What is bulimia?
Bulimia is a mental health condition and a type of eating disorder. People with bulimia may binge eat and then use behaviours such as purging to try to compensate for this. Bingeing is the part of the cycle when someone eats a lot of food in one sitting and may feel out of control while eating.
After a binge, people with bulimia will often feel guilty about what they’ve done and will purge to try to counteract the eating. Purging or compensatory behaviours can include making yourself sick, misusing laxatives or diuretics, fasting or exercising excessively.
People with bulimia may feel anxious about their weight and body image. A range of factors may contribute to someone developing bulimia, including psychological, social and life experiences.
With the right support, recovery from bulimia is possible.
Signs and symptoms of bulimia
People with bulimia may fear gaining weight, and often have a distorted perception of what their bodies really look like. They may feel a need to control their bodies, and bulimia can feel like a way to do this.
If you are worried someone may have bulimia, here are some signs you might notice:
- they are secretive about what they eat (or lie about what they eat)
- they often visit the toilet after mealtimes
- they talk about being unhappy with their weight or body
- they are exercising excessively
- they are storing or hiding food
- they are buying laxatives or other similar medication they don’t need.
If you recognise these signs in someone, it can help to speak to them and see if they would consider getting help. If you are worried you have bulimia yourself, you may recognise these symptoms:
- eating a large quantity of food in a short amount of time
- feeling the need to purge the food eaten
- making yourself sick after eating
- exercising to ‘make up’ for what you’ve eaten
- misusing laxatives or diuretics
- talking to yourself negatively and having low self-esteem
- feeling anxious around food and eating in front of others.
If you recognise these symptoms, getting help early can help you break the binge-purge cycle and rebuild your relationship with food and yourself. Visiting your GP is a great first step, as they can diagnose you and put together a treatment plan.
What causes bulimia?
There is no single known cause of bulimia. Eating disorders are complex mental health conditions, and a combination of biological, psychological, social and life factors may contribute to someone developing one. Factors which may contribute can include:
- Low self-esteem: Low self-esteem and concerns about body image may be associated with eating disorders. Some people may feel that losing weight will help them feel more accepted by others or improve their sense of self-worth.
- Depression: Some people with bulimia may also experience depression or low mood. Binge eating may provide temporary distraction or comfort, followed by feelings of guilt or distress, as well as purging.
- Stress: Stressful or traumatic experiences can contribute towards developing an eating disorder. Difficult experiences can affect people in different ways. Some people may use food to cope with difficult emotions.
- Anger: Some people may find it difficult to recognise, express or cope with strong emotions such as anger. For some, behaviours around food, including binge eating or purging, may become a way of coping with these difficult feelings.
Whatever someone's experience, help is available and recovery from bulimia is possible.
I felt I had to keep it together, somehow, so I started using bulimia as a coping mechanism.
Bulimia treatment
Treatment for bulimia can take time, but recovery is possible. Everyone's experience with bulimia is different.
Treatment is tailored to you and your needs. It might include other support for related mental health concerns, such as anxiety or depression. You may be referred to an eating disorder specialist.
Treatment can include:
- Talking therapy. For adults, treatment may include a bulimia-focused guided self-help programme based on cognitive behavioural therapy (CBT). For children and young people, NICE recommends bulimia-nervosa-focused family therapy (FT-BN).
- Medicine. You may be offered medicine, such as antidepressants, if you have another condition closely linked to bulimia, such as anxiety or depression.
- Nutritional support. Your treatment may include support from a nutrition specialist, such as a dietitian.
Alongside treatment for bulimia, you may need support with your physical health. Bulimia can lead to physical health problems, and your healthcare team can monitor and support your health during recovery.
How can a nutritionist help with bulimia?
A nutrition professional can offer additional support during recovery. They can help you understand your nutritional needs and help you create an eating plan that supports recovery and regular eating. Exploring new foods, trying new recipes and spending time preparing meals may also support you in developing a more positive relationship with food.
A nutrition professional can also support you in reconnecting with hunger and fullness cues as part of developing a healthier relationship with food. Nutrition support for eating disorders should not focus on weight, but on supporting your nutritional health and helping you develop a more positive relationship with food.
If you're looking for nutrition support as part of your recovery, you can use our advanced search to find a nutrition professional who works with bulimia nervosa.
