Bulimia nervosa

Bulimia (boo-LEE-me-uh) nervosa, commonly called bulimia, is a serious, potentially life-threatening eating disorder. People with bulimia may secretly binge — eating large amounts of food — and then purge, trying to get rid of the extra calories in an unhealthy way. For example, someone with bulimia may force vomiting or do excessive exercise. Sometimes people purge after eating only a small snack or a normal-size meal.

Bulimia can be categorized in two ways:

  • Purging bulimia. You regularly self-induce vomiting or misuse laxatives, diuretics or enemas after bingeing.
  • Nonpurging bulimia. You use other methods to rid yourself of calories and prevent weight gain, such as fasting, strict dieting or excessive exercise.

However, these behaviors often overlap, and the attempt to rid yourself of extra calories is usually referred to as purging, no matter what the method.

If you have bulimia, you're probably preoccupied with your weight and body shape, and may judge yourself severely and harshly for your self-perceived flaws. Because it's related to self-image — and not just about food — bulimia can be difficult to overcome. But effective treatment can help you feel better about yourself, adopt healthier eating patterns and reverse serious complications.

Symptoms Causes Risk factors Complications Prevention

Bulimia signs and symptoms may include:

  • Being preoccupied with your body shape and weight
  • Living in fear of gaining weight
  • Feeling that you can't control your eating behavior
  • Eating until the point of discomfort or pain
  • Eating much more food in a binge episode than in a normal meal or snack
  • Forcing yourself to vomit or exercise too much
  • Misusing laxatives, diuretics or enemas after eating
  • Using dietary supplements or herbal products for weight loss

When to see a doctor

If you have any bulimia symptoms, seek medical help as soon as possible. If left untreated, it may get worse and take over your life.

Talk to your primary care provider or a mental health provider about your bulimia symptoms and feelings. If you're reluctant to seek treatment, confide in someone about what you're going through, whether it's a friend or loved one, a teacher, a faith leader or someone else you trust. He or she can help you take the first steps to successful bulimia treatment.

Helping a loved one with bulimia symptoms

If you think a loved one may have symptoms of bulimia, have an open and honest discussion about your concerns. You can't force someone to seek professional care, but you can offer encouragement and support. You can also help find a qualified doctor or mental health provider, make an appointment and even offer to go along.

Because most people with bulimia are of normal weight or even slightly overweight, it may not be apparent to others that something is wrong. Red flags that family and friends may notice include:

  • Constantly worrying or complaining about being fat
  • Having a distorted, excessively negative body image
  • Repeatedly eating unusually large quantities of food in one sitting, especially high-fat or sweet foods
  • Not wanting to eat in public or in front of others
  • Going to the bathroom right after eating or during meals
  • Exercising too much
  • Having sores, scars or calluses on the knuckles or hands
  • Having damaged teeth and gums

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