Learn About Bulimia

What is the definition of Bulimia?

Bulimia is an eating disorder in which a person has regular episodes of eating a very large amount of food (bingeing) during which the person feels a loss of control over eating. The person then uses different ways, such as vomiting or laxatives (purging), to prevent weight gain.

Many people with bulimia also have anorexia.

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What are the alternative names for Bulimia?

Bulimia nervosa; Binge-purge behavior; Eating disorder - bulimia

What are the causes of Bulimia?

Many more women than men have bulimia. The disorder is most common in teenage girls and young women. The person usually knows that her eating pattern is abnormal. She may feel fear or guilt with the binge-purge episodes.

The exact cause of bulimia is unknown. Genetic, psychological, family, society, or cultural factors may play a role. Bulimia is likely due to more than one factor.

What are the symptoms of Bulimia?

With bulimia, eating binges may occur as often as several times a day for many months. The person often eats large amounts of high-calorie foods, usually in secret. During these episodes, the person feels a lack of control over the eating.

Binges lead to self-disgust, which causes purging to prevent weight gain. Purging may include:

  • Forcing oneself to vomit
  • Excessive exercise
  • Using laxatives, enemas, or diuretics (water pills)

Purging often brings a sense of relief.

People with bulimia are often at a normal weight, but they may see themselves as being overweight. Because the person's weight is often normal, other people may not notice this eating disorder.

Symptoms that other people can see include:

  • Spending a lot of time exercising
  • Suddenly eating large amounts of food or buying large amounts of food that disappear right away
  • Regularly going to the bathroom right after meals
  • Throwing away packages of laxatives, diet pills, emetics (drugs that cause vomiting), or diuretics
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What are the current treatments for Bulimia?

People with bulimia rarely have to go to the hospital, unless they:

  • Have anorexia
  • Have major depression
  • Need medicines to help them stop purging

Most often, a stepped approach is used to treat bulimia. Treatment depends on how severe the bulimia is, and the person's response to treatments:

  • Support groups may be helpful for mild bulimia without other health problems.
  • Counseling, such as talk therapy and nutritional therapy are the first treatments for bulimia that does not respond to support groups.
  • Medicines that also treat depression, known as selective serotonin-reuptake inhibitors (SSRIs) are often used for bulimia. Combining talk therapy with SSRIs may help, if talk therapy alone does not work.

People may drop out of programs if they have unrealistic hopes of being "cured" by therapy alone. Before a program begins, people should know that:

  • Different therapies will likely be needed to manage this disorder.
  • It is common for bulimia to return (relapse), and this is no cause for despair.
  • The process is painful, and the person and their family will need to work hard.
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What are the support groups for Bulimia?

The stress of illness can be eased by joining a support group. Sharing with others who have common experiences and problems can help you not feel alone.

What is the outlook (prognosis) for Bulimia?

Bulimia is a long-term illness. Many people will still have some symptoms, even with treatment.

People with fewer medical complications of bulimia and those willing and able to take part in therapy have a better chance of recovery.

What are the possible complications of Bulimia?

Bulimia can be dangerous. It may lead to serious health problems over time. For example, vomiting over and over can cause:

  • Stomach acid in the esophagus (the tube that moves food from the mouth to the stomach). This can lead to permanent damage of this area.
  • Tears in the esophagus.
  • Dental cavities.
  • Swelling of the throat.

Vomiting and overuse of enemas or laxatives can lead to:

  • Your body not having as much water and fluid as it should
  • Low level of potassium in the blood, which may lead to dangerous heart rhythm problems
  • Hard stools or constipation
  • Hemorrhoids
  • Damage of the pancreas
When should I contact a medical professional for Bulimia?

Call for an appointment with your health care provider if you or your child has symptoms of an eating disorder.

Upper gastrointestinal system
What are the latest Bulimia Clinical Trials?
Study on the Optimal Strategy of Chinese Patients With Bulimia Nervosa After Fluoxetine Treatment

Summary: Current treatment strategies for BN are limited. The total effective rate of pharmacotherapy and psychotherapy is only about 50%.The preliminary studies and clinical experience of this project indicate that :(1) fluoxetine, DBT and CBT were effective in controlling binge eating and purging behaviors in patients with BN;(2) the short-term efficacy of fluoxetine group is better than DBT group ;(3) t...

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Neural Bases of Multiple Forms of Self-regulatory Control in Bulimia Nervosa

Summary: The purpose of this study is to investigate areas of the brain responsible for self-regulation in adult women who have never had an eating disorder with women who have bulimia nervosa. More specifically, investigators are interested in changes in brain activation (e.g., changes in blood flow and oxygen use) when inhibiting responses and regulating emotions. Data collection will rely on a technolog...

What are the Latest Advances for Bulimia?
A community-based feasibility randomized controlled study to test food-specific inhibitory control training in people with disinhibited eating during COVID-19 in Italy.
Virtual Reality-Based Immersive Rehabilitation for Cognitive- and Behavioral-Impairment-Related Eating Disorders: A VREHAB Framework Scoping Review.
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Who are the sources who wrote this article ?

Published Date: May 10, 2020
Published By: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

American Psychiatric Association. Feeding and eating disorders. In: Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing. 2013:329-354.

Kreipe RE, Starr TB. Eating disorders. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 41.

Lock J, La Via MC; American Academy of Child and Adolescent Psychiatry (AACAP) Committee on Quality Issues (CQI). Practice parameter for the assessment and treatment of children and adolescents with eating disorders. J Am Acad Child Adolesc Psychiatry. 2015;54(5):412-425. PMID: 25901778 pubmed.ncbi.nlm.nih.gov/25901778/.

Tanofsky-Kraff M. Eating disorders. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 206.

Thomas JJ, Mickley DW, Derenne JL, Klibanski A, Murray HB, Eddy KT. Eating disorders: evaluation and management. In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 37.