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Bulimia Nervosa: Signs, Symptoms and Causes

  • Revised/Updated: 2019/05/24
  • Synopsis : Bulimia, also known as bulimia nervosa, is a deadly eating disorder in which an individual believes they are fat or overweight.

Bulimia nervosa is characterized by recurrent binge eating, followed by compensatory behaviors referred to as purging.

Media portrayals of an ideal body shape are widely considered to be a contributing factor to bulimia.

Main Document

Bulimia, also known as bulimia nervosa, a deadly and horrifying eating disorder in which an individual believes they are fat or overweight and lose weight through unhealthy and dangerous methods. Bulimia nervosa is characterized by recurrent binge eating, followed by compensatory behaviors referred to as purging. The most common form, practiced more than 75% of people with bulimia nervosa, is self-induced vomiting; fasting, the use of laxatives, enemas, diuretics, and over exercising are also common. Bulimia is extremely dangerous and in many cases deadly.

There are two sub-types of Bulimia Nervosa: purging and non-purging.

  • Purging Type: the patient uses self-induced vomiting (which may include use of emetics such as syrup of ipecac) and other ways to rapidly remove food from the body before it can be digested, such as laxatives, diuretics, and enemas.
  • Non-purging Type: occurring in approximately 6%-8% of cases, in which the patient uses excessive exercise or fasting after a binge to offset the caloric intake after eating. Purging-type bulimics may also exercise or fast, but as a secondary form of weight control.

Psychological Issues

Bulimia is related to deep psychological issues and feelings of lack of control. Sufferers often use the destructive eating pattern to feel in control over their lives. They may hide or hoard food and overeat when stressed or upset. They may feel a loss of control during a binge, and consume great quantities of food (sometimes over 20,000 calories). After a length of time, the sufferer of bulimia will find that they no longer have control over their binging and purging.

Most people with bulimia may seem perfectly normal and appear to be at a healthy weight. However, some people have such a low self-esteem and such a bad self-image that they turn to bulimia in an attempt to lose weight.

Many women with bulimia are actually high achievers in other areas such as school or work, and may be trying to cover up their bulimia by succeeding in other areas. Just remembering, anyone can have bulimia. If you do, don't be embarrassed. Treatment is available and help is out there.

Symptoms of Bulimia

Someone with bulimia nervosa will suffer many side effects. Some of the short term effects that this eating disorder can cause include (but are not limited to):

  • Fatigue
  • Depression and self-hatred
  • Headaches and bloodshot eyes
  • Chronically inflamed and sore throat
  • Severe dehydration from purging of fluids
  • Obsession with body weight and appearance
  • Malnutrition (due to extreme lack of food)
  • Extreme weight loss over a short period of time
  • Swollen salivary glands in the neck and jaw area
  • Intestinal distress and irritation from laxative abuse
  • Acid reflux disorder and other gastrointestinal problems
  • Worn tooth enamel, and increasingly sensitive and decaying teeth as a result of exposure to stomach acid
  • Electrolyte imbalance, too low or too high levels of sodium, calcium, potassium, and other minerals that can lead to a heart attack or stroke.

If these aren't enough to scare anyone off from even attempting to lose weight through bulimia, lets look at some long term effects of this vicious eating disorder:

  • Stomach ulcers
  • Constant dehydration
  • Ruptures of stomach and esophagus
  • More prone to developing dental cavities
  • Higher chance of suicidal behaviors and feelings
  • Irregular heartbeat which can lead to heart attacks
  • Tooth enamel breaks down due to constant contact with stomach acids when vomiting

Facts and Statistics

The periwinkle colored ribbon denotes awareness of eating disorders.
The periwinkle colored ribbon denotes awareness of eating disorders.

In 1979, Gerald Russell first published a description of bulimia nervosa, in which he studied patients with a "morbid fear of becoming fat" who overate and purged afterwards. He specified treatment options and indicated the seriousness of the disease, which can be accompanied by depression and suicide. In 1980, bulimia nervosa first appeared in the DSM-III.

  • The majority, about 80 to almost 90 percent of individuals with bulimia are women.
  • Some individuals may tend to alternate between bulimia nervosa and anorexia nervosa.
  • Media portrayals of an ideal body shape are widely considered to be a contributing factor to bulimia.
  • There is a genetic component to bulimia. Twin studies estimate the heritability of syndromic bulimia to be 54 - 83%.
  • Bulimics are much more likely than non-bulimics to have an affective disorder, such as depression or general anxiety disorder.
  • A survey of 496 adolescent girls reported that more than 12 percent experienced some form of eating disorder by the time they were 20.

It can be difficult to really know if someone has bulimia. However, if you are sure that someone you know and care about has bulimia, contact your doctor immediately. Confront the person about your feelings and try to help them. It's almost certain that they will be angry and embarrassed, as well as try to deny that they have bulimia. However, you need to be stern and insist they get help. You could be saving that persons life.


1 - - Body mass index percentile method recommended for clinical and research purposes for calculating expected body weight of adolescents with eating disorders | 2012/01/04

2 - - The more time adolescent girls spend in front of Facebook the more their chances of developing various eating disorders | 2011/02/07

3 - - Give Food A Chance - New Treatment Options for Eating Disorders Described in Book | 2010/09/13

4 - - Severity of binge eating disorder linked to childhood sexual or emotional abuse | 2010/05/12

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