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Bulimia - Know More About It

"It was ten years ago when I became bulimic. I had always worried about my weight and how I looked. I always thought I looked fat, regardless of what the scale showed or anyone said. But I had never made myself throw up-not until after college. It was a hard time right after college-I had more responsibilities. I felt very overwhelmed and turned to food to feel more in control of my life. Sometimes, I'd eat a lot of food and throw it up. Other times, I'd throw up a normal meal. At the time, it seemed like the only way I could cope. Luckily, I got help, after a friend talked to me about the problem. It took a lot of work, but I recovered."

What is bulimia?

Bulimia (buh-LEE-me-ah) nervosa, typically called bulimia, is a type of eating disorder. Someone with bulimia eats a lot of food in a short amount of time (called bingeing) and then tries to prevent weight gain by purging. Purging might be done in these ways:

  • Making oneself throw up
  • Taking laxatives, pills, or liquids that increase how fast food moves through your body and leads to a bowel movement (BM).

A person with bulimia may also use these ways to prevent weight gain:

  • exercising a lot
  • eating very little or not at all
  • taking pills to pass urine

What causes it?

Bulimia is more than just a problem with food. Purging and other behaviors to prevent weight gain are ways for people with bulimia to feel more in control of their lives and ease stress and anxiety. While there is no single known cause of bulimia, many things may have a role in its development:

  • Biology - there are studies being done to look at many genes, hormones, and chemicals in the brain that may have an effect on the development of, and recovery from, bulimia.
  • Culture - some cultures in the U.S. have an ideal of extreme thinness. Women may define themselves on how beautiful they are.
  • Personal feelings - someone with bulimia may feel badly about herself, feel helpless, and hate the way she looks.
  • Stressful events or life changes - things like starting a new school or job, being teased, or traumatic events like rape can lead to the onset of bulimia.
  • Families - the attitude of parents about appearance and diet affects their kids. Also, a person is more likely to develop bulimia if a mother or sister has it.

What are signs of bulimia?

People with bulimia may be underweight, overweight, or have a normal weight. This makes it harder to know if someone has this disorder. However, someone with bulimia may have these signs:

Uses extreme measures to lose weight

  • Uses diet pills, or takes pills to urinate or have a bowel movement (BM).
  • Goes to the bathroom all the time after she eats (to throw up).
  • Exercises a lot, even during bad weather, tiredness, sickness, or injury.

Shows signs of throwing up

  • Swelling of the cheeks or jaw area.
  • Cuts and calluses on the back of the hands and knuckles.
  • Teeth that look clear.

Acts differently

  • Is depressed
  • Doesn't see friends or participate in activities as much

What happens to someone who has bulimia?

Bulimia can be very harmful to the body. Some of the ways Bulimia affects your body and health are:

  • Blood: Anemia
  • Brain: Depression, fear of gaining weight, anxiety, dizziness, shame, low self-esteem.
  • Cheeks: Swelling, soreness.
  • Heart: Irregular heart beat, heart muscle weakened, heart failure, low pulse and blood pressure.
  • Body Fluids: Dehydration, low potassium, magnesium, and sodium.
  • Mouth: Cavities, tooth enamel erosion, gum disease, teeth sensitive to hot and cold foods.
  • Throat and Esophagus: Sore, irritated, can tear and rupture, blood in vomit.
  • Intestines: Constipation, irregular bowel movements (BM), bloating, diarrhea, abdominal cramping.
  • Hormones: Irregular or absent period.
  • Muscles: Fatigue.
  • Stomach: Ulcers, pain, can rupture, delayed emptying.
  • Skin: Abrasion of knuckles, dry skin.

Can someone with bulimia get better?

Yes, a person with bulimia can get better. Different types of therapy have worked to help people with bulimia. This may include individual, group, and family therapy. A class of medicines, also used for depression, like Zoloft, has been effective when used with therapy. These medicines change the way certain chemicals work in the brain.

Can women who had bulimia in the past still get pregnant?

Bulimia can cause problems with a woman's period. She may not get it every 4 weeks or it may stop. But researchers don't think this affects a woman's chances of getting pregnant after she recovers.

Does bulimia hurt a baby when the mother is pregnant?

If a woman with active bulimia gets pregnant, these problems may result:

  • Miscarriage
  • high blood pressure in the mother
  • baby isn't born alive
  • low birth weight
  • low Apgar score, which are tests done after birth to make sure the baby is healthy
  • during the delivery, they baby tries to come out with feet or buttocks first
  • birth by C-section
  • baby is born early
  • depression after the baby is born

What should I do if I think someone I know has bulimia?

If you know someone with bulimia, you can help. Follow these steps from the National Eating Disorders Association:

  • Set a time to talk. Set aside a time to privately talk about your concerns with your friend. Be open and honest. Make sure you talk in a place away from distractions.
  • Tell your friend about your concerns: Tell your friend about specific times when you were worried about her eating or exercise behaviors. Explain that you think these things may show a problem that needs professional help.
  • Ask your friend talk about these concerns. She or He could talk to a counselor or doctor who knows about eating issues. If you feel comfortable, offer to help your friend make an appointment or go with her to her appointment.
  • Avoid conflicts or a battle of the wills with your friend: If your friend doesn't admit to a problem, repeat your feelings and the reasons for them. Be a supportive listener.
  • Don't place shame, blame, or guilt on your friend. Do not use accusatory "you" statements like, "You just need to eat." Or, "You are acting irresponsibly." Instead, use "I" statements like, "I'm concerned about you because you refuse to eat breakfast or lunch." Or, "It makes me afraid to hear you vomiting."
  • Avoid giving simple solutions. Don?t say, "If you'd just stop, then everything would be fine!"
  • Express your continued support. Remind your friend that you care and want her to be healthy and happy.

For more information

You can find out more about bulimia by contacting the National Women's Health Information Center (NWHIC) at 800-994-WOMAN or the following organizations.

National Institute of Mental Health (NIMH), NIH, HHS
Phone:(866) 615-6464
Internet Address:

National Mental Health Information Center, SAMHSA, HHS
Phone: (800) 789-2647
Internet Address:

Academy for Eating Disorders (AED)
Phone: (703) 556-9222
Internet Address:

Eating Disorder Referral and Information Center
Phone: (858) 792-7463
Internet Address:

Harvard Eating Disorders Center (HEDC)
Phone: (617) 236-7766
Internet Address:

National Eating Disorders Association (NEDA)
Phone: (800) 931-2237
Internet Address:

Source: National Women's Health Information Center (NWHIC), August 2004, This FAQ was reviewed by Barbara E. Wolfe, PhD, RN, CS, FAAN, Assistant Professor of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School.

Adapted by Editorial Staff, November 2006
Last update, July 2008



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