Bulimia

What is bulimia?

Bulimia (or bulimia nervosa) is a serious mental illness. It can affect anyone of any age, gender, or background. People with bulimia are caught in a cycle of eating large quantities of food (called bingeing), and then trying to compensate for that overeating by vomiting, taking laxatives or diuretics, fasting, or exercising excessively (called purging). Early intervention offers the best chance for a rapid and sustained recovery from bulimia.

It’s normal for people who aren’t suffering from an eating disorder to choose to eat a bit more or “overindulge” sometimes. This shouldn’t be confused with a binge. During a binge, people with bulimia don’t feel in control of how much or how quickly they’re eating. Some people also say that they feel as though they’re disconnected from what they’re doing. The food eaten during a binge may include things the person would usually avoid. Episodes of bingeing are often very distressing because people with bulimia place strong emphasis on their weight and shape, and may see themselves as much larger than they are.

The binge/purge cycles associated with bulimia can dominate daily life and lead to difficulties in relationships and social situations. However, as sufferers often maintain a “normal” weight and often hide their illness from others, it can be very difficult to spot from the outside. Moreover, people with bulimia are often reluctant to seek help. As with other eating disorders, people around a person with bulimia will probably notice changes to their mood and feelings before seeing any physical change. They may also be preoccupied with and secretive around food, and feel self-conscious about eating around others. Low self-esteem, irritability and mood swings, and feelings of guilt, shame, and anxiety, especially after a binge, are also common.

If someone’s symptoms don’t exactly match all the criteria used to diagnose bulimia – for example, if the binge/purge cycles don’t occur as frequently as may be expected – they might be diagnosed with OSFED (other specified feeding or eating disorder). OSFED is as serious as any other eating disorder and it’s just as important that people suffering with it get treatment as quickly as possible.

What causes bulimia?

There are many different reasons that someone might develop bulimia, and many things that can be contributing factors. It’s important to remember that eating disorders are often not about food itself, and treatment should address the underlying thoughts and feelings that cause the behaviour.

However, bulimia can cause serious physical complications as well. Frequent vomiting can cause problems with the teeth, and people may go to lengths to make themselves sick that could cause them harm. Laxative misuse can seriously affect the heart and digestive system. People with bulimia may also experience symptoms such as tiredness, feeling bloated, constipation, abdominal pain, irregular periods, or occasional swelling of the hands and feet.

Bulimia can affect anyone of any age, thought it typically develops during adolescence or early adulthood. It is also possible for someone to move between diagnoses if their symptoms change – there is often a lot of overlap between different eating disorders. As such, bulimia may develop from another eating disorder, or a person’s symptoms may change to better resemble those of another eating disorder.

Signs of bulimia vary, but someone doesn’t have to have all of them to be suffering. It’s not always obvious that someone has an eating disorder – remember, they are mental illnesses.  If you’re worried about yourself or someone you know, even if only some of the signs on this page are present, you should still seek help immediately. The first step is usually to make an appointment with the GP.

What's it like to have bulimia?

I used to go to the food cupboard, fridge or freezer and eat as much as I could, as quickly as possible, to try to make myself feel happier and fill the hole I felt inside. Afterwards I felt physically and emotionally upset and guilty about all the food I had eaten, so I would make myself sick.
People thought I was really popular and together, but I knew I wasn’t, I felt like a fake.  I thought that people wouldn’t like me if they knew what I was really like.
The more I denied my body the food it needed, the deeper my hunger became, and the greater the sense of control I felt being restored. One day the hunger finally overwhelmed me. I began to purge. This quickly developed into a dangerous cycle of binge eating and vomiting.

Issue date: September 2017  Review date: September 2020 Version 2.0 Sources used to create this information are available by contacting Beat. We welcome your feedback on our information resources.