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[[File:Bulimiafaqdia.jpg|thumb|Bulemia]]
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'''Bulimia nervosa, often called bulimia, is a type of eating disorder.''' People with bulimia eat large amounts of food at one time, then try to get rid of the food or weight gain by throwing up, taking laxatives, fasting (not eating anything), or exercising a lot more than normal. Bulimia affects more girls and women than boys and men. Bulimia is a serious health problem, but people with bulimia can get better with treatment.
{{Infobox medical condition
 
| name                    = Bulimia nervosa
== What is bulimia? ==
| image                  = [[File:BulemiaEnamalLoss.JPG|250px]]
Bulimia nervosa, often called bulimia, is a type of eating disorder. Eating disorders are mental health problems that cause extreme and dangerous eating behaviors. These extreme eating behaviors cause other serious health problems and sometimes death. Some eating disorders also involve extreme exercise.
| caption                = Dental enamel erosion, a common symptom of bulimia nervosa
 
| field                  = [[Psychiatry]]
Women with bulimia eat a lot of food in a short amount of time and feel a lack of control over eating during this time (called binging). People with bulimia then try to prevent weight gain by getting rid of the food (called purging). Purging may be done by:
| synonyms                = Bulimia
 
| symptoms                = [[Binge eating]], [[purging]], [[self-induced vomiting]], [[laxative abuse]], [[fasting]], [[excessive exercise]]
* Making yourself throw up
| complications          = [[Electrolyte imbalance]], [[dehydration]], [[esophageal tears]], [[gastric rupture]], [[cardiac arrhythmia]], [[dental erosion]]
* Taking laxatives. Laxatives can include pills or liquids that speed up the movement of food through your body and lead to bowel movements.
| onset                  = Typically [[adolescence]] or [[young adulthood]]
Women with bulimia may also try to prevent weight gain after binging by exercising a lot more than normal, eating very little or not at all (fasting), or taking pills to urinate often.
| duration                = Long-term
Women with bulimia usually have self-esteem that is closely linked to their body image.
| causes                  = [[Genetic]], [[environmental]], [[psychological]] factors
 
| risks                  = [[Anxiety disorders]], [[depression]], [[substance abuse]], [[history of trauma]]
== What is the difference between bulimia and other eating disorders? == <!--T:7-->
| diagnosis              = Based on [[psychiatric evaluation]] and [[DSM-5]] criteria
Women with eating disorders, such as bulimia, anorexia, and binge eating disorder, have a mental health condition that affects how they eat, and sometimes how they exercise. These eating disorders threaten their health.
| differential            = [[Anorexia nervosa]], [[binge eating disorder]], [[gastroesophageal reflux disease]]
 
| prevention              = [[Healthy eating habits]], [[psychotherapy]], [[family therapy]]
Unlike women with anorexia, women with bulimia often have a normal weight. Unlike women with binge eating disorder, women with bulimia purge, or try to get rid of the food or weight after binging. Binging and purging are usually done in private. This can make it difficult to tell if a loved one has bulimia or another eating disorder.
| treatment              = [[Cognitive behavioral therapy]], [[nutritional counseling]], [[medications]] such as [[antidepressants]]
 
| medication              = [[Fluoxetine]]
It is possible to have more than one eating disorder in your lifetime. Regardless of what type of eating disorder you may have, you can get better with treatment.
| prognosis              = Variable; better with early treatment
 
| frequency              = Approximately 1-2% of women and 0.1-0.5% of men
== Who is at risk for bulimia? ==
| deaths                  = Rare, but can occur due to complications
Bulimia affects more women than men. It affects up to 2% of women1 and happens to women of all races and ethnicities.2
}}
 
# Bulimia Nervosa
Bulimia affects more girls and younger women than older women. On average, women develop bulimia at 18 or 19.3 Teen girls between 15 and 19 and young women in their early 20s are most at risk. But eating disorders are happening more often in older women. In one recent study, 13% of American women over 50 had signs of an eating disorder.4
'''Bulimia nervosa''' is an [[eating disorder]] characterized by episodes of [[binge eating]] followed by inappropriate methods of [[weight control]], such as [[purging]], [[fasting]], or excessive [[exercise]]. This condition is a serious mental health disorder that can have severe physical and emotional consequences.
 
