about bulimia, and let you know what your next steps should be.

Help Your Loved One See the Situation

It’s almost impossible for a person struggling with bulimia to realize their behaviors and views are disordered. When you’re ready to have a conversation with your loved one, it’s best to do it gently. Don’t be angry, don’t try to manipulate them, and don’t call them a “bulimic.”

Be prepared for resistance, too – you’re likely going to have to make several attempts to convince your loved one that they need help.

Take Care of Yourself

Few situations are as stressful as helping a loved one realize they need help for an eating disorder. It’s important to take care of yourself and recognize that you have limits. Try to practice self-care: eat regularly and get enough sleep.

What are the Symptoms of Bulimia Nervosa?

Like other eating disorders, bulimia has physical, behavioral and mental symptoms. Being able to recognize the symptoms of bulimia can help you know when to reach out for treatment.

Behavioral Symptoms of Bulimia Nervosa

Eating disorders like bulimia revolve around behaviors involving food:

• Eating an unusual amount of food compared to what you normally would at one sitting
• Making yourself vomit or using medications like diuretics or laxatives after binge eating
• Exercising to unhealthy extremes after binge eating
• Engaging in fasting or restrictive eating between binge sessions

Mental Symptoms of Bulimia Nervosa

It’s important to remember that eating disorders affect you mentally, too. Some mental symptoms include:

• Feeling like you’re not in control during binges
• Experiencing intense fear of gaining weight
• Trying to lose weight in unhealthy and dangerous ways
• Feeling very unhappy about your weight and body size
• Experiencing intense mood swings
• Struggling with other mental disorders, such as depression and anxiety

Physical Symptoms of Bulimia Nervosa

The binge-and-purge cycle of bulimia can cause serious health issues, including:

• Tooth decay and loss from repeated vomiting
• Digestive issues like acid reflux and constipation
• Swollen jawline and/or cheeks
• Injuries to your knuckles from forced vomiting
• Dehydration
• Muscle weakness

How is Bulimia Nervosa Different from Binge Eating?

While bulimia and BED both involve binge eating, purging is what makes bulimia different from BED. A person struggling with bulimia will often try to get rid of the food by forcing themselves to vomit, using medication, or other means. Researchers divide up these behaviors into two types:

• Purging Type: A person with this type of purging behavior will either make themselves vomit or use medications like diuretics to get food out of their system after bingeing.
• Non-Purging Type: A person with this type of behavior will use methods like intense exercise or fasting to compensate after bingeing.

What are the Symptoms of Bulimia Nervosa?

Like other eating disorders, bulimia has physical, behavioral and mental symptoms. Being able to recognize the symptoms of bulimia can help you know when to reach out for treatment.

Behavioral Symptoms of Bulimia Nervosa

Eating disorders like bulimia revolve around behaviors involving food:

• Eating an unusual amount of food compared to what you normally would at one sitting
• Making yourself vomit or using medications like diuretics or laxatives after binge eating
• Exercising to unhealthy extremes after binge eating
• Engaging in fasting or restrictive eating between binge sessions

Mental Symptoms of Bulimia Nervosa

It’s important to remember that eating disorders affect you mentally, too. Some mental symptoms include:

• Feeling like you’re not in control during binges
• Experiencing intense fear of gaining weight
• Trying to lose weight in unhealthy and dangerous ways
• Feeling very unhappy about your weight and body size
• Experiencing intense mood swings
• Struggling with other mental disorders, such as depression and anxiety

Physical Symptoms of Bulimia Nervosa

The binge-and-purge cycle of bulimia can cause serious health issues, including:

• Tooth decay and loss from repeated vomiting
• Digestive issues like acid reflux and constipation
• Swollen jawline and/or cheeks
• Injuries to your knuckles from forced vomiting
• Dehydration
• Muscle weakness

How is Bulimia Nervosa Different from Binge Eating?

While bulimia and BED both involve binge eating, purging is what makes bulimia different from BED. A person struggling with bulimia will often try to get rid of the food by forcing themselves to vomit, using medication, or other means. Researchers divide up these behaviors into two types:

• Purging Type: A person with this type of purging behavior will either make themselves vomit or use medications like diuretics to get food out of their system after bingeing.
• Non-Purging Type: A person with this type of behavior will use methods like intense exercise or fasting to compensate after bingeing.

What Happens if Bulimia Nervosa isn’t Treated?

We’ll say it plainly: left untreated, bulimia can become life threatening. The stress bingeing and purging puts on the body can cause damage very quickly…and some of this damage can be permanent, too.

Here are a few of the ways bulimia physically damages the body:

Dehydration

If you’ve ever had the stomach flu, you know how easy it is to become dehydrated when you vomit. But when you vomit many times, dehydration becomes a much more serious risk.

Also, dehydration causes our bodies to lose electrolytes like potassium and sodium. In turn, this can lead to heart problems…and in some cases, death.

Heart Problems

The heart problems caused by dehydration can include abnormal heart rhythms (arrhythmia), rapid or fluttering heartbeats (palpitations), and low blood pressure.

There’s another way bulimia can cause heart damage. Some use substances to induce vomiting, and over time, this can weaken the muscles of the heart, leading to permanent damage and death.

Digestive Issues

Purging can seriously disrupt the digestive system, sometimes in ways that require immediate medical attention:

• Damage to the esophagus: The esophagus is the organ that connects our throats to our stomach. Vomiting can seriously damage the esophagus, which can range from the relatively mild, like acid reflux, to situations that require emergency surgery, such as esophageal tears and rupture.
• Damage to the stomach and intestines: Purging with laxatives can cause long-term problems like irritable bowel syndrome, diarrhea, and constipation.

Oral Damage

Vomiting over long periods of time can damage the enamel on your teeth, as well as discolor them and cause gum disease. Bulimia can also cause sores in the mouth to develop. Finally, vomiting can enlarge your salivary glands, causing the face and neck to look puffy.

Other Areas

Bulimia can damage other areas of the body, including organs. Both purging and malnutrition can cause pancreatitis, or inflammation of the pancreas. Malnutrition can also damage the skin, hair, and nails, cause hormonal problems, and lead to pregnancy complications.

Get Help for Bulimia Nervosa Today at Center for Discovery

Like other eating disorders, bulimia can make you feel like you’re alone, hopeless, and misunderstood.

You’re not. With professional, specialized care, you’ll be able to manage and control your symptoms, rebuild a healthy relationship with food, and learn to truly love yourself again.

Center for Discovery has over 25 years of experience successfully treating eating disorders like bulimia. We offer personalized, evidence-based care for bulimia and other eating disorders, providing a nonjudgmental, comfortable space where you’ll be able to safely explore the roots of your problems…and treat them successfully.

You’ll also have access to our exclusive Path to Peace online eating disorder treatment program, specifically designed for people who struggle with binge eating and chronic dieting behaviors.

Bulimia can make your life seem like it’s not worth living. It is. You deserve to live your best life. Discover the you within you at CFD today. Contact us now to learn more.