Bulimia nervosa, more commonly referred to as bulimia, is an eating disorder that is oftentimes potentially life-threatening. People with bulimia are usually preoccupied with their weight and body shape, unnecessarily judging themselves for their per...

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Bulimia: Symptoms, Causes, Prevention, & Treatment 

Bulimia nervosa, more commonly referred to as bulimia, is an eating disorder that is oftentimes potentially life-threatening. People with bulimia are usually preoccupied with their weight and body shape, unnecessarily judging themselves for their perceived flaws, which causes them to secretly binge or eat large amounts of food with a loss of control, then try to get rid of the food in an unhealthy way. The most common way for a person with bulimia to purge the unwanted calories is to self-induce vomiting. Other but less common ways are to misuse laxatives, weight-loss supplements, or diuretics after binge eating. 

Because this disease is directly related to self-image and not so much about the food consumed, it can be incredibly hard to overcome. However, like other eating disorders, like anorexia, effective treatment can help those with bulimia feel better about themselves, adopt and maintain healthier eating patterns, and possibly reverse some of the serious complications caused by the mistreatment of the body-mind.  

It is normal for people who aren’t suffering from an eating disorder to overindulge sometimes: Taco Tuesday and Thanksgiving come directly to mind, but this shouldn’t be misconstrued as a binge. When someone with bulimia experiences binges eating, they feel out of control and don’t know how much they’re eating, with some even saying that they disconnect from what they’re doing. After the binge is over, that person feels extreme guilt about the high-calorie intake and finds any possible way to get rid of it. 

Bulimia is a severe mental illness. It can affect anyone of any age, gender, or background, that if not treated at the earliest possible point and properly, can cause life-altering risk factors. Read on to find out more about the symptoms, causes, prevention options, and treatment plans of bulimia. 

Symptoms and Warning Signs of Bulimia

The binge/purge cycles associated with bulimia can dominate daily life and possibly lead to relationship issues and fear of social situations, resulting in a social phobia known as Social Anxiety Disorder. Bulimia is known to cause serious physical complications, such as decaying teeth due to excessive vomiting and heart and digestive issues when/if laxatives are involved. 

Common signs and symptoms can include:

  • Living in constant fear of gaining weight

  • Excessively taking dietary supplements or herbal products for weight loss

  • Being overly preoccupied with your body shape and weight

  • Fasting, restricting calories, or avoiding specific “bad foods” between binge episodes

  • Feeling a loss of control while binging, such as not being able to stop eating or can’t control what you’re eating. 

  • Frequent episodes of eating abnormally large amounts of food in one sitting  

Emotional and Behavioral signs and symptoms include:

  • The disappearance of large amounts of food in a short period or many empty wrappers and containers that indicate large amounts of food have been consumed

  • Frequent trips to the bathroom after meals

  • Signs or the smell of vomit is persistent 

  • Presence of wrappers or packages of laxatives or diuretics

  • Abnormally uncomfortable eating around others

  • Development of food rituals, such as only eating specific food groups or excessive chewing

  • Skipping meals or only eating a minimal amount at regular meals.

  • Stealing or hoarding food in strange places

  • Drinking an excessive amount of water or non-caloric beverages, such as diet sodas or seltzers

  • Excessive use of gum, mints, or mouthwash

  • Lying about eating 

  • Covers body with overly baggy clothes 

  • Unusual swelling of the cheeks, face, or jaw area

  • Calluses on the back of hands and knuckles from vomiting

  • Discolored or stained teeth

  • Creating rituals or schedules time for binging and purging

  • Withdrawing from daily activities, friends, and family 

  • Overobsessing about weight or body appearance 

  • Extreme mood swings

Physical signs and symptoms include:

