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Mental HealthICD-10: F50.2Affects approximately 1-2% of women in the U.S.

Bulimia Nervosa

Also known as: Bulimia, Binge-Purge Disorder

Bulimia nervosa is a serious eating disorder characterized by recurring episodes of binge eating followed by compensatory behaviors such as self-induced vomiting, excessive exercise, or misuse of laxatives to prevent weight gain. It is driven by an intense fear of gaining weight and a distorted body image. Without treatment, bulimia can cause severe medical complications including electrolyte imbalances, dental erosion, and cardiac problems.

Symptoms

Recurrent episodes of eating unusually large amounts of food
Feeling a loss of control during binge episodes
Self-induced vomiting after eating
Misuse of laxatives, diuretics, or diet pills
Excessive exercise to compensate for eating
Preoccupation with body weight and shape
Swollen cheeks or jaw (parotid gland enlargement)
Dental problems (enamel erosion, cavities) from stomach acid
Calluses on knuckles from inducing vomiting (Russell's sign)

Causes

  • Combination of genetic, biological, and psychological factors
  • Societal pressure for thinness and cultural beauty standards
  • Low self-esteem and perfectionism
  • History of trauma, abuse, or adverse childhood experiences

Risk Factors

  • Female sex (more commonly diagnosed in women)
  • Adolescence and young adulthood
  • Family history of eating disorders or mental health conditions
  • Participation in appearance-focused activities (dance, gymnastics, modeling)
  • History of dieting

Diagnosis

  • Clinical interview assessing eating behaviors and attitudes
  • DSM-5 criteria (binge-purge episodes at least once weekly for 3 months)
  • Physical examination for signs of purging
  • Blood tests for electrolyte imbalances and kidney function
  • Dental examination for enamel erosion

Treatment

  • Cognitive behavioral therapy (CBT) specifically adapted for eating disorders
  • Interpersonal psychotherapy (IPT)
  • SSRI antidepressants (fluoxetine is FDA-approved for bulimia)
  • Nutritional counseling and meal planning
  • Medical stabilization of electrolytes and hydration
  • Inpatient or residential treatment for severe cases

Prevention

  • Promote positive body image and self-esteem in children and teens
  • Avoid extreme dieting and food restriction
  • Seek help early if disordered eating patterns develop
  • Educate about the dangers of purging behaviors

When to See a Doctor

  • You or someone you know engages in binge eating and purging behaviors
  • You feel unable to control your eating or compensatory behaviors
  • You experience symptoms of dehydration, fatigue, or dizziness
  • You notice dental damage or other physical signs of purging

Frequently Asked Questions

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Medical Disclaimer: This content is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider.

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