People with bulimia try to control their weight by severely restricting the amount of food they eat, then binge eating and purging the food from their body by making themselves sick or using laxatives. As with many eating disorders, women are much more likely to develop bulimia than men. However, bulimia nervosa is becoming increasingly common in boys and men.
Recent studies suggest that as many as 8pc of women have bulimia at some stage in their life. The condition can occur at any age, but mainly affects women aged between 16 and 40 (on average, it starts at the age of 18 or 19).
- Secrecy surrounding eating – Going to the kitchen after everyone else has gone to bed. Going out alone on unexpected food runs. Wanting to eat in privacy
- Lack of control over eating – Inability to stop eating. Eating until the point of physical discomfort and pain
- Eating unusually large amounts of food with no obvious change in weight.
- Disappearance of food, numerous empty wrappers or food containers in the garbage, or hidden stashes of junk food
- Alternating between overeating and fasting – Rarely eats normal meals
Purging signs and symptoms
- Going to the bathroom after meals – Frequently disappears after meals or takes a trip to the bathroom to throw up. May run the water to disguise sounds of vomiting
- Using laxatives, diuretics, or enemas after eating. May also take diet pills to curb appetite or use the sauna to “sweat out” water weight
- Smell of vomit – The bathroom or the person may smell like vomit. They may try to cover up the smell with mouthwash, perfume, air freshener, gum, or mints.
- Excessive exercising – Works out strenuously, especially after eating. Typical activities include high-intensity calorie burners such as running or aerobics.
Physical signs and symptoms
- Calluses or scars on the knuckles or hands from sticking fingers down the throat to induce vomiting.
- Puffy “chipmunk” cheeks caused by repeated vomiting.
- Discolored teeth from exposure to stomach acid when throwing up. May look yellow, ragged, or clear.
- Not underweight – Men and women with bulimia are usually normal weight or slightly overweight. Being underweight while purging might indicate a purging type of anorexia
- Frequent fluctuations in weight – Weight may fluctuate by 10 pounds or more due to alternating episodes of bingeing and purging
If you have bulimia, the first step is to recognise that you have a problem and visit your GP for a medical check-up and for advice on how to get treatment.
Therapy is a primary source of treatment for people with bulimia. Commonly an individual may be offered Cognitive Behavioral Therapy (CBT) which targets the unhealthy eating behaviours of bulimia.
- Breaking the binge-and-purge cycle – The first phase of bulimia treatment focuses on stopping the vicious cycle of bingeing and purging and restoring normal eating patterns. You learn to monitor your eating habits, avoid situations that trigger binges, cope with stress in ways that don’t involve food, eat regularly to reduce food cravings, and fight the urge to purge
- Changing unhealthy thoughts and patterns – The second phase of bulimia treatment focuses on identifying and changing dysfunctional beliefs about weight, dieting, and body shape. You explore attitudes about eating, and rethink the idea that self-worth is based on weight
- Solving emotional issues – The final phase of bulimia treatment involves targeting emotional issues that caused the eating disorder in the first place. Therapy may focus on relationship issues, underlying anxiety and depression, low self-esteem, and feelings of isolation and loneliness.
There is no single cause of bulimia. While low self-esteem and concerns about weight and body image play major roles, there are many other contributing causes. Eating can be an emotional release so people binge and purge when feeling angry, depressed, stressed or anxious.
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