Bulimia Nervosa Causes, Symptoms and Treatment

Bulimia nervosa is a serious psychological eating disorder. People with bulimia eat large amount of food in short time and then try to throw away (purge) the eaten food in an unhealthy manner. For example the method of purging can be anything like induced vomiting, use of laxative, diuretics, or exercising for prolonged period of time.

In most cases the affected individual does so in an attempt to avoid gaining weight. Patient usually binges and purges when he is alone or no one in present around him. He tries his best to conceal his habit. He keeps it a secret and thus it is missed and remains undiagnosed for a long period of time. Although men and women both can suffer from bulimia nervosa it is found to be more in women. Possibly it is connected with self image. Bulimia when diagnosed can be treated with counseling as well as medications.

Bulimia is of two types: Purging bulimia and non purging bulimia.

Purging bulimia: In this type the patient regularly induces vomiting or uses other methods of purging such as laxative, enema, and diuretics after bingeing.

Non purging bulimia: In this type, the patient may use other compensatory methods such as exercising intensely after bingeing or fasting for several days or follow strict dieting schedule. This he/she does to reduce weight or to get rid of calories that he has consumed.

Causes of Bulimia Bervosa

The exact cause of bulimia nervosa is not known although there are multiple factors that may contribute in its development. These factors can be related genetically, psychologically, due to environmental pressure, maintaining body image, etc. Most people suffering from bulimia are known to give excessive emphasis to the shape and weight of their body. For them being thin sized and in shape is everything in life. They constantly remain preoccupied with this behavior. Following are the risk factors for bulimia nervosa:

  • Females, especially young females are more likely to suffer from bulimia nervosa.
  • Most patients of bulimia are teenagers and in their twenties.
  • Patient may have someone in the family suffering from eating disorder.
  • Psychological concern regarding weight and physical image are two important factors that may trigger bulimia.
  • Environmental pressure may play a significant role in development of bulimia. In certain activities such as in media industry or film industry, modeling, dancing etc, people are more conscious of maintaining their thin physical appearance. The pressure on them is tremendous in this regards which can make them feel stressed and anxious sometimes even depressed regarding diet. This may lead to various eating disorders including bulimia.
  • Past history of sexual abuse or mental trauma
  • Lack of self esteem.


The signs and symptoms of bulimia nervosa may often be related with self induced vomiting and other methods of purging. The symptoms are more obvious when the habit of binge eating followed by purging is frequent.

  • Always seen to be preoccupied regarding maintenance of weight, eating food and body shape.
  • Patient always tries to remain alone. This self imposed isolation can affect personal relations with others.
  • Fluctuation of weight
  • Eats and purges in secrecy when no one is at home or visits bathroom frequently to purge soon after eating.
  • Trauma in mouth and throat from repeated induced vomiting.
  • Tooth damage and bad breathe from mouth
  • Knuckles develop calluses because the patient frequently gets hurt on the knuckles while putting his fingers inside his mouth to induce vomiting.
  • Dizziness and fainting
  • Very sensitive if someone comments on weight or his body shape.
  • Uncontrollable eating at one time.
  • Depressed, anxious and extremely irritable.
  • Disappearance of large amount of food from kitchen but patient will not tell the truth that she has eaten the food. She eats food secretly.
  • Repetitive behavior. For example looks in mirror frequently, measures weight frequently in one day, pinching on wrist
  • Exercising beyond limits and for long duration compulsively. Patient exercises in bad weather, even if sick or injured.
  • Frequent use of bathroom after meal to vomit or pass motions after laxative use.


Bulimia is a treatable condition although the recovering path may be a challenging task for patient as well as the health care provider. Treatment of bulimia requires involvement of many people that involves the doctor, the psychiatrist, dietician, and people at home. Psychotherapy consists of cognitive behavioral therapy and counseling the patient regarding her control over eating habit. Medications may be necessary if the patient is extremely stressed and depressed. In most cases antidepressants are used. The role of dieticians is to make a food plan that will help to provide nutritious food and at the same time help in achieving patient’s goal of healthy weight. Usually bulimia patients are treated at home, but sometimes they may need to be hospitalized if the symptoms are severe.