Bulimia nervosa is an eating disorder that occurs when you regularly eat large amounts of food in a short period of time (bingeing) and try to prevent weight gain by vomiting or using laxatives (purging). During bingeing, you may feel like you are unable to control your eating, leading to feelings of guilt or disgust that trigger purging.
UPMC experts offer comprehensive treatment for bulimia nervosa and various other eating disorders. Our multidisciplinary team will work with you to address the physical and psychological aspects of these disorders, promoting recovery, long-term health, and overall well-being.
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What Is Bulimia Nervosa?
Bulimia nervosa is an eating disorder that occurs when you regularly eat large amounts of food in a short period of time (bingeing) and try to prevent weight gain by vomiting or using laxatives (purging). During bingeing, you may feel like you are unable to control your eating, leading to feelings of guilt or disgust that trigger purging.
How are bulimia and binge eating disorder similar?
Symptoms of bulimia and binge eating disorder both include episodes of overeating during which you feel unable to stop. However, people with bulimia also engage in compensatory behaviors to counteract overeating and prevent weight gain, such as fasting, excessive exercise, self-induced vomiting, or misusing laxatives.
What are the types of bulimia nervosa?
There are two types of bulimia nervosa, including:
- Nonpurging — Engaging in fasting or excessive exercise to compensate for the effects of binge eating.
- Purging — Engaging in self-induced vomiting or misusing diet pills, laxatives, or diuretics to compensate for the effects of binge eating.
How common is bulimia nervosa?
Bulimia affects between 1% to 2% of people in the U.S. It is more common in females and often develops during the teen or young adult years.
What causes bulimia nervosa?
Experts aren’t sure what causes bulimia nervosa, but believe it could be linked to:
- Changes in brain chemicals.
- Depression, stress, or anxiety.
- Family history of eating disorders.
- Social or cultural pressures.
- Unhealthy food-related behaviors, such as extreme dieting.
Bulimia nervosa risk factors
You may be at a higher risk of developing bulimia nervosa if you have a family member who has had an eating disorder or if you are a young female. Additionally, having other mental health conditions or problems with body image and self-esteem may also increase your risk.
Complications of bulimia nervosa
Complications of bulimia nervosa may include:
- Abnormal heart rhythms.
- Constipation.
- Damage to your intestines or stomach.
- Dehydration.
- Electrolyte imbalances.
- Heart failure.
- Hemorrhoids.
- Increased risk of suicide and mental health conditions.
- Inflammation and tears in your esophagus.
- Tooth decay and cavities.
- Ulcers in your throat or stomach.
What are the health risks associated with bulimia?
Over time, bulimia can lead to serious physical and mental health problems. Repeated vomiting can cause problems with your digestive system and other dangerous health issues, such as electrolyte imbalances or dehydration. Bulimia also increases your risk of suicide and other mental health disorders.
How can I prevent bulimia?
Understanding your risk factors for bulimia can help you spot signs of abnormal eating patterns early. If you have anxiety, depression, or problems with self-esteem and body image, getting early mental health treatment can reduce your risk of developing bulimia nervosa.
What Are the Signs and Symptoms of Bulimia Nervosa?
Individuals with bulimia nervosa have recurrent episodes of binge eating, coupled with inappropriate behaviors aimed at undoing the effects of binging and preventing weight gain.
People with bulimia nervosa often have symptoms including:
- Fear of gaining weight.
- Feeling dissatisfied with their bodies.
- Wanting to lose weight.
People with bulimia nervosa typically are within the normal weight range, although some may be slightly underweight or overweight, and a few may be obese.
Common signs of bulimia
Common signs of bulimia include:
- Excessive exercise.
- Fasting.
- Misuse of laxatives, diet pills, or diuretics (water pills).
- Restricting their total caloric consumption between binges by selecting low-calorie or diet foods and avoiding foods they perceive as fattening or that might trigger a binge episode.
- Self-induced vomiting.
When should I see a doctor about my bulimia nervosa symptoms?
If you have symptoms of bulimia nervosa, you should schedule an appointment with your doctor. Early treatment can prevent serious complications.
How Do You Diagnose Bulimia Nervosa?
To diagnose bulimia nervosa, your doctor will ask about your symptoms. They'll also perform a physical exam and ask questions about your mental health.
What to expect during your visit
If your doctor suspects bulimia nervosa, they will:
- Ask about your mental health.
- Ask about your symptoms.
- Perform a physical exam.
- Order blood tests to check for electrolyte imbalances or dehydration.
- Review your health history and medications.
Criteria for diagnosing bulimia nervosa
Your doctor will use specific criteria to diagnose bulimia nervosa, including:
- Repeated episodes of binge eating accompanied by a sense of losing control during those episodes.
- Repeated use of inappropriate behaviors to prevent weight gain or to reverse it, such as:
- Excessive exercise.
- Fasting.
- Misuse of laxatives, diet pills, or diuretics (water pills).
- Self-induced vomiting.
- Both binge eating and inappropriate behaviors occur at least two times per week for at least three months.
- Self-esteem is overly influenced by weight or shape.
Bulimia nervosa prognosis
Bulimia requires long-term treatment and management. However, with psychological counseling and nutrition support, it is possible to reduce the risk of complications, recover, and prevent recurrence.
How Do You Treat Bulimia Nervosa?
The goals of bulimia nervosa treatment are to stop bingeing and purging, achieve and maintain a healthy weight, address mental health challenges, and manage triggers.
Treatment options may include:
Psychological counseling for bulimia nervosa
Also known as talk therapy, psychological counseling can help you understand your bulimia triggers and how to manage them. Your doctor may recommend individual, family, or group counseling, depending on your needs.
Nutrition counseling for bulimia nervosa
Nutrition counseling with a registered dietitian can teach you how to plan healthy meals and snacks that help you manage your weight while providing your body with the fuel it needs.
Medication for bulimia nervosa
If you have anxiety, depression, or another mental health condition that is triggering your bulimia, your doctor may prescribe antidepressant or anti-anxiety medication.
Why Choose UPMC for Bulimia Nervosa Care?
When you choose UPMC for bulimia nervosa care, you will receive:
- Access to eating disorder expertise — Our eating disorder experts treat the full spectrum of conditions using the latest, evidence-based treatment guidelines and strategies.
- A full range of treatment options — We offer psychiatric care, medication, and nutritional support that allows us to effectively treat all types of eating disorders while reducing your risk of complications.
- Multidisciplinary care — We partner with mental health professionals, registered dietitians, primary care providers, and other medical experts to provide complete care that optimizes your recovery and quality of life.