== Signs and Symptoms ==
== What are the symptoms of bulimia? ==
Individuals with bulimia nervosa may exhibit a variety of signs and symptoms, including:
Someone with bulimia may be thin, overweight, or have a normal weight. It can be difficult to tell based on a person's weight whether someone has bulimia. This is because binging and purging is most often done in private. However, family or friends may see empty food wrappers in unexpected places or vomit in the home.
* Recurrent episodes of binge eating, defined as consuming an unusually large amount of food in a discrete period of time.
 
* A feeling of lack of control over eating during the binge episodes.
Over time, some symptoms of bulimia may include:5
* Engaging in compensatory behaviors to prevent weight gain, such as self-induced vomiting, misuse of [[laxatives]], diuretics, or enemas.
 
* Fasting or engaging in excessive exercise.
* Swollen cheeks or jaw area
* Preoccupation with body shape and weight.
* Calluses or scrapes on the knuckles (if using fingers to induce vomiting)
* Frequent fluctuations in weight.
* Teeth that look clear instead of white and are increasingly sensitive and decaying
== Causes ==
* Broken blood vessels in the eyes
The exact cause of bulimia nervosa is unknown, but it is believed to be a combination of genetic, biological, psychological, and sociocultural factors. Some potential contributing factors include:
* Acid reflux, constipation, and other gastrointestinal problems
* [[Genetics]]: A family history of eating disorders may increase the risk.
* Severe dehydration
* [[Biological factors]]: Imbalances in brain chemicals such as [[serotonin]] may play a role.
 
* [[Psychological factors]]: Low self-esteem, perfectionism, and impulsive behavior are common traits.
Girls or women with bulimia may also have behavior changes such as:
* [[Sociocultural influences]]: Societal pressure to conform to certain body ideals can contribute to the development of bulimia.
 
== Diagnosis ==
* Often going to the bathroom right after eating (to throw up)
The diagnosis of bulimia nervosa is typically made based on the criteria outlined in the [[Diagnostic and Statistical Manual of Mental Disorders]] (DSM-5). Key diagnostic criteria include:
* Exercising a lot, even in bad weather or when hurt or tired
* Recurrent episodes of binge eating.
* Acting moody or sad, hating the way she looks, or feeling hopeless
* Recurrent inappropriate compensatory behaviors to prevent weight gain.
* Having problems expressing anger
* The binge eating and compensatory behaviors both occur, on average, at least once a week for three months.
* Not wanting to go out with friends or do activities she once enjoyed
* Self-evaluation is unduly influenced by body shape and weight.
 
== Treatment ==
People with bulimia often have other mental health problems, including depression, anxiety, or substance abuse.6
Treatment for bulimia nervosa often involves a combination of [[psychotherapy]], [[nutritional counseling]], and [[medication]]. Common approaches include:
 
* [[Cognitive-behavioral therapy]] (CBT): A type of therapy that helps individuals change negative thought patterns and behaviors.
== What causes bulimia? ==
* [[Interpersonal therapy]] (IPT): Focuses on improving interpersonal relationships and communication skills.
Researchers are not sure exactly what causes bulimia and other eating disorders. Researchers think that eating disorders might happen because of a combination of a person's biology and life events. This combination includes having specific genes, a person's biology, body image and self-esteem, social experiences, family health history, and sometimes other mental health illnesses.  
* [[Medications]]: [[Antidepressants]], such as [[selective serotonin reuptake inhibitors]] (SSRIs), may be prescribed to help reduce symptoms.
 
* [[Nutritional counseling]]: Guidance on healthy eating habits and meal planning.
Researchers are also studying unusual activity in the brain, such as changing levels of serotonin or other chemicals, to see how it may affect eating. Learn more about current research on bulimia.
== Complications ==
 
Bulimia nervosa can lead to a range of serious health complications, including:
== How does bulimia affect a woman's health? ==
* Electrolyte imbalances, which can lead to [[cardiac arrhythmias]] and [[heart failure]].
Purging through vomiting or taking laxatives can prevent your body from getting the important nutrients it needs from food. Over time, bulimia can affect your body in the following ways:
* Gastrointestinal problems, such as [[esophagitis]], [[gastritis]], and [[constipation]].
 
