Understanding Bulimia Nervosa
Bulimia nervosa is a serious eating disorder that involves episodes of binge eating followed by behaviours intended to compensate or “undo” the binge, such as self-induced vomiting, excessive exercise, or misuse of laxatives. It can affect people of all genders, ages, and backgrounds and often develops during adolescence or early adulthood.
What Is Bulimia Nervosa?
Bulimia nervosa is characterised by a cycle of:
- Binge eating – consuming large amounts of food in a short period, often accompanied by a feeling of loss of control
- Compensatory behaviours – actions taken to prevent weight gain, such as purging (vomiting), fasting, using laxatives, or excessive exercise
Unlike anorexia, people with bulimia often maintain a weight that falls within or above the normal range, which can make it harder to detect.
Common Signs and Symptoms
- Frequent episodes of binge eating followed by purging
- Feeling out of control during binges
- Preoccupation with body shape and weight
- Going to the bathroom immediately after eating
- Swollen cheeks or jaw, often due to vomiting
- Callused knuckles (from self-induced vomiting)
- Tooth enamel erosion or dental issues
- Chronic sore throat or acid reflux
- Irregular periods or fatigue
- Secretive behaviour around food
Physical and Emotional Risks
Bulimia nervosa can result in severe health complications, especially when it goes untreated. These may include:
- Electrolyte imbalances
- Dehydration
- Gastrointestinal issues
- Tooth decay and gum damage
- Irregular heartbeat or cardiac arrest
- Menstrual irregularities or fertility issues
- Depression, anxiety, and social withdrawal
The repetitive nature of purging behaviours can place a significant strain on the body and organs, particularly the heart and digestive system.
Causes and Risk Factors
Bulimia nervosa is often the result of a combination of biological, psychological, and social factors. Common risk factors may include:
- Low self-esteem or perfectionism
- History of dieting or weight-related criticism
- Cultural or social pressure to be thin
- Childhood trauma or emotional neglect
- Anxiety, depression, or obsessive-compulsive traits
- Family history of eating disorders or mental illness
Treatment and Recovery
Recovery from bulimia nervosa is entirely possible, though it often requires time, support, and professional guidance. Treatment approaches may include:
- Cognitive behavioural therapy (CBT)
- Nutritional rehabilitation and education
- Medical support and monitoring
- Family therapy (particularly for younger individuals)
- Support groups or online recovery communities
A key part of recovery is developing a healthier relationship with food and body image, learning to manage emotions, and breaking the binge-purge cycle.
Supporting Someone With Bulimia
- Avoid focusing on weight or appearance
- Encourage open and non-judgemental conversation
- Recommend professional help and offer support in finding it
- Be patient — recovery is not always linear
- Educate yourself on the condition to better understand their experience
Helpful Resources
- BEAT Eating Disorders (UK) – www.beateatingdisorders.org.uk
- NHS Eating Disorder Services – www.nhs.uk
- Mind UK – www.mind.org.uk
- First Steps ED – www.firststepsed.co.uk
Sources
BEAT. (2024). Bulimia Nervosa – Symptoms and Treatment. Retrieved from: https://www.beateatingdisorders.org.uk
NHS. (2023). Bulimia Nervosa. Retrieved from: https://www.nhs.uk
NICE. (2020). Eating disorders: recognition and treatment (NG69). Retrieved from: https://www.nice.org.uk/guidance/ng69
Treasure, J., Schmidt, U., & Kan, C. (2020). Eating Disorders. The Lancet Psychiatry, 7(12), 1047–1056.