What is bulimia nervosa? Potential causes, symptoms, and treatments

Recognizing an eating disorder isn’t always easy, but learning how to identify signs and symptoms is one of the first steps in helping people break dangerous habits and protect their mental and physical health. Bulimia nervosa, often called bulimia, is one example of a potentially life-threatening eating disorder. With bulimia, people eat an excessive amount of food and then engage in unhealthy behaviors to avoid gaining weight. 

What is bulimia nervosa?

Bulimia nervosa, often called bulimia, is an eating disorder characterized by episodes of overeating (binging) and compensatory behaviors to prevent weight gain. With bulimia, people eat large amounts of food in a short time, and they may feel like they’re not in control of what they’re doing. Then, they try to get rid of the food and prevent weight gain by throwing up, taking laxatives, fasting, or doing extreme exercise.

Bulimia can range from mild to extreme, with mild cases involving one to three compensatory behaviors per week. Extreme cases can include as many as 14 per week. Binging and compensatory behaviors usually occur in private, so the condition is not always noticeable to others. People with anorexia are usually underweight, although a person does not need to be underweight to have anorexia. But those with bulimia often maintain what’s considered a normal or healthy weight. 

Some common signs of bulimia include:

• Obsession with body image and an intense fear of gaining weight
• Feeling guilty or shameful about eating
• Frequent trips to the bathroom, especially after meals
• Food disappearing or appearing in unusual places
• Excessive exercise
• Withdrawing socially from friends and family
• Mood swings, depression, and irritability 

Bulimia can also cause physical signs and symptoms, including:

• Swollen cheeks or jawline
• Bloodshot eyes
• Dehydration
• Gastrointestinal problems like constipation, stomach cramps, and acid reflux
• Fainting
• Irregular menstrual periods
• Calluses on the back of the hands from self-induced vomiting 

Common causes of bulimia nervosa

Bulimia is more common in women than men and often begins during adolescence or early adulthood. Research suggests that bulimia and other eating disorders are likely caused by a combination of biological, psychological, and social factors, including:

• Genetics: Genetics may play a role in the development of eating disorders, meaning you have a greater risk of developing bulimia if someone in your family has the condition.

• Societal pressure: Diet culture and unrealistic beauty standards can contribute to body issues and eating disorders like bulimia. This type of societal pressure is especially tough for people with low self-esteem or those in professions that focus on weight and appearance.

• Environmental factors: Experiencing trauma, including physical or sexual abuse, may contribute to the development of bulimia. Growing up with parents who modeled unhealthy eating behaviors can also play a role.
• Mental health conditions: Having certain mental health conditions can increase a person’s risk for bulimia. Anxiety, depression, and obsessive-compulsive disorder (OCD) are commonly diagnosed alongside bulimia, yet research is still unclear if one causes the other.

Five potential treatments for bulimia nervosa

Bulimia is a serious condition that can have long-term mental and physical consequences without proper treatment and support. When treating bulimia, most people benefit from a comprehensive approach that integrates mental, medical, social, and nutritional care. 

1. Talk therapy

Talk therapy involves speaking with a therapist or other mental health professional about your condition and related issues. When treating bulimia, therapists often use interpersonal therapy to understand the link between bulimia and how you relate to others. They may also cognitive behavioral therapy (CBT) to help you identify and challenge unhealthy beliefs and behaviors around eating and body image. In addition to one-on-one therapy, many people benefit from participating in group therapy or family therapy. 

2. Nutritional counseling and support

Nutritional counseling focuses on helping people with bulimia develop a healthier relationship with food and their bodies. By working with a nutritionist or dietitian, you’ll learn to create balanced meals and snacks, develop healthier eating habits, and practice more mindful eating techniques that don’t involve binging and purging.

3. Medical support

When treating bulimia, it’s also important to consider how and how often a person purges because some situations may call for additional medical support. For example, self-induced vomiting can lead to problems like cardiac arrhythmia, teeth enamel erosion, and gastroesophageal reflux disease (GERD).

4. Medication management

Medications including antidepressants, antipsychotics, and mood stabilizers may be used to manage bulimia. They may also be helpful if you have other co-occurring mental health conditions, like anxiety or depression. 

5. Social support

Having a strong network of trusted family and friends is essential for navigating difficult moments during the recovery process. Many people also benefit from joining a support group or online community dedicated to helping people heal from bulimia or other eating disorders. These platforms provide a safe and confidential safe space to offer encouragement, advice, and support. 

Find care with Rula

Acknowledging that you or someone you know is experiencing an eating disorder like bulimia can be scary. But it’s the first step in learning how to manage symptoms and improve mental and physical health going forward. Many people don’t know where to start on their healing journey, which is why Rula is committed to connecting people with the support they need.

At Rula, we can find you a therapist who is taking new clients and accepts your insurance in less than 30 seconds. And, our network of over 10,000 therapists means you can begin treatment as soon as tomorrow. 

Find a therapist with Rula