* Dental issues, including [[tooth decay]] and [[gum disease]], due to repeated exposure to stomach acid.
* Stomach damage from overeating
* Mental health issues, such as [[anxiety]], [[depression]], and [[substance abuse]].
* Electrolyte imbalance (having levels of sodium, potassium, or other minerals that are too high or too low, which can lead to heart attack or heart failure)
==Gallery==
* Ulcers and other damage to your throat from vomiting
<gallery>
* Irregular periods or not having periods, which can cause problems getting pregnant
File:BulemiaEnamalLoss.JPG|Bulimia nervosa
* Tooth decay from vomiting
File:Bulimiafaqdia.jpg|Bulimia nervosa
* Dehydration
File:Oral Manifestation of Bulimia..jpg|Bulimia nervosa
* Problems having bowel movements or damage to the intestines from laxative abuse
File:Eating disorders world map-Deaths per million persons-WHO2012.svg|Bulimia nervosa
 
</gallery>
Long-term studies of 20 years or more show that women who had an eating disorder in the past usually reach and maintain a healthy weight after treatment.9
== See Also ==
 
* [[Anorexia nervosa]]
== How is bulimia diagnosed? ==
* [[Binge eating disorder]]
Your doctor or nurse will ask you questions about your symptoms and medical history. It may be difficult to talk to a doctor or nurse about secret eating, purging, or exercise behaviors. But doctors and nurses want to help you get better. Being honest about your eating behaviors with a doctor or nurse is a good way to ask for help.
* [[Eating disorders]]
 
== References ==
Your doctor may do blood or urine tests to rule out other possible causes of your symptoms. Your doctor may also do other tests to see whether you have any other health problems caused by bulimia. These tests may include kidney function tests or an electrocardiogram (ECG or EKG) to see if or how repeated binging and purging has affected your health.
* American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.).
 
* National Institute of Mental Health. Eating Disorders: About More Than Food.
== How is bulimia treated? ==
{{Mental health}}
Your doctor may refer you to a team of doctors, nutritionists, and therapists who will work to help you get better.
{{Eating disorders}}
 
Treatment plans may include one or more of the following:
 
* '''Nutrition therapy'''. People who purge (make themselves throw up or take laxatives) regularly should be treated by a doctor. Purging can cause life-threatening electrolyte imbalances. Some people with bulimia may need to be hospitalized if they have serious heart or kidney problems.
* '''Psychotherapy.''' Sometimes called "talk therapy," psychotherapy is counseling to help you change harmful thoughts or behaviors. This type of therapy may focus on the importance of talking about your feelings and how they affect what you do. For example, you might talk about how stress triggers a binge. You may work one-on-one with a therapist or in a group with others who have bulimia.
* '''Nutritional counseling.''' A registered dietitian or counselor can help you eat in a healthier way than binging and purging.
* '''Support groups''' can be helpful for some people with bulimia when added to other treatment. In support groups, girls or women and sometimes their families meet and share their stories.
* '''Medicine.''' Fluoxetine (Prozac) is the only medicine approved by the Food and Drug Administration (FDA) for treating bulimia, but only in adults. It may help reduce binging and purging and improve your thoughts about eating. Some antidepressants may help girls and women with bulimia who also have depression or anxiety.
 
Most girls and women do get better with treatment and are able to eat and exercise in healthy ways again.12Some may get better after the first treatment. Others get well but may relapse and need treatment again.
 
== How does bulimia affect pregnancy? ==
Bulimia can cause problems getting pregnant and during pregnancy.
 
Repeated purging and binging can make your menstrual cycle irregular (your period comes some months but not others) or your period may stop for several months. Irregular or missing periods mean you may not ovulate, or release an egg from the ovary, every month. This can make it difficult to get pregnant.13 However, if you do not want to have children right now and you have sex, you should use birth control.
 
