Bulimia: What is it Anyway?


Bulimia Nervosa, more commonly known as Bulimia, is an eating disorder that involves binge eating. Many, but not all people with bulimia follow a binge with purging by inducing vomiting or taking laxatives.  Some people with bulimia use diuretics or engage in excessive exercise in hopes of burning off the calories just consumed. These are also types of purging, or getting rid of something from the body, in this case, fat or pounds. Bulimia is dangerous, even life-threatening.

There are two types of bulimia: purging and non-purging. Those with purging bulimia enter a cycle of binging and purging. Those with non-purging bulimia binge but in between binges, try to control their weight through extreme methods like fasting, excessive exercise, or strict diets. This really deteriorates someone’s health.

Girl looking in mirror, bulimia, fairy princess, self-image
This little girl doesn’t seem to like what she sees in the mirror. Is she at future risk for bulimia?

It’s common for those with bulimia to think their bodies look different than they actually appear. A person with bulimia may look in the mirror and see a fat person, even though to others, he or she looks just right. People with bulimia also tend to be down on themselves, seeing all the bad and not so much the good. Someone with bulimia may be at a normal weight or may be too heavy. That makes it difficult to tell from the outside that the person with bulimia has an eating disorder.

While both males and females can get bulimia, it’s more common in females. Some fifteen percent of those with bulimia are male. Teens and young adults are most likely to get bulimia as are those in the public eye, for instance, dancers, athletes, models, and actors.

No one knows exactly how people end up getting bulimia, but there are things that can increase the risk. People who already have other mental health issues and in particular, those with a distorted view of reality, are at greater risk.

Also at risk are those who are strongly affected by peer pressure to fit into social circles or those whose parents expect a great deal from them. For some, it’s about seeing lots of media images of super-thin models and celebrities that tipped the balance and brought on the condition. But all sorts of emotional issues can also make someone vulnerable to bulimia, for instance, having anger management issues, being depressed, always wanting to be perfect, having trouble with controlling impulses, or any sort of past trauma, really.

Scale Measuring Tape
Bulimia may be accompanied by a constant need to weigh and measure.

Some studies show that bulimia may be hereditary while other studies say the condition may be caused by not having enough serotonin, a substance that helps different parts of the brain to communicate. Not having enough serotonin in the brain can affect mood.


The symptoms of bulimia include:

  • Fear of gaining weight
  • Talking about being overweight
  • Always thinking about weight and the body
  • Low self-image
  • Binge eating
  • Forced vomiting
  • Regular use of laxatives or diuretics
  • Taking weight loss herbs
  • Frequent or excessive exercising
  • Stained teeth from vomiting
  • Having calluses on the back of the hands
  • Using the bathroom right after meals
  • Avoiding eating around other people
  • Withdrawing from regular social activities

Bulimia’s Effects

Woman measuring self
We see a person of normal weight. The person with bulimia may see a blimp.

Bulimia can cause dehydration, chemical imbalance in the body, and vitamin deficiencies. Women with bulimia may stop getting their menstrual periods. Cavities and gum disease are common, and bulimia may even cause heart problems and kidney failure. Many people with bulimia have problems with depression and anxiety and may also abuse drugs or alcohol.


Diagnosing bulimia means having a physical examination during which the doctor might order blood and other lab tests. A psychologist may need to examine the patient as well, to find out how the person feels about his body and about his weight. In the case where bulimia has gone on for a long time, more testing may need to be done to see if there is damage to the major organs, such as the heart and the kidneys.

The Diagnostic and Statistical Manual of Mental Disorders lists six criteria for diagnosing bulimia. If a person has three out of six of the criteria, this means the person has bulimia. The six criteria are:

  1. Recurrent binging
  2. Purging by vomiting
  3. Excessive exercise
  4. Taking pills (laxatives, diuretics, weight-loss herbs)
  5. Binging and purging twice a week or more for three months
  6. Tying self-worth to weight


Bulimia treatment is about developing a healthy relationship with the self and with food. It’s usual to have a team of experts helping the person with bulimia, since bulimia is both a mental health issue and a physical issue. Treatment may include any and all of the following:

  • Antidepressant medication
  • Psychotherapy
  • Cognitive behavioral therapy (CBT)
  • Family therapy
  • Nutrition education
  • Binge eating disorder treatment
  • Dietician support
  • Treatment for complications, for instance with a dentist or cardiologist

Some people with bulimia may need to enroll in a day program or live-in treatment program for eating disorders. In these programs, patients have supervised nutritious meals, attend support groups, have therapy sessions, and do exercises to increase awareness of the body. Doctors and other medical staff may be on hand to treat patients for complications from bulimia, they’ll be sure to offer the best treatment options for eating disorders.

Bulimia is learning to have a healthy relationship with the way you look.
Treatment for bulimia is, in part, learning to feel good about what you see in the mirror.


If left undiagnosed and untreated, or if treatment doesn’t work, the outlook for bulimia nervosa is grim. The physical complications from bulimia can even be life-threatening. As with most illnesses however, early diagnosis and treatment means a better, more effective outcome. While a person with bulimia may have to fight the urge to binge and purge all her life, it’s possible to develop and maintain a healthy relationship to food and a good self-image, too.


There may not be such a thing as life after bulimia, but there certainly is life after learning to fight the symptoms and cope with the ongoing struggle of bulimia. If you think you or a loved one may have bulimia, don’t wait. Walk, don’t run, to get help as soon as possible. Here are some resources to start you on the road to recovery:

Academy for Eating Disorders

Phone: 847-498-4274

American Psychological Association

Phone: 800-374-2721

National Association of Anorexia Nervosa and Associated Disorders

Phone: 847-498-4274

National Eating Disorders Association

Phone: 800-931-2237 

National Institute of Mental Health (NIMH), NIH, HHS

Phone: 866-615-6464 or Live online chat



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About Varda Epstein

Varda Meyers Epstein serves as editor in chief of Kars4Kids Parenting. A native of Pittsburgh, Pennsylvania, Varda is the mother of 12 children and is also a grandmother of 12. Her work has been published in The Washington Post, The Huffington Post, The Learning Site, The eLearning Site, and Internet4Classrooms.