Bulimia Nervosa


Bulimia Nervosa

Bulimia nervosa is an eating disorder characterised by recurrent binge eating, followed by compensatory behaviours.

The most common form is defensive vomiting, sometimes called purging.

Fasting , the use of laxatives, enemas, diuretics and over exercising are also common.

Fast facts about Bulimia

  • It’s rooted in compulsive habits.
  • People with Bulimia Binge-Eat 11 Times a Week on Average.
  • People with bulimia can have normal body weights.
  • Bulimia is Associated with the Highest Suicide Risk of any Eating Disorder.
  • Bulimia Is Not Always Associated with Vomiting.
  • The average age when bulimia begins is 20.
  • The recommended amount of care that someone receives while receiving professional treatment for eating disorder is 3 to 6 months of direct supervision.
  • It is estimated that eight out of 10 women who have received treatment for an eating disorder are act discharge from the treatment facility or care program too soon.
  • The weight of the average  American fashion model: 45 kg
  • The average weight of an American woman: 64 kg

Signs & symptoms

These cycles often involve rapid and out–of–control eating,

which may stop when the bulimic is interrupted by another person or the stomach hurts from over extension,

followed by self-induced vomiting or other forms of purging.

This cycle may be repeated several times a week or, in more serious cases, several times a day and may directly cause:

  • Dehydration and hypokalemia  (potassium deficiency) caused by frequent vomiting
  • Electrolyte imbalance, which can lead to cardiac arrhythmia, cardiac arrest and even death
  • Oesophagitis (inflammation of the oesophagus)
  • Oral trauma, in which repetitive insertion of fingers or other objects causes lacerations in the lining of the mouth or throat.
  • Delayed emptying of the stomach
  • Constipation
  • Infertility
  • Enlarged glands in the neck, under the jaw-line
  • Peptic ulcers
  • Scars on the backs of hands due to repeated trauma from incisors
  • Constant fluctuations
  • Erosion of tooth enamel
  • Chronic gastric reflux after eating

Get help

The longer an eating disorder goes untreated, the more advanced it becomes. Get professional help as soon as possible.

Helping someone with bulimia

If you suspect that your friend or family member has bulimia, talk to the person about your concerns. Your loved one may deny bingeing and purging, but there’s a chance that he or she will welcome the opportunity to open up about the struggle.

Either way, bulimia should never be ignored. The person’s physical and emotional health is at stake. While you can’t force anyone to get better, there are things you can do to help.

If your loved one has bulimia

Offer compassion and support. Keep in mind that the person may get defensive or angry. But if he or she does open up, listen without judgment and make sure the person knows you care.

Avoid insults, scare tactics, guilt trips, and patronizing comments. Since bulimia is often caused and exacerbated by stress, low self-esteem, and shame, negativity will only make it worse.

Set a good example for healthy eating, exercising, and body image. Don’t make negative comments about your own body or anyone else’s.

Accept your limits. There isn’t a lot you can do to “fix” your loved one’s bulimia. The person with bulimia must make the decision to move forward.

Take care of yourself. Know when to seek advice for yourself from a counselor or health professional. Dealing with an eating disorder is stressful, and it will help if you have your own support system in place.

Self help

Break the binge and purge cycle

The first step in bulimia recovery is stopping the vicious cycle of bingeing and purging. In order to do this, it’s essential that you quit trying to diet. Dieting triggers bulimia’s destructive cycle of bingeing and purging. The irony is that the stricter the diet, the more likely it is that you’ll become preoccupied, even obsessed, with food. When you starve yourself, your body responds with powerful cravings—its way of asking for needed nutrition.

As the tension, hunger, and feelings of deprivation build, the compulsion to eat becomes too powerful to resist: a “forbidden” food is eaten; a dietary rule is broken. With an all-or-nothing mindset, you feel any diet slip-up is a total failure. After having a bite of ice cream, you might think, “I’ve already blown It, so I might as well go all out.”

Unfortunately, the relief that bingeing brings is extremely short-lived. Soon after, guilt and self-loathing set in. And so you purge to make up for bingeing to regain control. But purging only reinforces binge eating. Though you may tell yourself this is the last time, in the back of your mind there’s a voice saying you can always throw up or use laxatives if you lose control again. However, purging doesn’t come close to wiping the slate clean after a binge.

