Bulimia Nervosa

Eating Disorder

What is bulimia nervosa?

Bulimia Nervosa is an eating disorder, the eating is uncontrollable over-eating and also is referred to as binge-eating, it is followed by behaviors created to stop weight gain that would come from the binge-eating. The behaviors used to control weight are, “self-induced vomiting; the abuse of laxatives, diuretics, or other purging medications; fasting; and excessive exercise” (Nolen-Hoeksema, 2014, p. 343). “Bulimia is a mental health disorder. People with bulimia tend to show signs of depression, anxiety, or obsessive-compulsive disorders. They’re also at risk for substance abuse problems and suicidal behavior” (The Effects of Bulimia, 2016, para. 2). A person with bulimia may become obsessed with endless monitoring of food and weight. Their binge-eating is done in secret and they try to hide all evidence of their behaviors. “Bulimia is often discovered by family members, roommates, and friends when people with the disorder are caught vomiting or leave messes after they vomit” (Nolen-Hoeksema, 2014, p. 343).

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Possible causes of bulimia nervosa:

Although there is no exact cause, there are multiple factors that contribute to developing this eating disorder. According to (Ekern, 2015, para. 4), the main causes of bulimia are:

  • Stressful transitions or life changes

  • History of abuse or trauma

  • Negative body image

  • Poor self-esteem

  • Professions or activities that focus on appearance/performance

Unlike a woman with anorexia nervosa, “a woman with bulimia nervosa has a more realistic perception of her actual body shape and weight. Still, people with bulimia nervosa are constantly dissatisfied with their shape and weight and concerned about losing weight” (Nolen-Hoeksema, 2014, p. 343).

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Signs & Symptoms

There are many signs and symptoms that an individual suffering from bulimia nervosa will show. These symptoms can cause serious health problems long-term if the person is not getting treatment. “In the long term, patients with bulimia nervosa risk developing a number of serious medical complications, including irregular menses or amenorrhea, dehydration from reduced fluid intake, damage to teeth and gums from vomiting, electrolyte imbalances that can induce heart arrhythmias, and a variety of gastrointestinal disorders” (Treating bulimia nervosa, 2009, p. 4). These symptoms and signs include:

  • Rotten teeth from being exposed to stomach acid as a result of frequent vomiting
  • Broken blood vessels in the eyes
  • Low blood pressure
  • Severe dehydration
  • Irregular heartbeat which can cause heart failure
  • Inflammation in the throat
  • Ruptured esophagus
  • Skin peeling and scars on hands or fingers from exposure to acid when vomiting is induced
  • Using the bathroom frequently after meals
  • Eating in private
  • Having very little control when eating

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There are many treatment options available for Bulimia Nervosa, which include therapy and drug treatments. Cognitive-behavioral therapy has gathered the most experimental support for the treatment of bulimia nervosa. “This therapy helps patients identify and change distorted thoughts—about themselves and food— that underlie their compulsive behavior, and find better ways to cope with life stresses” (Treating bulimia nervosa, 2009, p. 5). “The therapist teaches the client to monitor the cognitions that accompany her eating, particularly the binge episodes and the purging episodes. Then the therapist helps the client confront these cognitions and develop more adaptive attitudes toward weight and body shape” (Nolen-Hoeksema, 2014, p. 257). The combination of medication with therapy seems to have the best effect in treating bulimia nervosa long-term. Medication approved by the FDA used to treat bulimia nervosa and other eating disorders is fluoxetine also known as Prozac, “Studies consistently report that SSRIs rapidly reduce the frequency of binge eating and purging, as well as improve mood. But they also find that patients taking medication alone are more likely to stop treatment early—which is why combining it with psychotherapy usually works best” (Treating bulimia nervosa, 2009, p. 5).

Myths & Misconceptions

There are many widespread misconceptions and myths about eating disorders. According to The Center for Eating Disorders (2016), “These myths can lead to stigma, making it difficult for some individuals to seek treatment and often making it less likely that medical professionals will identify or diagnose eating disorders when they occur outside of the stereotypes.” Some myths and misconceptions include:

  • You can tell if someone has an eating disorder simply by looking at them

  • Eating Disorders are caused by Photo-shopped images in the media

  • Men don’t get eating disorders

  • Eating Disorders are a lifestyle choice; someone can choose to stop having an eating disorder

  • Purging is an effective way to lose weight

  • Anorexia is the only life threatening eating disorder

  • Recovery from eating disorders is rare

By increasing awareness and educating more people about the facts of eating disorders, these myths and misconceptions can be dismissed.

Are you looking for a therapist?

  • Credentials or factors to look for in a therapist if you decide to pursue treatment are, check to see if the therapist or psychologist has had graduate educational training and research upon receiving a doctoral degree and if they have completed a clinical intership in health setting such as a hospital or clinic. Comfort level is important, make sure you are very comfortable and feel at ease when speaking to them about your personal issues.

  • Types of degrees & educational background someone should have when treating these disorders are, a bachelors degree should be earned first then a masters degree, taking and completing psychology courses, those who specialize in eating disorders usually complete a graduate degree in health education, clinical counseling, and psychology.

  • Must be licensed by the state they are practicing in.


Ekern, J. (2015). Bulimia Nervosa: Causes, Symptoms, Signs & Treatment Help. Retrieved from http://www.eatingdisorderhope.com/information/bulimia

Nolen-Hoeksema, S. (2014). Abnormal psychology (6th ed.). New York: McGraw-Hill.

The Effects of bulimia on the Body. (2016). Retrieved from http://www.healthline.com/health/bulimia/effects-on-body

Treating bulimia nervosa: a combination of cognitive behavioral therapy and medication works best. (2009). Harvard Mental Health Letter, 26(3), 4-5 2p. [PDF file]. Retrieved from http://eds.b.ebscohost.com.bakerezproxy.palnet.info/eds/pdfviewer/pdfviewer?vid=18&sid=2bcf8783-b67e-4c81-8b67-5828500a9c3a%40sessionmgr106&hid=117

Eating Disorder Facts & Myths. (2016). The Center for Eating Disorders. Retrieved from http://eatingdisorder.org/eating-disorder-information/facts-myths/