Bulimia Nervosa

Bulimia Nervosa is a serious and dangerous eating disorder characterised by eating large amounts of food in a relatively short amount of time (known as a binge), followed by extreme compensatory efforts to avoid gaining weight. For an individual with bulimia life can become a constant battle between the desire to lose weight and the overwhelming compulsion to binge.

During a binge an individual suffering from bulimia will usually experience a sense of loss of control, often being unaware of what and how much they are eating and feeling unable to stop. After a binge the person will often experience feelings of shame or guilt and might then engage in behaviour to prevent themselves from gaining weight or to get rid of the food (purging). This can include making themselves vomit, using medications such as laxatives, or exercising. This behaviour tends to become a vicious cycle, which becomes very habitual and difficult to change.

Individuals suffering from bulimia nervosa tend to place an extreme focus on their body shape and weight (body image concerns), which in turn has a negative effect on their self-esteem and sense of self worth. Often, individuals will also engage in binge eating in an effort to manage uncomfortable emotions, using eating as a coping strategy against feelings of worthlessness, again leaving them trapped in a vicious cycle.

People with bulimia nervosa are often embarrassed or feel ashamed about their behaviour, try to hide it from loved ones and can be worried about seeking help because they feel that they may be judged. For this reason, it can take a long time for someone to try to get help. 

Unfortunately many people do not realise that bulimia nervosa is a dangerous condition that can have severe health consequences if left untreated. These include damage to teeth, mouth and the digestive tract, and in severe cases, electrolyte imbalances that can lead to heart failure and death. 

Bulimia is thought to affect twice as many people as anorexia does, and may affect up to 8% of the population over the course of their lives. The most common age for experiencing bulimia is between 16 and 44 years of age, with twice as many women being affected than men.

  • Frequent episodes of eating unusually large amounts of food
  • Alternating between overeating and fasting
  • Lack of control over eating
  • Secrecy surrounding eating
  • Disappearance and/or hoarding of food
  • Frequent fluctuations in weight
  • Going to the bathroom after meals
  • Using laxatives, diuretics, or enemas after eating
  • Sore throat, tooth decay and bad breath caused by excessive vomiting
  • Calluses or scars on the knuckles or hands
  • Puffy “chipmunk” cheeks
  • Excessive exercising
  • Depressed mood and irritability
  • Increased social isolation
  • Irregular periods 

The best evidence-based treatment for bulimia nervosa in adults is Cognitive Behavioural Therapy (CBT). CBT has been found consistently superior to most other psychological therapies for bulimia (NICE, 2004b). Family Based Treatment has been shown to have better results than CBT for adolescents.  For those that need extra help, anti-depressants like Fluoxetine have also shown to be effective.  

Click on the links to read about anorexia nervosa and binge eating disorder