Bulimia nervosa belongs to the group of eating disorder (ED). It characterizes by behaviors in which people have recurrent attacks, consuming large amounts of food in a short period of time.

Bulimia is a female-dominated disease, for each man it affects about 9 women who start suffering from it over time. It usually starts between the ages of 16 and 20. In the last ten years, the prevalence and incidence rates have been stable. Bulimia affects approximately 2% of the population. About 4% of the population suffers from unspecified eating disorders, in which some overeat or purge, but do not meet the criteria of bulimia nervosa.

People with bulimia tend to restrict their diet to reduce weight. However, hunger and impulsive movements are part of the deeper psychological distress, leading to binge eating. This usually happens at night, and the foods that lead to overeating are the foods that they usually try to avoid. Candy, pastries, pasta, and bread are among the most common.

Overeating can produce and internal feeling of dissatisfaction. This causes them to adopt behaviors such as the use of laxatives or exercise excessively. This can cause physical problems such as electrolytes loss, like sodium and potassium, putting their health at risk. Bulimia Nervosa can be life threatening or cause serious physical consequences such as heart disease, low blood pressure and physical changes.

Causes of Bulimia

Bulimia is a disease that has nothing to do with make-believe. Patients suffering from bulimia often have low self-esteem, interpersonal difficulties, emotional instability, trauma, emotional disorders or feelings of emptiness. This discomfort makes them seek their identity in weight loss, and this leads them to complicated clinical complications.

Therefore, although society considers thinness as the business card of success, it is this psychological discomfort that makes patients want to lose weight. This way, biological, psychological and social factors interfere with the origin of this disease, causing patients to distort their own vision. The food restriction imposed by the patient causes a strong state of anxiety and the need to eat large amounts of food.

So far, the biological factors involved in the development of the disease are not clear. On the other hand, some triggers related to social environment, such as diet and fear of being body shamed, are well known. Many factors are compatible with bulimia. Such as affective disorders that occur within the family, drug abuse, obesity, diabetes, and distortions of the body itself.

It is important to clarify that eating disorders do not usually appear when any of these factors are manifest solely, but the combination of multiple factors can lead to bulimia.

What are the symptoms of Bulimia?

Patients who suffer from Bulimia often try to cover up their binging behavior. And as most patients do not tend to lose weight, it can pass unnoticeable for a long time. Typical symptoms of bulimia are as they follow:

Overeating or binge eating:

The person eats a lot of food in a short period of time and cannot control their intake. The objective of the binge is to achieve satisfaction. Patients try to avoid places with food and try to eat alone. Their behavior is often asocial, they tend to isolate themselves, and food is their only topic. Also, a lack of control over food can produce a great sense of guilt and shame.

Use of laxatives:

To prevent weight gain and compensate for excessive or excessive intake, patients vomit, use laxatives, diuretics, or drugs. They also resort to other methods that allow weight control, such as in sports activities.

Repeated Behaviors:

Binge-vomiting cycles occur at least twice a week.

Low self-esteem.

In addition to overall performance, the following symptoms can also appear:

Metal disorders

Patients with bulimia nervosa characterize by having strong impulsivity and low self-control. This can also lead patients to get into dangerous situations or get into arguments easily, or have big mood swings. Also, the frequency of low self-esteem leads to symptoms of depression and anxiety. Some patients might even develop problems with addiction to alcohol, drugs or substances.

Physical symptoms

There are many physical symptoms that manifest with bulimia. Some of them are weakness or headache, swollen face by an increased salivary gland (especially parotid glands). Others include dental problems, dizziness, hair loss, irregular menstruation and sudden weight gain and loss. However, patients with Bulimia usually do not seem to lose weight, this is more frequent in anorexia. Bulimia can coexist with other diseases or behaviors, such as sexual promiscuity. The clinical consequences are:

– Arrhythmias that can lead to a heart attack.

– Dehydration

– Irritable Intestine.

– Gastroesophageal reflux.

– Hiatal hernia.

– Dental cavity.

– Bone loss

– Perforation of the esophagus

– Stomach rupture

– Pancreatitis

What is the treatment of Bulimia?

In treating bulimia, the first step is to have a psychiatrist evaluate the patient. After this, there are two methods of treatment: medication or psychotherapy, although the ideal method is to combine the two.

Medication use can improve binge eating, impulsivity and binging behavior. In addition, they can also be psychotherapeutic and effective. Through this psychological method, patients can control impulsivity, emotional instability and improve their mood. It will also increase self-esteem and interpersonal relationships.

The other part of the treatment should focus on nutritional methods. Working closely with endocrinologists and nutritionists will ensure the physical and organic health of the patient. Ultimately, it is about establishing healthy lifestyle habits and self-care so that patients can control their health. Patients need to understand that nobody wants them to gain weight, but to stay healthy within the weight standard, the goal is to stop the pain of weight gain.

How can family members help the patient who has Bulimia?

– The best way to help a person with binge eating disorder is to realize that they have an eating disorder. Some suggestions your environment can follow are:

– Avoid commenting on weight, food, etc.

– Understand that bulimia is a serious problem, not silly of people who suffer.

– Try not to control the patient all the time, just talk about the problem. This will keep the patient from feeling overwhelmed and will promote your understanding.

– Put aside the blackmail and wait “If I eat, I’ll buy you what you want.” These formulas are useless and make the situation worse.


  1. Castillo, M., & Weiselberg, E. (2017). Bulimia Nervosa/Purging Disorder. Current Problems in Pediatric and Adolescent Health Care, 47(4), 85–94. doi:10.1016/j.cppeds.2017.02.004 (LINK)
  2. Gibson, D., Workman, C., & Mehler, P. S. (2019). Medical Complications of Anorexia Nervosa and Bulimia Nervosa. Psychiatric Clinics of North America, 42(2), 263–274. doi:10.1016/j.psc.2019.01.009 (LINK)

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