Bulimia can also cause problems during pregnancy. Bulimia raises your risk for:
 
* Miscarriage (pregnancy loss)
* Premature birth (also called preterm birth), or childbirth before 37 weeks of pregnancy
* Delivery by cesarean section (C-section)
* Having a low birth weight baby (less than five pounds, eight ounces at birth)
* Having a baby with a birth defect
* Depression after the baby is born (postpartum depression)
 
== If I had an eating disorder in the past, can I still get pregnant? ==
Women who have recovered from bulimia and have normal menstrual cycles have a better chance of getting pregnant and having a safe and healthy pregnancy.
 
If you had an eating disorder in the past, it may take you a little longer to get pregnant (about six months to a year) compared to women who never had an eating disorder.
 
Tell your doctor if you had an eating disorder in the past and are trying to become pregnant.
 
== If I take medicine to treat bulimia, can I breastfeed my baby? == <!--T:36-->
Maybe. Some medicines used to treat bulimia can pass through breastmilk. Certain antidepressants can be used safely during breastfeeding.
 
Talk to your doctor to find out what medicine works best for you. Learn more about medicines and breastfeeding in our Breastfeeding section. You can also enter a medicine into the LactMed® database to find out if the medicine passes through breastmilk and any about possible side effects for your nursing baby.
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[[Category:Eating disorders]]
[[Category:Eating disorders]]
[[Category:Culture-bound syndromes]]
[[Category:Mental health]]
[[Category:Vomiting]]
[[Category:Psychiatry]]
[[Category:Psychiatric diagnosis]]

Latest revision as of 19:38, 4 April 2025

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD's medical weight loss NYC, sleep center NYC
Philadelphia medical weight loss and Philadelphia sleep clinics

Bulimia nervosa
File:BulemiaEnamalLoss.JPG
Synonyms Bulimia
Pronounce N/A
Specialty N/A
Symptoms Binge eating, purging, self-induced vomiting, laxative abuse, fasting, excessive exercise
Complications Electrolyte imbalance, dehydration, esophageal tears, gastric rupture, cardiac arrhythmia, dental erosion
Onset Typically adolescence or young adulthood
Duration Long-term
Types N/A
Causes Genetic, environmental, psychological factors
Risks Anxiety disorders, depression, substance abuse, history of trauma
Diagnosis Based on psychiatric evaluation and DSM-5 criteria
Differential diagnosis Anorexia nervosa, binge eating disorder, gastroesophageal reflux disease
Prevention Healthy eating habits, psychotherapy, family therapy
Treatment Cognitive behavioral therapy, nutritional counseling, medications such as antidepressants
Medication Fluoxetine
Prognosis Variable; better with early treatment
Frequency Approximately 1-2% of women and 0.1-0.5% of men
Deaths Rare, but can occur due to complications


  1. Bulimia Nervosa

Bulimia nervosa is an eating disorder characterized by episodes of binge eating followed by inappropriate methods of weight control, such as purging, fasting, or excessive exercise. This condition is a serious mental health disorder that can have severe physical and emotional consequences.

Signs and Symptoms[edit]

Individuals with bulimia nervosa may exhibit a variety of signs and symptoms, including:

  • Recurrent episodes of binge eating, defined as consuming an unusually large amount of food in a discrete period of time.
  • A feeling of lack of control over eating during the binge episodes.
  • Engaging in compensatory behaviors to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics, or enemas.
  • Fasting or engaging in excessive exercise.
  • Preoccupation with body shape and weight.
  • Frequent fluctuations in weight.

Causes[edit]

The exact cause of bulimia nervosa is unknown, but it is believed to be a combination of genetic, biological, psychological, and sociocultural factors. Some potential contributing factors include:

Diagnosis[edit]

The diagnosis of bulimia nervosa is typically made based on the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Key diagnostic criteria include:

  • Recurrent episodes of binge eating.
  • Recurrent inappropriate compensatory behaviors to prevent weight gain.
  • The binge eating and compensatory behaviors both occur, on average, at least once a week for three months.
  • Self-evaluation is unduly influenced by body shape and weight.

Treatment[edit]

Treatment for bulimia nervosa often involves a combination of psychotherapy, nutritional counseling, and medication. Common approaches include:

Complications[edit]

Bulimia nervosa can lead to a range of serious health complications, including:

Gallery[edit]

See Also[edit]

References[edit]

  • American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.).
  • National Institute of Mental Health. Eating Disorders: About More Than Food.
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