  • Noticeable fluctuations in weight

  • Dizziness

  • Sleep problems

  • Fainting/ vertigo

  • Swelling around the salivary glands

  • Fine, soft, downy hair on arms or face

  • Stomach cramps, constipation, or acid reflux

  • Constantly feeling cold

  • Dry Skin and nails

  • Cavities or teeth discoloration from constant vomiting 

  • Thinning, dry, and brittle hair

  • Muscle weakness

  • Swelling extremities

  • Missing periods or not having a period in women and girls

In addition to the myriad of physical, emotional, and behavioral complications, people with bulimia can also be at risk for other mental health disorders, such as:

It is important to know that recurring binge and purge cycles can affect the entire digestive system, leading to chemical and electrolyte imbalances that affect the heart and other major organ functions, which can be life-threatening and, worse, fatal. Electrolyte imbalances can kill without warning by inducing cardiac arrest.  


The exact cause of bulimia is unknown -- there are many reasons someone develops bulimia, and many things can be contributing factors as with many diseases and disorders. It’s most likely a combination of biological, psychological, and environmental factors.

  • Biological. Although it's not yet clear if or which genes are involved, there could be genetic changes that make some people at higher risk of developing bulimia. Some people may have a genetic tendency toward perfectionism, sensitivity, and addiction, all of which are associated with bulimia.

  • Psychological. People with bulimia may also have obsessive-compulsive or addictive traits that make it easier to stick to unrealistic diets and forgo food despite being hungry. They may have an extreme drive for perfectionism, which causes them to think they're never thin enough. They may also be suffering from anxiety, binging, and purging to control the stress they feel.

  • Environmental. Unfortunately, American culture emphasizes thinness. People pride themselves and often equate success with being thin. Usually, among young girls, peer pressure may help fuel the need and want to be thin.

Preventing Bulimia

Unfortunately, there is no sure-fire way to prevent bulimia. There are ways to help people suffering from bulimia, such as creating healthier behaviors, talking to a licensed professional before the disease takes over everyday life, or joining a therapy group. Most people with bulimia are resistant to acknowledge they have a problem or can’t see the signs themselves, and until that person wants to get help, here are some other things to do that might help:

  • Have regular, enjoyable family meals

  • Build a person’s body confidence by fostering and reinforcing healthy body image, no matter their size or shape

  • Focus on leading a healthy lifestyle

  • Avoid talking about weight at home

  • Don’t encourage dieting, especially if it involves unhealthy weight control, such as fasting, using laxatives, or self-induced vomiting

  • Talk to your primary care provider if any signs become prevalent - they may be able to see early indicators to help prevent further development.

Put, if you notice yourself or someone you love having issues with food that could lead to an eating disorder, talk to them in a concerned and supportive manner. Let them know that they aren’t alone, and if treated early on, it is possible to recover from what could be life-altering or even deadly fully. 

Treatment for Bulimia

Getting help is the most important thing you can do for yourself or someone you know has bulimia. It may feel as though you are alone; you’re not! 

If you notice that a family member or friend has low self-esteem, severe dieting habits, and dissatisfaction with appearance, consider talking to them about these issues. Although you may not prevent an eating disorder from developing, you can talk about healthier behavior or treatment options.

Talk to Your Doctor

Unfortunately, many people with bulimia don't want treatment, at least initially. Their desire to remain thin overrides concerns about their health. If you have a loved one you're worried about, urge her or him to talk to a doctor.

Look Into Online Therapy

Online therapy has become wildly popular, especially during 2020, when a global pandemic impacted the way we interact with other people. It has proven to be just as effective as in-person therapy. Online therapy is convenient and has many benefits, such as no travel time, is usually more affordable, and you can be in the comfort of your own home. At the same time, you connect with a licensed therapist. 

A few online therapists include: 

Join an Online Support Group

People who have bulimia oftentimes say they feel as though they’re the only ones dealing with this disorder; that they are alone on this journey. Group therapy helps people understand that they are not the only ones who have feelings of inadequacy or overweight. 

This type of care focuses on the individual's problems. After one person shares, other people in the group are encouraged to share their similar thoughts and experiences, leading to a mutual understanding that other people are struggling with bulimia or other eating disorders and that you don’t have to face this by yourself. 

Group therapy options include: