Bulimia Nervosa: Know the signs, why it happens and how to prevent it

Bulimia nervosa is an eating disorder where you often have episodes of excessive bingeing of food and then find ways to get rid of it.
Bulimia Nervosa patients over consume food and then look for ways to purge themselves soon after. Image courtesy: Adobe Stock
Anjuri Nayar Singh Published: 9 May 2024, 22:00 pm IST
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If you have been a Gossip Girl fan, do you remember the initial episodes where Blair Waldorf talks about her “condition”; where she eats uncontrollably and then forces herself to throw up? That’s Bulimia Nervosa for you. It is an eating disorder where a person eats beyond measure and then tries to get rid of it by throwing up.

Bulimia Nervosa is a mental condition and can get life-threatening as well, besides potentially causing physical and emotional harm. Generally, patients with Bulimia Nervosa have an obsession with both food as well as weight loss. Read on to learn more about this disorder, its symptoms and treatment.

What is bulimia nervosa?

Bulimia Nervosa is an eating disorder characterised by periods of binge-eating, or eating beyond control, and then purging, which may involve vomiting, using laxatives, or engaging in excessive physical activity to prevent weight gain. The National Institute of Health states that this condition happens usually in adolescent females. It also quotes The Diagnostic and Statistical Manual of Mental Disorders- 5th edition (DSM-V), which states that the person loses control and is not able to curb his portions, and eats much more than what people generally eat during that time. “In addition to binge eating and purging, people with bulimia nervosa often have feelings of guilt, shame, or embarrassment about their eating habits,” explains internal medicine expert Dr Basavaraj S Kumbar.

Symptoms of bulimia nervosa

Bulimia Nervosa starts at the age of 12.4 years, and affects 1.5 percent of women and 0.5 percent of men in the US at some point in their lives, states the National Institute of Health. Bulimia nervosa symptoms include physical signs such as:

  • Swelling around the cheeks or jaw
  • Calluses on the knuckles from inducing vomiting
  • Damage to teeth along with bad breath.
  • Digestive issues like feeling bloated or constipated, as well as developing food intolerances.
  • Loss of menstrual periods or irregularities in their menstrual cycle

Besides these, a few other generic symptoms accompany the disorder. Other symptoms can include fainting or dizziness, feeling tired, and having trouble sleeping. “These symptoms can vary from person to person, but they often indicate the presence of bulimia nervosa,” explains Dr Kumbar.

Bulimia nervosa patients are obsessed with food and losing weight. Image courtesy: Freepik

What causes Bulimia Nervosa?

A combination of things can cause bulimia nervosa. In some cases, it is related to specific cultural forces or standards concerning appearance and size. Moreover, personal issues such as negative self-image, perfectionism, and inability to deal with feelings may also contribute to its development. “Additionally, genetic predisposition and family background characterized by eating disorders can make one more susceptible to this condition,” explains Dr Kumbar. All in all, these are the typical causes of bulimia nervosa. According to a study in Psychiatry Research, serotine deficiency in the brain can also lead to this eating disorder.

Also Read: Do you have a binge eating disorder? 5 tips to cope with it

Complications caused by Bulimia Nervosa

Different problems can be caused by Bulimia Nervosa. The continuous cycle of bingeing and purging can lead to serious issues in your body. Physical complications include:

  • Damage to the digestive system
  • Teeth and gum decay as a result of vomiting frequently.
  • Irregular heartbeats or even total failure.
  • Electrolyte imbalances from purging
  • Dehydration
  • Digestive issues or malnutrition

Besides this, bulimia can take an emotional toll which affects relationships. It can also impact daily living and mental stability.

Who is more at risk of getting bulimia nervosa?

Anyone can get bulimia nervosa, regardless of their age, sex, or background. However, certain things can make it more likely to happen:

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  • Young people between the ages of 13 and 20 are at the highest risk for developing eating disorders like bulimia nervosa.
  • Individuals who have a family history of mental illness or anorexia may be vulnerable too because they could suffer from both conditions simultaneously.
  • Societal expectations about beauty standards (especially when combined with peer pressure) can also increase one’s chances of getting bulimia nervosa.

How to help someone with bulimia Nervosa?

The Substance Abuse and Mental Health Services Administration in the US states that eating disorders such as Bulimia Nervosa can be life-threatening, and the patients are at a high risk of committing suicide as well.

Supporting a person with bulimia nervosa means being present for them nonjudgmentally and helping them to find professional support. “Pay close attention to what they say, make it clear that you care about them, and recommend psychotherapy or self-help groups that focus on eating disorders,” recommends Dr Kumbar. Propose going together if there is willingness. Looking after yourself and getting professional guidance on assisting your loved one in their journey towards recovery are both important steps.

In bulimia nervosa, patients overconsume food, and in anorexia nervosa, they starve themselves. image courtesy: Adobe Stock

How to live with Bulimia Nervosa?

Bulimia nervosa self-care can be challenging, but it’s important to remember that recovery is possible with the right support. “Focus on seeking professional help from therapists or doctors who specialise in treating eating disorders. Remember to be patient with yourself, practice self-care, and reach out to trusted friends or family members for support when needed,” says Dr Kumbar. Stay committed to your recovery journey and know that you’re not alone in facing this challenge.

How is Bulimia Nervosa diagnosed?

Bulimia nervosa is typically diagnosed by a healthcare professional, such as a doctor or mental health specialist. They will conduct a thorough evaluation, which may include discussing the person’s eating habits, thoughts, and feelings related to food and body image. “The healthcare provider may also perform physical exams and order blood tests to rule out other medical conditions,” says Dr Kumbar.

If the person meets the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), they may be diagnosed with bulimia nervosa. The DSM-5 classifies the disorders into various levels of severity. An average of 1-3 episodes in a week happen in a mild case, in a moderate case, 4-7 episodes take place in a week, and in a severe case, 8-13 episodes happen in a week.  If a person has an extreme case of bulimia, then they will have 14 or more episodes in a week.

How to treat Bulimia Nervosa?

The common strategy for treating bulimia nervosa is to apply a variety of therapies that are specifically designed to address the needs of an individual.

1. Antidepressants

Bulimia nervosa medications include antidepressants that are to be given to the patient. These pills help restore the chemical imbalance in the brain. According to the National Institute of Mental Health, a person suffering from an eating disorder may also be suffering from depression and anxiety. Therefore, it is critical to treat these as well.

2. Psychotherapy and CBT

Psychotherapy and CBT are regarded as the most effective treatment method. The principle on which these therapies work is that you find a way to counter harmful thoughts and behaviour. A study published in the American Journal of Psychiatry states that after getting cognitive behavioural therapy (CBT) for five months, 42 percent of patients had stopped bingeing and purging, while 6 percent stopped after getting psychotherapy.

3. Managing stress and having a coping mechanism

Even though many people can achieve a full recovery, there might still be occasional relapses, especially during periods when they are under a lot of stress. The risk of having another episode can be lowered by acquiring healthy coping mechanisms and maintaining good relationships while also properly managing stress.

4. Nutrition and weight management

Adequate knowledge should be given to patients about nutrition as well as healthy ways to manage weight. The National Institute of Mental Health states that nutritional counselling can help. This would include being on a diet that provides adequate nutrition, maintaining weight at a healthy level and reducing excessive exercise.


Bulimia Nervosa is an eating disorder that causes you to eat and purge. While there is no way to prevent the disorder, early intervention can help manage it. This can be a life-threatening disorder as well and needs to be treated with therapy and bulimia nervosa medication immediately.


Bulimia nervosa vs anorexia nervosa: How are they different?

The two are eating disorders and people suffering from these conditions are obsessed with weight and food. However, people suffering from anorexia nervosa often starve themselves or heavily limit the amount of food that they consume. People will bulimia eat very large amounts of food.

Can Bulimia affect your chances of getting pregnant?

Yes, it can. Bulimia impacts your menstrual cycle because of the purging and bingeing. This would lead to you not ovulating every month and experiencing irregular periods. It also increases the chances of miscarriage, postpartum depression and preterm birth.

When can you discover you have bulimia nervosa?

Bulimia generally onsets in your late teenage years. You are more at risk if you have a family history of eating disorders and weight-control problems.





Anjuri Nayar Singh

Anjuri Nayar Singh has over 12 years of experience in writing for various topics including lifestyle, films, television and OTT. She also writes on art and culture, education and human interest stories. ...Read More

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