Bulimia Nervosa: What is it, signs and symptoms, and treatment options

What is bulimia?

Bulimia nervosa, often referred to as just bulimia, is a debilitating eating disorder that can have a devastating impact on health, wellbeing, quality of life, and can be extremely difficult to cope with.

If you have bulimia, you will have difficulty controlling your eating urges and the amount of food you eat, leading to significant and frequent binges. You may or may not perform some compensatory behaviours like vomiting, using laxatives or excessively exercising to control your weight. You may have some degree of fear around weight gain and often, the impact of your overeating will be your primary concern.

Signs of bulimia

It can sometimes be difficult to spot the signs of bulimia. Unlike some other eating disorders, bulimia may not cause a significant change in your weight, as the cycles experienced can balance weight out.

However, there are some common symptoms someone can experience when struggling with this eating disorder. These include:

• Binge eating followed by purging
• An obsession with food and calories
• Going to the toilet straight after meals to make yourself sick
• Taking laxatives
• Excessive exercise
• Feeling guilty and ashamed after binge eating
• Repeatedly weighing yourself
• Mental health problems such as depression, anxiety and panic attacks
• Self-harm and suicidal thoughts
• Anger management issues

The most common symptoms of bulimia nervosa are bingeing and purging food. Someone with bulimia will often go to great lengths to try to hide these behaviours. Bingeing and purging can be defined as:

• Binge eating – this is when you eat excessively; even if you’re not hungry (often up to three or four times the usual amount of food). People tend to binge on foods that are considered to be unhealthy such as crisps, chocolate or other types of ‘junk food’
• Purging – after binge eating, bulimia sufferers will often try to remove the calories they have consumed using harmful methods. These may include making yourself sick, exercising excessively or abusing laxatives

The binge-purge cycles associated with this eating disorder can be triggered by hunger, stress, anxiety or at times, for no obvious reasons.

Purging may have started as a way to prevent worrying about overeating, but as time has gone on, it can become a way to manage feelings, where you get an overwhelming need to binge and purge when you feel angry, tired or lonely. You may also plan time out for bingeing and purging, and have found that you are spending more and more money on food.

Long term effects of bulimia

As the bingeing and purging cycles come around, the bulimia symptoms experienced may ease. However, these cycles can create long-term effects and problems. These include:

• Chronic gastric reflux
• Ulcers
• Tooth decay
• Kidney damage
• Chest pain
• Infertility
• Cardiac arrhythmia

Treatment options for bulimia

Treatment options can vary depending on the severity of the eating disorder and for how long someone has been struggling with bulimia. Based on the level of support you may need, an eating disorder specialist will assess your symptoms and recommend treatment be delivered on an outpatient, day care or inpatient (residential) basis.

Bulimia can be treated with a number of therapeutic techniques and a combination of techniques is often used by professionals to help you overcome bulimic challenges. There are also ways family members and friends can help someone with bulimia at home, encouraging recovery when medical professionals are not around. 

Common treatments include:

• Cognitive behaviour therapy (CBT)
• Cognitive behaviour therapy enhanced (CBT-E)
• Dialectical behaviour therapy (DBT)
• Dietetic input
• Food exposure interventions
• Body image workshops
• Antidepressants

A mix of specialist psychiatrists, psychologists, therapists and other highly skilled eating disorder professionals will help you on your recovery journey and ensure you have the right support and treatment plans at our specialist hospitals and wellbeing centres.

The aim of these treatments is to help you:

• Identify your irrational beliefs regarding food, diet and body image
• Identify the causes and underlying triggers for your unhealthy eating habits
• Address dysfunctional thought patterns and behaviours
• Replace your negative thoughts with healthier and more rational alternatives
• Develop a healthy relationship with food
• Learn healthy coping strategies for the future
• Enable you to return to a positive and fulfilling way of life

It’s important to remember that bulimia nervosa is treatable and those struggling can make a full recovery with appropriate treatment. 

Nobody has to struggling with an eating disorder alone, there is support available with Priory. Get in touch today and start your eating disorder recovery journey.