Purging does NOT prevent weight gain

Purging isn’t effective at getting rid of calories, which is why most people suffering with bulimia end up gaining weight over time. Vomiting immediately after eating won’t eliminate more than 50% of the calories consumed— usually much less. This is because calorie absorption begins the moment you put food in the mouth. Laxatives and diuretics are even less effective. Laxatives get rid of only 10% of the calories eaten, and diuretics none at all. You may weigh less after taking them, but that lower number on the scale is due to water loss, not true weight loss.

Develop a healthier relationship to food

Once you stop trying to restrict calories and follow strict dietary rules, you will no longer be overwhelmed with cravings and thoughts of food. By eating normally, you can break the binge-and-purge cycle and still reach a healthy, attractive weight.

Pay attention to your hunger. Don’t wait until you’re starving. This only leads to overeating! Eat as soon as you notice you’re feeling moderately hungry.

Eat regularly. Don’t skip meals. Try not to let over 4 hours pass without a meal or snack.

Don’t restrict foods. When something is off limits, it becomes more tempting. Instead of saying “I can never eat ice cream,” say “I will eat ice cream as an occasional treat.”

Focus on what you’re eating. How often have you binged in an almost trance-like state, not even enjoying what you’re consuming? Instead of eating mindlessly, be a mindful eater. Slow down and savor the textures and flavors. Not only will you eat less, you’ll enjoy it more.

Learn to tolerate unpleasant feelings

While bingeing is often triggered by overly strict dieting that backfires, it can also be a way to control or numb unpleasant moods or feelings.

The next time you feel the urge to binge, ask yourself if there’s something else going on. Is there an intense feeling you’re trying to avoid? Are you eating to calm down, comfort yourself, or to relieve boredom? If so, instead of using food as a distraction, take a moment to stop whatever you’re doing and investigate what’s going on inside.

Identify the emotion you’re feeling. Is it anxiety / Shame / Hopelessness / Anger / Loneliness / Fear /Emptiness?

Accept the experience you’re having. Avoidance and resistance only make negative emotions stronger. Instead, try to accept what you’re feeling without judgement.

Dig deeper and explore what’s going on. Where do you feel the emotion in your body? What kinds of thoughts are going through your head?

Distance yourself. Realize that you are NOT your feelings. Emotions are passing events, like clouds moving across the sky. They don’t define who you are.

Sitting with your feelings may feel extremely uncomfortable at first, maybe even impossible. But as you resist the urge to binge, you’ll start to realize that you don’t have to give in. Even emotions that feel intolerable are only temporary. They’ll quickly pass if you stop fighting them. You’re still in control. You can choose how to respond.

Challenge dysfunctional thoughts

The bingeing and purging of bulimia is often fueled by dysfunctional, self-sabotaging ways of thinking that undermine your confidence, color everything in an unrealistically negative light, and make you feel helpless, inadequate, and ashamed. But you can learn to put a stop to these unhealthy mental habits.

Damaging mindsets that fuel bulimia

All-or-nothing thinking. You have a hard time seeing shades of grey, at least when it comes to yourself. If you’re not perfect, you’re a total failure and might as well binge.

Emotional reasoning. You believe if you feel a certain way, it must be true. “I feel fat” means “I am fat.” “I feel hopeless” means you’ll never get better.

Must’s, must-not’s, and have-to’s. You hold yourself to a rigid set of rules (“I must not eat such and such a food,” “I have to get straight A’s,” “I must always be in control.” etc.) and beat yourself up if you break them.

Labeling. You call yourself names based on mistakes and perceived shortcomings. “I’m unhappy with how I look” becomes “I’m disgusting.” Slipping up becomes “I’m a failure.”

Catastrophizing. You jump to the worst-case scenario. If you backslide in recovery, for example, you assume that there’s no hope you’ll ever get better.

Put your thoughts on the witness stand

Once you identify the destructive thoughts patterns that you default to, you can start to challenge them with questions such as:

“What’s the evidence that this thought is true? Not true?”

“What would I tell a friend who had this thought?”

“Is there another way of looking at the situation or an alternate explanation?”

“How might I look at this situation if I didn’t have bulimia?”

As you cross-examine your negative thoughts, you may be surprised at how quickly they crumble. In the process, you’ll develop a more balanced perspective.


You can do a self test quiz : Eating disorder Quiz.

This is not to diagnose – but to inform.


For more help, you can text chat to an online counselor on LIVE CHAT.

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